Characteristics of the first 2000 patients registered in a specialist headache clinic

ObjectivesHeadache is a common cause of medical consultations. We aim to analyse demographic characteristics of the first 2000 patients in our register, and the incidence of their different headaches coded according to the International Classification of Headache Disorders, second edition (ICHD-II)Patients and methodsIn January 2008, a headache outpatient clinic was established in a tertiary hospital. Patients could be referred by general practitioners according to criteria established by prior consensus, as well as by general neurology or other specialty clinics. The following variables were prospectively collected for all patients; age, sex, referral source, complementary tests required, and the previously prescribed symptomatic or prophylactic therapies. All headaches were classified according to ICHD-II. When a patient fulfilled criteria for more than one type of headache, all of them were diagnosed and classified.ResultsIn October 2012, 2000 patients (ratio women/men 2.59/1) had been seen in our headache clinic. The median age was 42 years (range, 11-94), 55.3% were referred from primary care, and 68.1% did not require complementary tests. A total of 3095 headaches were recorded in these 2000 patients, of which 2222 (71.8%) were considered primary headaches, 382 (12.3%) secondary headaches including 117 (3.8%) corresponding to cranial neuralgias, 136 (4.3%) were unclassified headaches, and 238 (7.7%) were included in the Appendix to the ICHD-II. The most represented group was group 1 (migraine) accounting for 53% of all headaches.ConclusionsThe characteristics of the first 2000 patients in our register were comparable to those previously described in other types of outpatient headache clinics. Migraine was the most frequent diagnosis, and secondary headaches were not as frequent in our series. Most headaches could be coded according to ICHD-II criteria.

ResumenObjetivosAnalizar las características demográficas de los 2.000 primeros pacientes del registro de una consulta monográfica de cefaleas (CMC), y la incidencia de los diferentes tipos de cefaleas codificadas según los criterios de la clasificación internacional de cefaleas, ii edición (CIC-II)Pacientes y métodosEn enero de 2008 se estableció una CMC en un hospital terciario. Los pacientes podían ser derivados desde atención primaria en formato de alta resolución, la consulta general de neurología u otras especialidades. Se atendieron fuera de agenda a profesionales del centro o familiares. Recogimos prospectivamente en cada paciente la edad, el sexo, la vía de acceso a la consulta y los tratamientos sintomáticos o profilácticos prescritos con anterioridad. Las cefaleas fueron clasificadas de acuerdo a la CIC-II; cuando un paciente cumplía criterios para más de un tipo de cefalea todas eran diagnosticadas y clasificadas.ResultadosEn octubre de 2012 2.000 pacientes (ratio mujeres/hombres: 2,59/1) habían sido incluidos. La mediana de edad de estos pacientes era de 42 años (rango: 11-94). El 55,3% fueron derivados desde atención primaria. Un 68,1% no requirió pruebas complementarias. Se codificaron 3.095 cefaleas; 2.222 (71,8%) primarias y 382 (12,3%) secundarias. Ciento diecisiete (3,8%) neuralgias craneales, 136 (4,3%) no clasificables y 238 (7,7%) incluidas en el apéndice de investigación de la CIC-II. El grupo más representado era el 1 (migraña) con un 53% del total de cefaleas.ConclusionesLas características de nuestro registro son comparables a las descritas previamente en consultas monográficas de cefaleas. La migraña fue el diagnostico más habitual. Las cefaleas secundarias no son frecuentes en nuestra serie. La mayoría de las cefaleas pudieron ser codificadas por la CIC-II.