Classification and clinical features of primary headache in Akaki Textile Mill workers, Ethiopia
Background: Various forms of headaches are among the most common complaints of the nervous system in neurologic practice. Primary headache disorders are disabling. They are defined based on symptom-profiles on the characteristics of attacks, which general and neurological examinations reveal to be normal and are mostly diagnosed by a good history and a physical examination. Most headaches can be optimally managed in primary care settings.
Objective: to describe the clinical profiles, triggering factors and classification of primary headaches among the workers of Akaki Textile Mills in Addis Ababa.
Methods: A cross-sectional study wherein data collection and examination of cases using a structured and pre-tested questionnaire were done by the investigator.
Results: Of 181 cases with primary headache the majority (60%) were tension type headaches with a female to male ratio of 1.8 to 1, followed by migraine headache in (38%), cluster headache and trigeminal autonomic cephalalgia 1.2% in each. Twenty-eight percent had migraine without aura; 9% had migraine with aura and 0.6% of the patients with probable migraine. The clinical profiles of migraine were found to be unilateral headache, throbbing or pulsating quality, severe to moderate attacks, aggravated by physical activity and relieved by resting or lying down, phonophobia, photophobia and nausea or vomiting. The triggering factors were stress, smell, weather, exhaustion and alcohol. Family history of migraine was found in 44%. Frequent episodic tension type headache was found most commonly in 26% followed by infrequent tension type in 22%, chronic tension type in 11% and probable tension type in 2%. Family history of tension headache was found in 40%. The clinical profiles of tension headache were bilateral headache localized to the forehead in a band like pressure or tightness with a mild to moderate intensity and anorexia. Some of the triggering factors were annoyance or stress, change of weather, smell, and exhaustion.
Conclusion and Recommendation: clinical profiles and triggering factors help in the diagnosis of primary headaches. Community based well designed study representing the whole nation both rural and urban is recommended.