Headache and migraine

What are headache and migraine

There are many types of headache. The two most common types are tension headache and migraine. Other types are cluster headache and substance-related headache. Substance-related headache may result from the excessive use of medication to counter headache such as paracetamol or NSAIDs. But the chronic consumption of caffeinated beverages such as coffee, tea, ice tea, cola and chocolate can also result in chronic headache.

What are the complaints associated with headaches and migraines?

  • Tension headache usually feels like a tight band around the head. It starts and subsides gradually. The pain can last for a very short time but it can also persist for days and sometimes weeks. The neck and shoulders are also often painful and tense.
  • Migraine is a moderate or severe pounding headache that is almost always associated with nausea or vomiting. The pain is usually on one side of the head. There are often signs indicating an imminent migraine attack. Aura, for example, may result in sparkling or other visual effects. Some people will smell particular odours just before an attack. During the attack, people with migraine are often sensitive to light and sound. A migraine attack can vary in duration from half a day to three days.
  • Substance-induced headache: this results in chronic headache that is present for more than three days a week and more than half of the day.
  • Cluster headache: these headaches take the form of attacks in which there is severe pounding or stabbing, unilateral headache around the eye or temple lasting from 15 minutes to 3 hours, accompanied by restlessness. This type of headache comes in bouts lasting several weeks in which certain factors may cause the attacks to occur. These include alcohol, histamines, nitrates, long air journeys or staying at high altitude, in mountains for example. The intervals between the bouts often increase with age. 498

People with intellectual disabilities sometimes find it impossible to communicate that they are suffering from headaches. The people around them may then notice only a change in behaviour.

How common are headache and migraine in the general population?

On any given day, one in six Dutch people (about 17%) suffer from headache.  171

The lifetime prevalence of headache is 95% for women and 90% for men.  171

Tension headaches and migraines are seen in children starting at the age of about six years. The prevalence of tension headache in the general population is high (about 60%) and it decreases with age. The prevalence of migraine in the general population is about 15%. The prevalence of migraine (in women and men) decreases with age. Both types of headache are more common in women than in men. People with tension headaches may also have migraines, and vice-versa. About 4 in 5 people with tension headaches or migraine report another type of headache over time. The total prevalence of the chronic forms of the various types of headache in the general population are a few percent (2 to 4%), about half to almost two-thirds of which is thought to be medication-induced headache. Cluster headache is rare in the general population. The incidence rate in general practice is 0.1 per 1000. This form of headache is more common in men than in women.  498

 

The GEM study of almost 6500 Dutch people aged between 20 and 65 years found a lifetime prevalence for migraine of 33% for women and 13.3% for men.  172  

How common are headache and migraine in people with intellectual disabilities?

A Dutch questionnaire study answered by the parents of all 2271 adolescents with an intellectual disability in the provinces of Groningen and Drenthe found that 12.7% had suffered from chronic headache in the previous year.  173

The European POMONA questionnaire survey of a random sample of 1269 adults with intellectual disabilities found a prevalence rate for headache or migraine of 16.1%. 

The question was: do you have migraine or frequent headaches, or have you had them in the last year?   174

Headache or migraine can easily be overlooked because of other complaints in people with intellectual disabilities. They can also have a negative impact on sleep patterns.  499

15% to 60% General population 12.7% to 16.1% People with intellectual disabilities (one-year prevalence)

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