2010年BSH偏头痛诊断指南.pptVIP

1. Introduction;Migraine occurs in 15% of the UK adult population, in women more than men in a ratio of 3:1. An estimated 190,000 attacks are experienced every day, with three quarters of those affected reporting disability. Whilst migraine occurs in children (in whom the diagnosis is often missed) and in the elderly, it is most troublesome during the productive years (late teens to 50’s). ;As a result, over 100,000 people are absent from work or school because of migraine every working day. The cost to the economy may exceed ￡1.5 billion per annum. ;Tension-type headache in its episodic subtype affects up to 80% of people from time to time,2 many of whom refer to it as “normal” or “ordinary” headache. Consequently, they mostly treat themselves without reference to physicians using over-the-counter (OTC) medications and generally effectively. Nevertheless, it can be a disabling headache over several hours3 and the high prevalence of this disorder means its economic burden through lost work and reduced working effectiveness is similar to that of migraine.;In a minority of people, episodic tension-type headache is frequent, whilst up to 3% of adults have the chronic subtype occurring on more than 15 days every month. These people have high morbidity and may be substantially disabled; many are chronically off work.;Cluster headache is much less common, with a prevalence of about 0.05%, but it is both intense and frequently recurring. Medication-overuse headache is usually a chronic daily headache, and may affect 2% of adults as well as some children. Both of these disorders contribute significantly to the disability burden of headache. Despite these statistics, there is evidence that headache disorders are under-diagnosed and under-treated in the UK, as is the case throughout Europe and in the USA.;2. Scope and purpose of these guidelines;3. Headache classification;Table I. The International Classification of Headache Disorders, 2nd Edition9;4. Diagnosis of