title: Nosology and treatment of primary headache in a Swiss headache clinic.
abstract: We assessed demographics, diagnoses, course, severity, impact and treatment of primary headache outpatients from records in the Headache and Pain Clinic, Neurological Department, Zürich University Hospital. All outpatients seen from 1996 to 1998 for migraine, tension-type headache, and both, were included. Diagnoses, drug, physical and alternative treatments before and after referral were listed. Descriptive statistics were used for differences between the general population and this sample, the diagnoses, and treatments. The coexistence of migraine and tension-type headache, and the high frequencies of headache days would have excluded most migraine patients from typical drug trials: at best, only one third were eligible. The socioeconomic impact of combined and difficult syndromes calls for comprehensive management beyond simple treatment with instant relief drugs. The diagnostic and therapeutic practices of referring physicians exposed a deficit of information on headache, and a need for relevant education.
authors.affiliation: Headache and Pain Unit, Neurology Department, Zürich University Hospital, Frauenklinikstrasse 26, Switzerland.
authors.forename: Stanislaw
authors.initials: S
authors.lastname: Kozak
authors.forename: Andreas R
authors.initials: AR
authors.lastname: Gantenbein
authors.forename: Hansruedi
authors.initials: H
authors.lastname: Isler
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Merikangas
authors.forename: Jules
authors.initials: J
authors.lastname: Angst
authors.forename: Alex
authors.initials: A
authors.lastname: Gamma
authors.forename: Reto
authors.initials: R
authors.lastname: Agosti
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D015897:Comorbidity; D000529:Complementary Therapies / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D003951:Diagnostic Errors / Q000517:prevention & control*; D004338:Drug Combinations; D004357:Drug Synergism; D006801:Humans; D017533:Marital Status / Q000706:statistics & numerical data; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D018781:Tension-Type Headache / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy
chemical_list: D000700:Analgesics; D004338:Drug Combinations