Orthostatic and non-orthostatic headache in postural tachycardia syndrome.
OBJECTIVE
Orthostatic and non-orthostatic headache spectrum was prospectively studied in 24 consecutive patients with postural orthostatic tachycardia syndrome (POTS).


METHODS
Patients were interviewed about clinical aspects of headache and its precipitation during head-up tilt (HUT). Autonomic functions were assessed using a standard battery of tests. The relationship of orthostatic headache to cardiovascular variables was examined using unpaired two-tailed t-test.


RESULTS
Orthostatic headache occurred during daily activity in 14 patients (58.3%) and during HUT in 15 patients (62.5%). Age under 30 years and increasing duration of tilt were predictive for orthostatic headache. Of the 24 patients, 23 (95.8%) had non-orthostatic headache fitting the criteria of migraine or probable migraine.


CONCLUSIONS
Orthostatic headache affected two-thirds of POTS patients, especially those under age 30. Patients with orthostatic headache should be clinically assessed for POTS and informed of this association to reduce short-term morbidity. Migraine afflicted almost all POTS patients. This co-morbidity should be considered in management of POTS.
Khurana
Ramesh K
RK
Department of Medicine, Union Memorial Hospital, Baltimore, MD 21218, USA. ramesh.khurana@medstar.net
Eisenberg
Lindsay
L
D000293:Adolescent; D000328:Adult; D005260:Female; D006261:Headache / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054972:Postural Orthostatic Tachycardia Syndrome / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D011187:Posture / Q000502:physiology; D012189:Retrospective Studies; D018667:Tilt-Table Test / Q000379:methods*; D055815:Young Adult