title: Clinical and Demographical Characteristics of Patients with Medication Overuse Headache in Argentina and Chile: Analysis of the Latin American Section of COMOESTAS Project.
abstract: BACKGROUND
  Data on the characteristics of Medication Overuse Headache (MOH) in Latin American (LA) are scarce. Here we report the demographic and clinical features of the MOH patients from Argentina and Chile enrolled in the multinational COMOESTAS project in the period 2008-2010.
  
  
  METHODS
  The LA population was formed by 240 MOH subjects, 110 from Chile and 130 from Argentina, consecutively attending the local headache centres. In each centre, specifically trained neurologist interviewed and confirmed the diagnosis according to the ICHD-II criteria. A detailed history was collected on an electronic patient record form.
  
  
  RESULTS
  The mean patient age was 38.6 years, with a female/male ratio of 8:2. The mean time since onset of the primary headache was 21 years, whereas duration of MOH was 3.9 years. The primary headache was migraine without aura in 77.5 % and migraine with aura in 18.8 %. Forty two % of the patients self-reported emotional stress associated with the chronification of headache; 43.8 % reported insomnia. The most overused medications were acute drug combinations containing ergotamine (70 %), NSAIDs (33.8 %) and triptans (5.4 %).
  
  
  CONCLUSIONS
  Though little described, MOH is present also in LA, where it affects mostly women, in the most active decades of life. Some differences emerge as regards the demographic and clinical characteristics of MOH in this population as compared to Europe or Northern America. What seems more worrying about MOH in Argentina and Chile is that most patients overuse ergotamine, a drug that may cause serious adverse events when used chronically. These findings once more underscore the importance of properly diagnose and treat MOH.
authors.affiliation: Department of Neurology, Pontificia Universidad Católica of Chile, Santiago, Chile. bshand@uc.cl.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Shand
authors.affiliation: Integral Pain Centre, Fundación para la Lucha contra las Enfermedades Neurológicas Infantiles (FLENI), Buenos Aires, Argentina. mtgoicochea@fleni.org.ar.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Goicochea
authors.affiliation: Department of Neurology, Pontificia Universidad Católica of Chile, Santiago, Chile. rvalen@med.puc.cl.
authors.forename: Raul
authors.initials: R
authors.lastname: Valenzuela
authors.affiliation: Department of Neurology, Pontificia Universidad Católica of Chile, Santiago, Chile. rfadic@med.puc.cl.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Fadic
authors.affiliation: Danish Headache Centre, Glostrup Amtssygehuset, University of Copenhagen, Copenhagen, Denmark. rigmor.jensen@regionh.dk.
authors.forename: Rigmor
authors.initials: R
authors.lastname: Jensen
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy. cristina.tassorelli@mondino.it.|Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. cristina.tassorelli@mondino.it.
authors.forename: Cristina
authors.initials: C
authors.lastname: Tassorelli
authors.affiliation: Headache Science Centre, C. Mondino National Neurological Institute, Pavia, Italy. giuseppe.nappi@mondino.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nappi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001118:Argentina / Q000453:epidemiology; D002677:Chile / Q000453:epidemiology; D057286:Electronic Health Records; D005260:Female; D051271:Headache Disorders, Secondary / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000139:chemically induced; D000067490:Prescription Drug Overuse / Q000009:adverse effects*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D013315:Stress, Psychological; D014363:Tryptamines / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014363:Tryptamines
keywords: Chronic headache; Ergotamine; Medication Overuse Headache (MOH)