important facts
- Headache disorders are one of the most common disorders of the nervous system.
- Headache disorders ranked third in the overall burden of neurological disease (after stroke and dementia) when measured in age-standardized disability-adjusted life years (DALYs) in 2019.
- Headache disorders characterized by recurrent headaches carry personal and societal burdens such as pain, disability, reduced quality of life, and economic costs.
- Only a small number of people around the world with headache disorders are properly diagnosed and treated by health care providers.
- Headaches have been underestimated, underrecognized, and undertreated around the world.
overview
Headache disorders, characterized by recurrent headaches, are among the most common disorders of the nervous system. Headaches are the painful and disabling feature of primary headache disorders: migraines, tension-type headaches, and cluster headaches. Headaches can be caused by or secondary to a variety of other conditions, the most common of which is medication overuse headache. Headaches, especially migraines, can also affect children and adolescents, but in different ways. Migraine headaches in children often occur on both sides of the head and are usually short in duration. But just like in adults, migraines in childhood and adolescence can cause them to miss school, sports, and other activities.
prevalence
Globally, headache disorders affect approximately 40% of the population, or 3.1 billion people in 2021, and are more common in women than men. Headache disorders are one of the top three most common neurological disorders in most age groups, starting at age 5 and remaining in the top three until age 80. Although there are regional differences, headache disorders are a global problem, affecting people of all races and incomes.Level and geographical area (1).
Headaches are not only painful, but they can also interfere with your daily life. Global Health Estimates 2019 found that headache disorders are the third most common cause of disability-adjusted life years (DALYs) worldwide, after stroke and dementia.
Headache disorders can burden individuals with significant personal suffering, reduced quality of life, and economic costs. Repeated headache attacks can take a toll on family life, social life, and employment due to the constant fear of another attack. Trying to cope with a chronic headache disorder for a long time can also make you more susceptible to other illnesses. For example, anxiety and depression are much more common in people who experience migraines than in healthy people.
Types of headache disorders
Migraines, tension-type headaches, and medication-overuse headaches are of public health importance because they cause high rates of disability and poor health outcomes in the population.
Migraine
Migraine is a primary headache disorder that is mostly episodic, usually lasting between 4 and 72 hours, and is associated with nausea, vomiting, and/or photophobia or phonophobia. In some cases, it may be preceded by a short-lasting aura of unilateral, reversible visual, sensory, or other symptoms.
Migraines most often begin in adolescence and generally affect people between the ages of 35 and 45. It is more common in women, probably due to hormonal influences. Children usually have migraine headaches of shorter duration and more pronounced abdominal symptoms.
The exact cause of migraines is currently unknown, but it is thought to be caused by the release of pain that creates inflammatory substances around nerves and blood vessels in the head. It can be caused by alcohol or certain foods.
Migraine headaches are characterized by repeated attacks and often last a lifetime.
Attacks typically include:
- headache, i.e.
- of moderate or severe intensity
- on one side or behind the eye
- pulsating quality
- worsened by daily physical activity
- Duration ranges from a few hours to 2-3 days.
- Hypersensitivity to light and sound.and
- nausea.
tension headache
Tension-type headaches (TTH) are described as a feeling of pressure or tightness, like a band around your head, and can radiate into or from your neck. They can be stress-related or related to musculoskeletal problems in the neck. It often begins during the teenage years and affects 50% more women than men.
Episodic TTH occurs less than 15 days per month and is reported in more than 70% of some populations. Transient TTH attacks typically last several hours, but can last several days.
Chronic TTH can be continuous and is more disabling than episodic TTH.
cluster headache
Cluster headache (CH) is a primary headache disorder characterized by frequently recurring (up to several times a day), brief but very severe headaches, usually concentrated in or around one eye, It is accompanied by lacrimation and bloodshot eyes. The affected side often has a runny or stuffy nose, and the eyelids may droop.
CH is relatively rare, affecting fewer than 1 in 1000 adults, and 6 men to 1 woman. Most people who develop CH are over the age of 20. CH has episodic and chronic forms.
Headaches caused by drug abuse
Medication overuse headache (MOH) is caused by chronic and excessive use of drugs to treat headaches. MOH is the most common secondary headache disorder.
Up to 5% of the population can be affected, with more women than men. MOH, by definition, occurs more days than not, is oppressive, persistent, and often makes you feel your worst when you wake up.
Social and economic burden
Migraines and other headaches can affect people's ability to work through decreased productivity and interpersonal relationships. People often try to continue working despite potentially debilitating symptoms. Loss of productivity associated with headaches can impact people's careers, safety, finances, relationships, and mental health. It also causes economic losses to companies and society.
process
Many people suffering from headaches do not receive effective diagnosis or care. Appropriate treatment of headache disorders requires training of medical professionals, accurate diagnosis and symptom recognition, appropriate treatment with cost-effective medications, simple lifestyle modifications, and patient education. The main types of medications for treating headache disorders include analgesics, antiemetics, certain antimigraine medications, and preventive medications. Treatment for migraine involves taking pain medication at the first sign of symptoms (such as visual auras) to prevent associated headaches. Simple interventions that educate people about medication overuse headaches, migraine triggers, and lifestyle modifications can be highly effective. Symptoms can often be reduced simply by limiting or eliminating alcohol, regular sleep and exercise schedules, eating a healthy diet, staying hydrated, and using a headache calendar to identify other triggers.
Barriers to effective care
Lack of knowledge among healthcare providers is a major clinical barrier. Many people with headache disorders are undiagnosed and untreated. In many countries, medications such as sumatriptan for migraine are not available.
This lack of awareness is widespread in society as well. Headache disorders are mostly temporary, non-fatal, and non-contagious, so they are not recognized as serious by the general public. Low uptake in developed countries may indicate that many affected people are unaware that effective treatments exist. It is estimated that half of people with headache disorders self-medicate.
Many governments seeking to control medical costs fail to recognize that headaches place a huge burden on society. They recognized that the direct costs of treating headache disorders are small compared to the enormous indirect cost savings (e.g., due to fewer working days) if resources are appropriately allocated to treating headache disorders. You may not have done so.
WHO response
These clear burdens require action. WHO recognizes this and has partnered with multiple non-governmental organizations to address headaches. WHO published his Atlas of Headache Disorders in 2011, which describes the burden of headache disorders and the resources available to reduce them.
In May 2022, the World Health Assembly approved a multidisciplinary global action plan on epilepsy and other neurological diseases for 2022-2031. This action plan addresses the challenges and gaps in providing care and services for people with neurological disorders such as epilepsy and headache disorders that exist around the world, ensuring a comprehensive and coordinated response across sectors. To do. This includes elevating policy priorities and strengthening governance, implementing strategies for the provision, promotion and prevention of effective, timely and responsive diagnosis, treatment and care, promoting research and innovation, and informing Includes system enhancements.
The WHO position statement on optimizing brain health across the lifespan is a technical complement to the global action plan. This position paper provides a conceptual framework for brain health and behavior across a range of determinants, including physical health, a healthy environment, safety and security, learning and social connectedness, and access to quality services. We offer ways to optimize your brain health throughout your life.
References
1. On behalf of the GBD Network, Jamie D. Steinmetz, Katrin Seeher, Nicoline Schiess, Emma Nichols, Bochen Kao, Chiara Servilli, Vanessa Cavalera, Christopher JL Murray, Kan-Ying Lian Ong, Valerie L. Feigin, Theo Voss, and Tarun Dua. Global, regional, and national burden of diseases affecting the nervous system, 1990–2021: Systematic analysis of the Global Burden of Disease Study 2021. Lancet Neurol. (in press).
