Canan YÜCESAN, Mine Hayriye SORGUN

196

Multipl sklerozda baș ağrısı ve fonksiyonel sistem tutulumu

Amaç: MS atakta ba ș a ğ rı sı olabileceğ ine dair olgu bildirimleri vard ı r. Atakta ba ș a ğ rı sı ile fonk-siyonel sistem tutulumları n ı de ğ erlendiren bir çal ı ș ma yoktur. Bu çal ı ș man ı n amac ı atakta ba șa ğ rı sı varl ı ğ ı ve tipi ile fonksiyonel sistem tutulumu arası nda ili șki olup olmad ı ğ ı n ı n ara ștı rı lma-sı d ı r.Hastalar ve Yöntem: Çal ı șmaya katı lmayı kabul eden atak dönemindeki 64 MS de ğ erlendirildi;anamnezinde depresyonu olan ve/veya Hamilton depresyon skalas ı ndan 8 ve üzerinde puanalan 16 hasta çal ı șmaya al ı nmad ı ve 48 MS hastas ı üzerinden de ğ erlendirme yap ı ld ı . Bu hastala-rı n ba ș a ğ rı ları sorguland ı ve nörolojik muayeneleri yap ı ld ı . Bulgular: 48 hastan ı n 17sinde (%35,4) remisyonda olan ba ș a ğ rı sı atak döneminde de vard ı .Sadece atak döneminde ba ș a ğ rı s ı olan hasta yoktu. Ba ș a ğ rı sı olan hastaları n 9unda (%52,9)gerilim tipi ba ș a ğ rı sı , 7sinde (%41,2) migren, 1inde sı n ı fland ı rı lamayan ba ș a ğ rı s ı (%5,9) vard ı .Atak dönemindeki fonksiyonel sistem tutulum bulguları ile atak döneminde ba ș a ğ rı sı n ı n varl ı ğ ıve tipleri arası nda ili ș ki saptanmad ı .Yorum: MS hastaları n ı n yakla ș ı k 1/3ünde ataklar ba ș a ğ rı s ı n ı tetiklemektedir. Atak dönemindeba ș a ğ rı sı n ı n varl ı ğ ı ve tipi ile nörolojik muayenede etkilenen fonksiyonel sistemler arası ndaili șki yoktur.

Headache and functional system involvement in multiple sclerosis

Objective: There have been case reports suggesting relapses may cause headache in MS patients. It has not been investigated if there is any relation between attack-related headache andinvolvement of functional systems in MS patients. The aim of the study was to evaluate if therewas any correlation between functional system involvement in neurological examination andthe presence and/or type of headache. Patients and Methods : Sixty-four MS patients who were in relapse period were evaluated forthe study; 16/64 patients who had depression in their past medical history and/or had > 8 scorein Hamilton depression scale were excluded; 48 MS patients were included the study. The patients were questioned about headache and were underwent a complete neurological examination.Results: Seventeen (%35,4) of 48 MS described headache in both remission and relapse period.None of the patients described headache in only relapse period. Nine patients had tension typeheadache (%52,9), 7 patients had migraine (%41,2), and 1 patient had unclassified headache(%5,9). It was not found any relation between any functional system involvement and the pres-ence and/or types of headaches in MS attacks. Conclusion: Relapses triggers headache about 1/3 of MS patients. There is not relation between attack-related headache and functional system involvement in neurologic examination.
PDF

___

  • 1. Sadiq S.A. Multiple Sclerosis. In: Rowland LP eds. Merrit’s Textbook of Neurology 9th ed. New York: Williams & Wilkins; 2000.p.941-963.
  • 2. Compston N, McAlpine D. Some aspects of the natural history of disseminated sclerosis. Q J Med 1952;21:135-167.
  • 3. D’Amico D, La Mantia L, Rigamonti A, et al. Prevalence of primary headaches in people with multiple sclerosis. Cephalalgia 2004; 24:980-984.
  • 4. Vacca G, Marano E, Brescia Mora V, De Vito M, Parente E, Orefice G. Multiple sclerosis and headache co-morbidity. A case-control study. Neurol Sci 2007; 28:133-135.
  • 5. Freedman MS, Gray TA.Vascular headache: a presenting symptom of multiple sclerosis. Can J Neurol Sci. 1989;16(1):63-66.
  • 6. Nicoletti A, Pati F, Lo Fermo S, et al. Headache and multiple sclerosis: a population based case kontrol study in Catania. Cephalagia 2008; 28:1163-1169.
  • 7. Putzki N, Pfriem A, Limmroth V, et al. Prevalance of migraine, tension-type headache and trigeminal neuralgia in multiple sclerosis. European Journal of Neurology 2009;16:262-267.
  • 8. Doi H, Matsushita T, Isobe N, Ishizu T, Ohyagi Y, Kira J. Frequency of chronic headaches in Japanese patients with multiple sclerosis: with special reference to opticospinal and common forms of multiple sclerosis. Headache 2010;50(1):149.
  • 9. Ergün U, Ozer G, Sekercan S, et al. Headaches in the different phases of relapsing-remitting multiple sclerosis: a tendency for stabbing headaches during relapses. Neurologist 2009;15(4):212-6.
  • 10. Kister I, Caminero A.B, Monteith T.S, et al. Migraine is comorbid with multiple sclerosis and associated with a more symptomatic MS course. J Headache Pain 2010;11:417-425.
  • 11. Editorial. Headache in Multiple Sclerosis. British Medical Journal 1969: 713-714.
  • 12. Villani V, Prosperini L, Ciuffoli A, Pizzolato R, Savletti M, Sette G. Primary headache and multiple sclerosis: preliminary results of prospective study. Neurol Sci 2008; 29:146-148.
  • 13. Sandyk R, Awerbuch G.I. The cooccurrence of multiple sclerosis and migraine headache: the serotoninergic link. Int. J Neurosci. 1994;76(3-4):249- 257.
  • 14. .Haas DC, Kent PF, Friedman DI. Headache caused by a single lesion of multiple sclerosis in the periaqueductal gray area. Headache 1993;33(8):452-455.
  • 15. Rolak L.A., Brown S. Headaches and multiple sclerosis: a clinical study and review of the literature. Neurol 1990;237(5):300-2.
  • 16. Gee J.R, Chang J, Dubli A.B, Vijayan N. The Association of Brainstem Lesions With Migraine-Like Headache: An Imging Study of Multiple Sclerosis. Headache 2005;45:670-677.
  • 17. Galer B.S, Lipton R.B, Weinstein S, Bello L, Solomon S. Apoplectic headache and oculomotor palsy: An unusual presentation of multiple sclerosis. Neurology 1990;40:1465-1466.
  • 18. Leandri M, Cruccu G, Gottlieb A. Cluster headache-like pain in multiple sclerosis. Cephalagia 1999;19:732-4.
  • 19. Gentille S, Ferrero M, Vaula G, Rainero I, Pinessi L. Cluster headache attacks and multiple sclerosis. J Headache Pain 2007;8:245-247.
  • 20. Alstadhaug K, Breivik K, Rusic Z. Recurrent Headache Due to MS Plaque. Headache 2008;48 (3): 453-454.
  • 21. Fragoso Y.D, Brooks J.B. Two cases of lesions in brainstem in multiple sclerosis and fefractory migraine. Headache 2007;47(6):852-4.
  • 22. Liu F.C, Fuh J.L, Wang S.J. Symptomatic trigeminal autonomic cephalalgia associated with allodynia in a patient with multiple sclerosis. J Chin Med Assoc 2008;71(11): 583-6.
  • 23. Boneschi F.M, Colombo B, Annovazzi P, et al. Lifetime and actual prevalence of any type of pain and headache in multiple sclerosis. Multiple Sclerosis 2008; 14:514- 521.
  • 24. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 33:1444-1452,1983.
  • 25. Headache Classification Subcmmittee of the International Headache Society. The International Classification of Headache Disorders 2nd Edition. Cephalalgia 2004; 24 Supplement 1; 9-160.
Ankara Üniversitesi Tıp Fakültesi Mecmuası-Cover
  • Başlangıç: 1947
  • Yayıncı: Erkan Mor
Arşiv
Sayıdaki Diğer Makaleler

Endoscopic treatment of simultaneously detected fibroepithelial polyps of ureter and bladder

Ural OĞUZ, Ali ÜNSAL, Cengiz KARA, Berkan REŞORLU

Comparing the different fixatives for examination of liver tissue ultrastructure

Sibel KILIÇOĞLU, Esra ERDEMLİ

Hastanelerde maliyet analizi ve faaliyet tabanlı maliyetleme yöntemine dayalı bir uygulama

İsmail AĞIRBAŞ, Ümit ERKOL

Anlatı sallık ve tıp etiği eğitimindeki yeri

Mustafa Volkan KAVAS

Multipl sklerozda baș ağrısı ve fonksiyonel sistem tutulumu

Canan YÜCESAN, Mine Hayriye SORGUN