The Prevalence and Characteristics of Different Types of Headache in Patients With Behçet's Disease, a Case–Control Study

Abstract

BACKGROUND: Headache is one of the most common neurologic symptoms of Behçet's disease (BD) that may be due to migraine, tension-type headache, uveitis, or direct consequence of neuro-Behçet's disease (NBD) or other causes. OBJECTIVE: To study the prevalence and characteristics of different types of headache in patients with BD. METHOD: Subjects were recruited as consecutive patients who referred to Behçet's Clinic at the Nemazee Hospital, Shiraz, Southern Iran, from March 2004 to March 2006. All patients fulfilled the International Study Group criteria for BD. Each patient was interviewed for history of BD and headache. Neurological examinations and, if necessary, ancillary investigations were performed for each patient. Control group was an age- and sex-matched population. Headache entities fulfilled the International Headache Society criteria. RESULTS: In total, 35% (63/180) of patients had no headache. Migraine with and without aura was the cause of headache in 1.7% (3/180) and 25.6% (46/180) of patients, respectively. Tension-type headache was found in 23.9% (43/180) of patients. In 8.3% (15/180) of patients, headache could be justified by NBD. Headache due to uveitis was observed in 3.3% (6/180) of patients and 4 patients (2.2%) had other causes of headache. Migraine was significantly more common in patients than the control group (OR: 2.9, P < .0001). Considering the effect of gender, migraine was also significantly more frequent in patients than in the control group both in females (OR: 3.1, P < .0001) and males (OR: 3.2, P = .006). CONCLUSION: Migraine and tension-type headaches are the most prevalent types of headaches in Behçet's patients. NBD must be meticulously investigated in patients with BD who presented with headache.