Headache in the Tropics: India
Headache management in the Tropics is somewhat different from what prevails in the Temperate zones primarily because of the many regional factors that impact a primary headache disorder like migraine. There are different geographical factors, different environmental problems and different cultural attitudes. The aim of this chapter is to try and appraise a worldwide audience of these factors that influence headache prevalence and treatment in the Tropics.
India with a population of 1.2 billion is the second most populous country in the world and is located in the Tropics to the north of the equator. Some of the epidemiological studies on headache from this region have been detailed. Medication overuse headache is not so common in India as in the West. Barriers to care have been divided into those that are patient-related, physician-related and regional. Overpopulation, low literacy levels, low income, growing urbanization, different triggering factors and nonavailability of latest treatment options are some of the more important regional problems. Alongside are listed the efforts needed to overcome these barriers.
Special measures are therefore required to tackle the burden of headache in India. Addressing these issues will also go a long way to providing headache relief in other Tropical regions where similar conditions prevail and where more than 40% of the world population lives.
KeywordsMigraine Patient Chronic Daily Headache Secondary Headache Medication Overuse Headache Headache Management
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
Chakravarty A (2003 Jun) Chronic daily headaches: clinical profile in Indian patients. Cephalalgia 23(5):348–353PubMedCrossRefGoogle Scholar
Chakravarty A, Mukherjee A, Roy D (2004 Oct) Trigeminal autonomic cephalagias and variants: clinical profile in Indian patients. Cephalalgia 24(10):859–866PubMedCrossRefGoogle Scholar
Garg RK, Kar AM, Singh MK (2004 Apr) Prednisolone-responsive headache in patients with solitary cysticercus granuloma and seizures. Headache 44(4):365–369PubMedCrossRefGoogle Scholar
Gourie-Devi M, Gururajb G, Satishchandraa P, Subbakrishnac DK (2004) Prevalence of neurological disorders in Bangalore, India: A community-based study with comparison between urban and rural areas. Neuroepidemiology 23:261–268PubMedCrossRefGoogle Scholar
Gupta R, Bhatia MS (2006) A report of cranial autonomic symptoms in migraineurs. Cephalalgia 27:22–28CrossRefGoogle Scholar
Lal V (2010 Jan-Feb) Ophthalmoplegic migraine: Past, present and future. Neurol India 58(1):15–19PubMedCrossRefGoogle Scholar
Mark AS, Casselman J, Brown D et al (1998) Ophthalmoplegic migraine: reversible enhancement and thickening of the cisternal segment of the oculomotor nerve on contrast enhanced MRI images. Am J Neuroradiol 19:1887–1891PubMedGoogle Scholar
Panda S, Tripathi M (2005 Feb) Clinical profile of migraineurs in a referral centre in India. J Assoc Physicians India 53:111–115PubMedGoogle Scholar
Ravishankar K (1997) Headache pattern in India: A headache clinic analysis of 1000 patients. Cephalalgia 17:316–317, 1Google Scholar
Ravishankar K (2004 Sep) Barriers to headache care in India and efforts to improve the situation. Lancet Neurol 3(9):564–567PubMedCrossRefGoogle Scholar
Ravishankar K (2006 Nov) ‘Hair wash’ or ‘head bath’ triggering migraine: observations in 94 Indian patients. Cephalalgia 26(11):1330–1334PubMedCrossRefGoogle Scholar
Ravishankar K (2008a) Medication overuse headache in India. Cephalalgia 28(11):1223–1226PubMedCrossRefGoogle Scholar
Ravishankar K (2008b) Ophthalmoplegic migraine: still a diagnostic dilemma? Curr Pain Headache Rep 12(4):285–291PubMedCrossRefGoogle Scholar
Ravishankar K, Karthik G (2007) Ophthalmoplegic migraine-suggestions for revision of nosology based on normal imaging in four patients [abstract]. Cephalalgia 27:1182CrossRefGoogle Scholar
Shah PA, Nafee A (1999 Nov) Clinical profile of headache and cranial neuralgias. J Assoc Physicians India 47(11):1072–1075PubMedGoogle Scholar
Shukla R, Barthwal MK, Srivastava N, Nag D, Seth PK, Srimal RC, Dikshit M (2001a) Blood nitrite levels in patients with migraine during headache-free period. Headache 41(5):475–481PubMedCrossRefGoogle Scholar
Shukla R, Khanna VK, Pradeep S, Husain M, Tandon R, Nag D, Dikshit M, Srimal RC, Seth PK, Platelet H (2001b) Ketanserin binding in migraine. Cephalalgia 21(5):567–572PubMedCrossRefGoogle Scholar
© Lifting The Burden 2011