Spectrum of headache disorders in Pakistan: a multicenter study

Amina Javed; Shafaq  Saleem; Safia Awan; Saba Zaidi; Manzoor Lakhair; Fahad Saleem; Waleed Shahzad; Ahmed Wali

doi:10.56310/pjns.v20i02.443

Amina Javed Aga Khan University Hospital, Karachi
Shafaq Saleem Aga Khan University Hospital, Karachi
Safia Awan Aga Khan University Hospital, Karachi
Saba Zaidi Liaquat National Hospital, Karachi
Manzoor Lakhair LUMS, Jamshoro
Fahad Saleem Mukhtar Sheikh Hospital, Multan
Waleed Shahzad CDA hospital, Islamabad
Ahmed Wali Bolan Medical Complex, Quetta

DOI: https://doi.org/10.56310/pjns.v20i02.443

Keywords: Migraine, Tension-type headache, Cranial neuralgia, Demographics

Abstract

Background and Objective:

Headache disorders represent some of the most prevalent neurological conditions worldwide. While community-based studies provide general prevalence, data on their diagnostic spectrum in specialized clinical settings in Pakistan remain limited. The objective of this multicenter study was to evaluate the demographic distribution and spectrum of headache disorders among patients presenting to neurological services across Pakistan.

Methods:

This cross-sectional observational study was carried out at 39 neurology centers across Pakistan, from August 2017 to December 2019. Diagnosis was made using International Classification of Headache Disorders, 3rd edition (ICHD-3). Demographic details, and headache subtypes were compared across gender and age. Chi-square analysis was used, with p < 0.05 considered significant.

Results:

Among the 5,366 patients, 1,903 (35.4%) were male and 3,463 (64.6%) were female. The most frequent age group was 18-30 years. Migraine was the predominant diagnosis (57.4%), with a significantly higher prevalence in females than males (60.8% vs 51.2%; p < 0.001). Tension-type headache (30.2%) and cranial neuralgias (4.8%) both increased with age. Other headache disorders included cluster headache (1.7%), and headaches attributed to psychiatric (1.2%) and vascular disorders (1.0%), along with other secondary causes, which were less frequent overall and showed heterogeneous age and gender distributions across subtypes.

Conclusion:

This regional dataset highlights migraine as the most prevalent headache disorder, especially in younger adults and females, while tension-type headache and cranial neuralgias are more frequent in older patients. These findings emphasize important demographic variations in headache patterns in tertiary care settings in Pakistan.