Current Journal of Neurology
Volume:7 Issue: 24, 2008

Headache is a common symptom that constitutes a major health problem to all countries in the world. Tension-type headache and migraine comprise two third of different kinds of headaches. This study was conducted to estimate the prevalences of migraine and tension -type headaches,(TTH) it's associated occupational risk factors among Shiraz hospitals staff, to report on clinical�characteristics of migraine and TTH, and comparison of headaches with IHS diagnosis criteria.

This was a case- control study using prevalence data a random sample (stratified random sample) of 1023 hospital staffs of Shiraz (Iran). Subjects were stratified by personnel category (nurse, clerical and manual). For each patient, two controls of the same sample were selected who had never been diagnosed as having migraine or tension type headaches. Logistic regression was used for data analysis.

Prevalence of Migraine was estimated as 11.2% (115 subjects), tension-type headache as 19.5% (199 subjects) and coexisting migraine and tension headaches 3.2% (33 subjects). In this study, clinical characteristics of headache like type, site, number, intensity, concomitant symptom headaches, also that effects of headaches on work have surveyed.TTH and migraine headaches was significantly associated with self reported abnormal sleep pattern and female gender. Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly.

The average of prevalence of migraine and tension headaches were lower than in western countries but higher than in previous studies conducted in other Asian countries. Clinical characteristics were almost consistent with IHS criteria, Headache- related missed work rates higher for subjects with Migraine headache, also tension – type headache and migraine were separate disorders and not part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.

Essential tremor is the most common abnormal movement in the world. there is no associate neurologic abnormality. Tremor in this disease has low frequency and it's prevalence is 3 to 5 percent in community.

This prospective study was conducted on 120 patients with essential tremor in neurology clinic of shahid mostafa Khomeini hospital (shahed university) from 2005to 2008. Patients assigned randomly in two groups. 59 patients received propranolol 40 mg 3 times daily for 3 weeks and 61 patients in another group received gabapentin 300 mg 3 times daily for the same duration. Fahn – Tolosa-Marin tremor rating scale (TRS) that is a numerical scale (0-88) was used for evalution in both groups.

120 patients completed the study.56 (47%) patients were male and 64(53%) patients were female. Mean age was 43.9(26-59) years old. At the beginning of study the TRS was 38.6±1 and 39.1±1 in patients taking propranolol and gabapentin respectively. at the end of study TRS was 28.4±1 and 25.6±1 in propranolol and gabapentin group respectively. Statistical analysis with SPSS software showed significant difference in both group after treatment. (P<0.0005)

Gabapentin can be used as an effective drug in the treatment of essential tremor it's efficacy is at least equal to propranolol. Due to its lower side effects and better tolerance especially in patients with cardiac and respiratory problems and in older patients this drug can be as the first selection in these patients.