J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 10, Number 2, February 2018, pages 125-133

Prevalence of Migraine Headache in Taif City, Saudi Arabia

**Table 1.** The IHS Criteria for Migraine [6]
Migraine without aura
A. At least five attacks fulfilling criteria B-D.
B. Headache attacks lasting 4 - 72 h (untreated or unsuccessfully treated)
C. Headache has at least two of the following four characteristics:
1. Unilateral location
2. Pulsating quality
3. Moderate or severe pain intensity
4. Aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)
D. During headache at least one of the following:
1. Nausea and/or vomiting
2. Photophobia and phonophobia
E. Not better accounted for by another ICHD-3 diagnosis.
Migraine with aura
A. At least two attacks fulfilling criteria B and C
B. One or more of the following fully reversible aura symptoms:
1. Visual
2. Sensory
3. Speech and/or language
4. Motor
5. Brainstem
6. Retinal
C. At least two of the following four characteristics:
1. At least one aura symptom spreads gradually over ≥ 5 min, and/or two or more symptoms occur in succession
2. Each individual aura symptom lasts 5 - 60 min
3. At least one aura symptom is unilateral
4. The aura is accompanied, or followed within 60 min, by headache
D. Not better accounted for by another ICHD-3 diagnosis, and transient ischemic attack has been excluded

Table 1. The IHS Criteria for Migraine [6]

Migraine without aura

A. At least five attacks fulfilling criteria B-D.

B. Headache attacks lasting 4 - 72 h (untreated or unsuccessfully treated)

C. Headache has at least two of the following four characteristics:

1. Unilateral location

2. Pulsating quality

3. Moderate or severe pain intensity

4. Aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)

D. During headache at least one of the following:

1. Nausea and/or vomiting

2. Photophobia and phonophobia

E. Not better accounted for by another ICHD-3 diagnosis.

Migraine with aura

A. At least two attacks fulfilling criteria B and C

B. One or more of the following fully reversible aura symptoms:

1. Visual

2. Sensory

3. Speech and/or language

4. Motor

5. Brainstem

6. Retinal

C. At least two of the following four characteristics:

1. At least one aura symptom spreads gradually over ≥ 5 min, and/or two or more symptoms occur in succession

2. Each individual aura symptom lasts 5 - 60 min

3. At least one aura symptom is unilateral

4. The aura is accompanied, or followed within 60 min, by headache

D. Not better accounted for by another ICHD-3 diagnosis, and transient ischemic attack has been excluded

**Table 2.** Prevalence of Migraine in Different Study Groups Sorted by Gender
Diagnosis	Female	Male
Migraineurs with aura	26	16.3	13	6.7
Migraineurs without aura	10	6.3	1	0.5
Headachers	103	64.4	125	64.4
Non-headachers	21	13.1	55	28.4
Total	160	100.0	194	100.0

Table 2. Prevalence of Migraine in Different Study Groups Sorted by Gender

Diagnosis

Female

Male

Prevalence (%)

Migraineurs with aura

16.3

6.7

Migraineurs without aura

6.3

0.5

Headachers

103

64.4

125

64.4

Non-headachers

13.1

28.4

Total

160

100.0

194

100.0

**Table 3.** Different Demographic Characteristics Among Study Participants
	Female	Male	Total	P
*The Chi-square statistic is significant (P < 0.05). †The Chi-square statistic is significant (P < 0.001). N: number of observations.
Habitat
City	151	94.4%	167	86.1%	318	89.8%	0.010*
Town/village	9	5.6%	27	13.9%	36	10.2%
Marital status
Divorced	6	3.8%	1	0.5%	7	2.0%	0.056
Married	74	46.3%	88	45.4%	162	45.8%
Single	78	48.8%	105	54.1%	183	51.7%
Widow	2	1.3%	0	0.0%	2	0.6%
Employed	47	29.4%	95	49.0%	142	40.1%	< 0.001†
Retired	2	1.3%	15	7.7%	17	4.8%
Employment status
Student “not working”	53	33.1%	46	23.7%	99	28.0%
Student “working”	10	6.3%	7	3.6%	17	4.8%
Unemployed	48	30.0%	31	16.0%	79	22.3%
Education Level
Bachelor’s	101	63.1%	104	53.6%	205	57.9%	0.232
Diploma	6	3.8%	11	5.7%	17	4.8%
High school/or less	43	26.9%	69	35.6%	112	31.6%
Master	7	4.4%	9	4.6%	16	4.5%
PhD	3	1.9%	1	0.5%	4	1.1%
Smoking tobacco
No	155	96.9%	123	63.4%	278	78.5%	< 0.001†
Yes	5	3.1%	71	36.6%	76	21.5%

Table 3. Different Demographic Characteristics Among Study Participants

Female

Male

Total

*The Chi-square statistic is significant (P < 0.05). †The Chi-square statistic is significant (P < 0.001). N: number of observations.

Habitat

City

151

94.4%

167

86.1%

318

89.8%

0.010*

Town/village

5.6%

13.9%

10.2%

Marital status

Divorced

3.8%

0.5%

2.0%

0.056

Married

46.3%

45.4%

162

45.8%

Single

48.8%

105

54.1%

183

51.7%

Widow

1.3%

0.0%

0.6%

Employed

29.4%

49.0%

142

40.1%

< 0.001†

Retired

1.3%

7.7%

4.8%

Employment status

Student “not working”

33.1%

23.7%

28.0%

Student “working”

6.3%

3.6%

4.8%

Unemployed

30.0%

16.0%

22.3%

Education Level

Bachelor’s

101

63.1%

104

53.6%

205

57.9%

0.232

Diploma

3.8%

5.7%

4.8%

High school/or less

26.9%

35.6%

112

31.6%

Master

4.4%

4.6%

4.5%

PhD

1.9%

0.5%

1.1%

Smoking tobacco

155

96.9%

123

63.4%

278

78.5%

< 0.001†

Yes

3.1%

36.6%

21.5%

**Table 4.** Characteristics Migraine and Associated Diagnostics/Medications Among Study Participants
	Female	Male	Total	P
The Chi-square statistic is significant (P < 0.05). †The Chi-square statistic is significant (P < 0.001). N: number of observations.
Headache
No	21	13.1%	55	28.4%	76	21.5%	0.002*
Yes	139	86.9%	139	71.6%	278	78.5%
Headache frequency
2 - 4	29	20.9%	36	25.9%	65	23.4%	< 0.001†
Five times and more	87	62.6%	68	48.9%	155	55.8%
Less than 2 times	23	16.5%	35	25.2%	58	20.9%
Headache duration
1 - 3 days	25	18.0%	9	6.5%	34	12.2%	0.108
13 - 24 h	13	9.4%	7	5.0%	20	7.2%
6 - 4 h	34	24.5%	31	22.3%	65	23.4%
7 - 12 h	11	7.9%	9	6.5%	20	7.2%
Less than 4 h	48	34.5%	81	58.3%	129	46.4%
More than 3 days	8	5.8%	2	1.4%	10	3.6%
Pain score
1 - 3	20	14.4%	25	18.0%	45	16.2%	0.002*
4 - 6	52	37.4%	76	54.7%	128	46.0%
6 - 9	45	32.4%	31	22.3%	76	27.3%
> 9	22	15.8%	7	5.0%	29	10.4%
Pain type
Burning pain	6	4.3%	1	0.7%	7	2.5%	0.001*
Pressure pain	64	46.0%	59	42.4%	123	44.2%
Throbbing pain	69	49.6%	79	56.8%	148	53.2%
Examined by a doctor
No	94	67.6%	102	73.4%	196	70.5%	< 0.001†
Yes	45	32.4%	37	26.6%	82	29.5%
Investigations done
Blood tests	10	7.2%	3	2.2%	13	4.7%	0.001*
CT	10	7.2%	6	4.3%	16	5.8%
EEG (electroencephalogram)	4	2.9%	6	4.3%	10	3.6%
MRI	1	0.7%	1	0.7%	2	0.7%
MRT	5	3.6%	0	0.0%	5	1.8%
None	108	77.7%	122	87.8%	230	82.7%
X-ray	1	0.7%	1	0.7%	2	0.7%
Headache medications
No	61	43.9%	57	41.0%	118	42.4%	0.009*
Yes	78	56.1%	82	59.0%	160	57.6%
Improvement by medications
Always	28	35.9%	31	37.8%	59	36.9%	0.003*
Never	1	1.3%	1	1.2%	2	1.3%
Sometimes	49	62.8%	50	61.0%	99	61.9%

Table 4. Characteristics Migraine and Associated Diagnostics/Medications Among Study Participants

Female

Male

Total

The Chi-square statistic is significant (P < 0.05). †The Chi-square statistic is significant (P < 0.001). N: number of observations.

Headache

13.1%

28.4%

21.5%

0.002*

Yes

139

86.9%

139

71.6%

278

78.5%

Headache frequency

2 - 4

20.9%

25.9%

23.4%

< 0.001†

Five times and more

62.6%

48.9%

155

55.8%

Less than 2 times

16.5%

25.2%

20.9%

Headache duration

1 - 3 days

18.0%

6.5%

12.2%

0.108

13 - 24 h

9.4%

5.0%

7.2%

6 - 4 h

24.5%

22.3%

23.4%

7 - 12 h

7.9%

6.5%

7.2%

Less than 4 h

34.5%

58.3%

129

46.4%

More than 3 days

5.8%

1.4%

3.6%

Pain score

1 - 3

14.4%

18.0%

16.2%

0.002*

4 - 6

37.4%

54.7%

128

46.0%

6 - 9

32.4%

22.3%

27.3%

> 9

15.8%

5.0%

10.4%

Pain type

Burning pain

4.3%

0.7%

2.5%

0.001*

Pressure pain

46.0%

42.4%

123

44.2%

Throbbing pain

49.6%

56.8%

148

53.2%

Examined by a doctor

67.6%

102

73.4%

196

70.5%

< 0.001†

Yes

32.4%

26.6%

29.5%

Investigations done

Blood tests

7.2%

2.2%

4.7%

0.001*

7.2%

4.3%

5.8%

EEG (electroencephalogram)

2.9%

4.3%

3.6%

MRI

0.7%

MRT

3.6%

0.0%

1.8%

None

108

77.7%

122

87.8%

230

82.7%

X-ray

0.7%

Headache medications

43.9%

41.0%

118

42.4%

0.009*

Yes

56.1%

59.0%

160

57.6%

Improvement by medications

Always

35.9%

37.8%

36.9%

0.003*

Never

1.3%

1.2%

1.3%

Sometimes

62.8%

61.0%

61.9%

**Table 5.** History and Nature of the Attacks Among Study Participants
	Female	Male	Total	P
*The Chi-square statistic is significant (P < 0.05). †The Chi-square statistic is significant (P < 0.001). N: number of observations.
Symptoms before attack
Muscle weakness	3	1.9%	7	3.6%	10	2.8%	0.002*
Nausea	33	20.6%	21	10.8%	54	15.3%
None	58	36.3%	63	32.5%	121	34.2%
Numbness in the skin	2	1.3%	4	2.1%	6	1.7%
Sensitivity to light	16	10.0%	6	3.1%	22	6.2%
Sensitivity to noise	7	4.4%	9	4.6%	16	4.5%
Sight disorders	15	9.4%	26	13.4%	41	11.6%
Speech defects	2	1.3%	3	1.5%	5	1.4%
Vomiting	2	1.3%	0	0.0%	2	0.6%
Symptoms during attack
Nausea	58	36.3%	21	10.8%	79	22.3%	< 0.001†
None	31	19.4%	71	36.6%	102	28.8%
Sensitivity to light	25	15.6%	29	14.9%	54	15.3%
Sensitivity to noise	19	11.9%	17	8.8%	36	10.2%
Vomiting	5	3.1%	1	0.5%	6	1.7%
Symptoms after attack
Muscle weakness	8	5.0%	6	3.1%	14	4.0%	0.108*
Nausea	9	5.6%	10	5.2%	19	5.4%
None	94	58.8%	99	51.0%	193	54.5%
Numbness in the skin	2	1.3%	2	1.0%	4	1.1%
Sensitivity to light	9	5.6%	4	2.1%	13	3.7%
Sensitivity to noise	6	3.8%	6	3.1%	12	3.4%
Sight disorders	5	3.1%	8	4.1%	13	3.7%
Speech defects	3	1.9%	3	1.5%	6	1.7%
Vomiting	2	1.3%	1	0.5%	3	0.8%
Knowing the trigger
No	80	50.0%	87	44.8%	167	47.2%	0.002*
Yes	59	36.9%	52	26.8%	111	31.4%
Waking up by pain
Always	16	10.0%	7	3.6%	23	6.5%	0.001
Never	63	39.4%	79	40.7%	142	40.1%
Sometimes	59	36.9%	52	26.8%	111	31.4%
Family history of headache
No	42	30.2%	58	41.7%	100	36.0%	< 0.001†
Yes	97	69.8%	81	58.3%	178	64.0%

Table 5. History and Nature of the Attacks Among Study Participants

Female

Male

Total

*The Chi-square statistic is significant (P < 0.05). †The Chi-square statistic is significant (P < 0.001). N: number of observations.

Symptoms before attack

Muscle weakness

1.9%

3.6%

2.8%

0.002*

Nausea

20.6%

10.8%

15.3%

None

36.3%

32.5%

121

34.2%

Numbness in the skin

1.3%

2.1%

1.7%

Sensitivity to light

10.0%

3.1%

6.2%

Sensitivity to noise

4.4%

4.6%

4.5%

Sight disorders

9.4%

13.4%

11.6%

Speech defects

1.3%

1.5%

1.4%

Vomiting

1.3%

0.0%

0.6%

Symptoms during attack

Nausea

36.3%

10.8%

22.3%

< 0.001†

None

19.4%

36.6%

102

28.8%

Sensitivity to light

15.6%

14.9%

15.3%

Sensitivity to noise

11.9%

8.8%

10.2%

Vomiting

3.1%

0.5%

1.7%

Symptoms after attack

Muscle weakness

5.0%

3.1%

4.0%

0.108*

Nausea

5.6%

5.2%

5.4%

None

58.8%

51.0%

193

54.5%

Numbness in the skin

1.3%

1.0%

1.1%

Sensitivity to light

5.6%

2.1%

3.7%

Sensitivity to noise

3.8%

3.1%

3.4%

Sight disorders

3.1%

4.1%

3.7%

Speech defects

1.9%

1.5%

1.7%

Vomiting

1.3%

0.5%

0.8%

Knowing the trigger

50.0%

44.8%

167

47.2%

0.002*

Yes

36.9%

26.8%

111

31.4%

Waking up by pain

Always

10.0%

3.6%

6.5%

0.001

Never

39.4%

40.7%

142

40.1%

Sometimes

36.9%

26.8%

111

31.4%

Family history of headache

30.2%

41.7%

100

36.0%

< 0.001†

Yes

69.8%

58.3%

178

64.0%

**Table 6.** Logistic Regression Between Different Co-Variables and Migraine Prevalence
Predictors	B	SE	Adjusted OR (95% CI)†	P
B: logistic regression coefficient; SE: standard error of logistic regression coefficient; OR: odds ratio; CI: confidence interval; P: probability value. *Statistically significant (< 0.05). †Adjusted relative odds are odds ratio for migraineur status relative to the reference group (= 1.0) for each covariate, after adjusting for all covariates by logistic regression.
Age	-0.03	0.02	0.97 (0.93 - 1.02)	0.219
Gender	-1.28	0.42	0.28 (0.12 - 0.63)	0.002*
Habitat	-0.77	0.77	0.46 (0.1 - 2.11)	0.320
Marital status	-0.46	0.37	0.63 (0.3 - 1.3)	0.211
Employment status	-0.22	0.12	0.8 (0.64 - 1.01)	0.060
Education level	0.06	0.15	1.06 (0.79 - 1.42)	0.694
Smoking tobacco	0.01	0.51	1.01 (0.37 - 2.76)	0.978

Table 6. Logistic Regression Between Different Co-Variables and Migraine Prevalence

Predictors

Adjusted OR (95% CI)†

B: logistic regression coefficient; SE: standard error of logistic regression coefficient; OR: odds ratio; CI: confidence interval; P: probability value. *Statistically significant (< 0.05). †Adjusted relative odds are odds ratio for migraineur status relative to the reference group (= 1.0) for each covariate, after adjusting for all covariates by logistic regression.

Age

-0.03

0.02

0.97 (0.93 - 1.02)

0.219

Gender

-1.28

0.42

0.28 (0.12 - 0.63)

0.002*

Habitat

-0.77

0.77

0.46 (0.1 - 2.11)

0.320

Marital status

-0.46

0.37

0.63 (0.3 - 1.3)

0.211

Employment status

-0.22

0.12

0.8 (0.64 - 1.01)

0.060

Education level

0.06

0.15

1.06 (0.79 - 1.42)

0.694

Smoking tobacco

0.01

0.51

1.01 (0.37 - 2.76)

0.978