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Query: UMLS:C0018681 (headache)
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The McGill-Melzack Pain Questionnaire (MMPQ), comprised primarily of adjectives descriptive of pain, was administered to 100 patients seeking treatment for headache. Diagnostic classification of patients into migraine or muscle contraction headache groups was conducted by a screening neurologist using information other than pain description. Reliability determinations were made following independent diagnosis by two other neurologists using a headache pain history and symptom form (HPHSF) devoid of pain adjectives. Comparison of 30 subjects HPHSF's revealed that the screening neurologist's diagnosis and that of two other neurologists, (tau = .87, rho < .01) and (tau = .48, rho < .05), indicate high agreement between three physicians in headache diagnosis devoid of pain description. Results show that migraine headache patients report significantly more affective words (t 99 = 3.89, rho < .001) than do muscle contraction headache sufferers; however, no significant differences existed between the groups' use of sensory or evaluative works. Migraine sufferers, while not reporting their headache as more severe "generally," did report more intense pain when recalling headache at its "worst" (t99 = 2.69, rho < .01) and at its "least" (t99 = 1.74, rho < .05) compared to the muscle contraction headache 'group. Discriminant analyses were conducted on one-half of the sample to determine diagnostic group membership on the basis of pain description alone. Findings revealed that group membership could be predicted at a 90% rate (chi2 145 = 33.06, rho < .001). A cross validation on the second half of the sample confirmed these findings (chi2 1.48 = 13.08, rho < .05) suggesting that the MMPQ is of value in headache diagnosis. Differences between electromyographic studies and headache pain report are discussed as well as suggestions concerning modification of the MMPQ for headache assessment.
Headache 1982 Jan
PMID:The mcGill-Melzack Pain Questionnaire in the diagnosis of headache. 1715 41

Most patients who complain of recurrent headaches have migraine, muscle contraction headache, or both. At a patient's first office visit for headache, the family physician should carry out a physical and neurological examination. The type of headache and factors that can precipitate it may then be explained, and the patient should be advised to take only simple analgesics for pain, as soon as he recognizes the first symptom of headache. A daily diary can help reveal specific factors that precipitate the patient's headaches. He can also benefit from educational material, and be taught relaxation techniques to ease headache pain. At least one follow up office visit is necessary in order to emphasize and review instructions from the previous assessment, and to give the patient an opportunity to consider the explanation and problems and voice any remaining concerns or questions.
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PMID:The management of chronic headaches. 2127 63


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