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Document Type

Original Article

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.

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