Objective： To investigate the masseter inhibitory tension-type headache （TTH）. Methods： MIR was studied in 21 sex matched to the study cohort. Median age of patients was reflex （MIR） and its eventual changes in ...Objective： To investigate the masseter inhibitory tension-type headache （TTH）. Methods： MIR was studied in 21 sex matched to the study cohort. Median age of patients was reflex （MIR） and its eventual changes in patients with episodic patients with episodic TTH and 30 healthy subjects, with age and 17.0 years （ranged 16-49 years）, median duration of disease 12 months （1-5 years）, and median frequency of headache 7.5 d per month. Results： The second period of suppression （$2） of MIR was reduced in intensity and duration in 10% of controls and 66.7% （confidence interval （CI） 45.3%-85%; P〈0.05） of patients with episodic TTH （X2=74.9; P〈0.001）. In 3 （14.3%） of patients with episodic TTH, S2 was completely absent. No significant correlation between the duration of disease and headache frequency was found. Conclusion： Our results confirm the link between episodic TTH and reduction or absence of S2. Teenage patients with episodic TTH may exhibit marked pathological changes in S2 in contrast to older individuals.展开更多
Background and purpose: Vascular and tension-type headache is most commonly encountered, and SI17 therapy has been tested to treat headache with good results. The efficacy of SI17 therapy for vascular and tension-... Background and purpose: Vascular and tension-type headache is most commonly encountered, and SI17 therapy has been tested to treat headache with good results. The efficacy of SI17 therapy for vascular and tension-type headache was compared and the effect of SI17 therapy on pancreatic polypeptide (PP) was studied. Materials and methods: 29 cases of vascular headache (20 cases in acute attack during the trial) and 27 cases of tension-type headache (19 cases in acute attack) were enrolled in the study. Plasma PP level before and 4th day after treatment was measured by radioimmunoassay. Results: SI17 therapy is better for the treatment of vascular headache. Vascular headache with higher PP level and tension-type headache with normal PP level had good therapeutic results. Conclusion: The clinical efficacy is better for vascular headache with the increase of vagus tension and for tension-type headache with normal vagus tension. 展开更多
We present the rationale and design of a master protocol study that clarifies the effectiveness and safety of Chinese herbal formulas on Qi-stagnation and blood-stasis pattern(QBP).Three randomized controlled trials(R...We present the rationale and design of a master protocol study that clarifies the effectiveness and safety of Chinese herbal formulas on Qi-stagnation and blood-stasis pattern(QBP).Three randomized controlled trials(RCTs)and real-world observational studies.Based on three registry cohorts of stable angina,tension-type headache and primary dysmenorrhea,patients with QBP will be enrolled in RCTs to receive either Xuefu Zhuyu(血府逐瘀,XFZY)oral liquid or a placebo,while patients with non-QBP will be enrolled in the observational studies and experience follow-up.1414 patients(RCTs:574;observational studies:840)will be recruited at seven centers in China over a 3-year period.The primary outcome is the visual analog scale of pain intensity.Adverse events will also be reported.The analysis will be undertaken separately in each sub-study,and then an overall analysis combining multiple subgroups will be performed to comprehensively investigate the effect of XFZY oral liquid.This study will provide high-quality evidence of XFZY oral liquid for QBP patients and show a paradigm of post-marketing evaluation of the effectiveness and safety for Chinese medicine following the notion of the pattern dominating different disease research models.展开更多
Objective:To observe the clinical efficacy of acupuncture plus auricular point sticking for tension-type headache(TTH).Methods:A total of 90 TTH patients were divided into an acupuncture group,an auricular point stick...Objective:To observe the clinical efficacy of acupuncture plus auricular point sticking for tension-type headache(TTH).Methods:A total of 90 TTH patients were divided into an acupuncture group,an auricular point sticking group and an observation group by random number table method,with 30 cases in each group.Patients in the observation group received acupuncture plus auricular point sticking for treatment,while those in the acupuncture group only received acupuncture and those in the auricular point sticking group only received auricular point sticking for treatment.The headache attack frequency and the scores of visual analog scale(VAS),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were observed before treatment,after treatment and 3 months after treatment.The clinical efficacy was evaluated at the follow-up of 3 months after treatment.Results:At follow-up,there were significant differences in clinical efficacy among the three groups(P<0.01 or P<0.05),and the clinical efficacy ranking from high to low was the observation group,the acupuncture group and the auricular point sticking group.After treatment and at follow-up,the VAS score,headache attack frequency,SAS and SDS scores in the three groups were significantly lower than those before treatment(all P<0.01).The above four results in the observation group were lower than those in the acupuncture group and the auricular point sticking group at the same time point(all P<0.01);VAS score in the acupuncture group was lower than that in the auricular point sticking group(both P<0.05).At follow-up,the headache frequency in the acupuncture group was lower than that in the auricular point sticking group(P<0.05).Conclusion:Either using acupuncture and auricular point sticking together or separately can reduce the headache degree of TTH patients,reduce the number of headache attacks,and relieve anxiety and depression.The efficacy of acupuncture plus auricular point sticking is most significant.展开更多
Objective:To investigate the clinical efficacy and safety of miniscalpel-needle(MSN)treatment for tension-type headache(TTH).Method:Seven medical databases were searched to identify randomized controlled trials(RCTs)e...Objective:To investigate the clinical efficacy and safety of miniscalpel-needle(MSN)treatment for tension-type headache(TTH).Method:Seven medical databases were searched to identify randomized controlled trials(RCTs)evaluating the effect and safety of MSN treatment.All articles published up to November 15,2018 were retrieved.A meta-analysis was conducted for the included studies,and the risk of bias was assessed.Primary outcomes were visual analogue scale(VAS)or numeric rating scale(NRS)score.Secondary outcomes were clinical effective rates including total effective rate(TER),markedly effective rate(MER),and totally cured rate(TCR)determined by improvement in clinical symptoms or VAS scores,the frequency of adverse events(AEs)that occurred during the study,and participant quality of life(QOL).Results:Seven RCTs involving 724 participants were included.MSN treatment showed significantly higher MER and TCR[relative risk(RR)1.27,95%confidence interval(Cl)1.01 to 1.61;RR 1.31,95%Cl 1.09 to 1.57,respectively],but not TER(RR 1.03,95%Cl 0.96 to 1.10)compared to acupuncture.MSN treatment plus conventional treatment showed significant lower VAS and higher TER,MER,and TCR(mean difference-3.54,95%Cl-3.80 to-3.28;RR 1.14,95%Cl 1.06 to 1.23;RR 2.31,95%Cl 1.50 to 3.58;RR 3.01,95%Cl 2.25 to 4.02,respectively)compared to conventional treatment.Conclusions:According to current evidence,MSN treatment as a monotherapy or as an adjunctive treatment to other existing treatments might have benefits on treating TTH.However,since the number and the sample size of studies included were both small and the methodological quality was poor,the findings of this review should be interpreted with great caution,and our confidence in the results is low.A high quality RCT using objective outcomes should be performed on this topic.展开更多
Objective: To explore the demographic and disease-related factors associated with acupuncture response in patients with chronic tension-type headache(CTTH). Methods: Using data from the randomized clinical trial(218 c...Objective: To explore the demographic and disease-related factors associated with acupuncture response in patients with chronic tension-type headache(CTTH). Methods: Using data from the randomized clinical trial(218 cases) consisting of 4 weeks of baseline assessment, 8 weeks of treatment, and 24 weeks of follow-up, participants were regrouped into responders(at least a 50% reduction in monthly headache days at week 16 compared with baseline) and non-responders. Twenty-three demographic and disease-related factors associated with acupuncture response in 183 participants were analyzed by multivariable logistic regression. Results: One hundred and nineteen(65.0%) participants were classified as responders. Four factors were significantly independently associated with acupuncture response, including treatment assignment, headache intensity at baseline, and 2 domains [general health(GH) and social functioning(SF)] from the 36-Item Short Form Health Survey quality of life questionnaire. Treatment assignment was associated with nonresponse: participants receiving true acupuncture were 3-time more likely to achieve a CTTH response than those receiving superficial acupuncture [odds ratio(OR) 0.322, 95% confidence interval(CI) 0.162 to 0.625, P=0.001]. Compared with patients with mild-intensity headache, patients with moderate-intensity headache were twice as likely to respond to acupuncture(OR 2.001, 95% CI 1.020 to 4.011, P=0.046). The likelihood of non-response increased by 4.5% with each unit increase in the GH grade(OR 0.955, 95% CI 0.917 to 0.993, P=0.024) while decreased by 3.8% with each unit increase in the SF grade(OR 1.038, 95% CI 1.009 to 1.069, P=0.011). Conclusions: Greater headache intensity, lower GH score, and higher SF score were associated with better acupuncture responses in CTTH patients. These 3 factors require independent validation as predictors of acupuncture effectiveness in CTTH.展开更多
目的观察王氏额针治疗紧张型头痛的临床有效性和安全性。方法回顾分析120例紧张型头痛患者,将采用额针治疗的60例患者纳入观察组,将采用常规针刺治疗的60例患者纳入对照组,连续治疗3周。对比两组的临床疗效、疼痛视觉模拟量表(visual an...目的观察王氏额针治疗紧张型头痛的临床有效性和安全性。方法回顾分析120例紧张型头痛患者,将采用额针治疗的60例患者纳入观察组,将采用常规针刺治疗的60例患者纳入对照组,连续治疗3周。对比两组的临床疗效、疼痛视觉模拟量表(visual analogue scale,VAS)评分、中医证候积分、头痛发作频率及持续时间、健康调查简表(the MOS item short from health survey,SF-36)评分,记录不良反应。结果观察组的有效率92.98%(53/57),明显高于对照组的77.59%(45/58)(P<0.05);同一时间点比较,观察组患者的头痛VAS评分、中医证候总积分均明显低于对照组(P<0.01);与对照组比较,观察组治疗后降低头痛的发作频率,缩短疼痛持续时间,均优于对照组(P<0.01);治疗后随访3个月,观察组患者躯体疼痛、精神健康评分明显高于对照组,差异有统计学意义(P<0.01),生命活力、社会功能评分明显高于对照组,差异有统计学意义(P<0.05),其余各项评分均差异无统计学意义(P>0.05)。结论王氏额针能有效改善紧张型头痛患者的头痛程度,提高生活质量,安全有效,值得推广。展开更多
Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,preva...Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,prevalence rate,disability-adjusted life years(DALYs),and age-standardized DALY rates were analyzed by sex,age group,and province for headache disorders and their subtypes(migraine and tension-type headache[TTH])between 1990 and 2021.Percentage changes during this period were also estimated.Results In 2021,approximately 426 million individuals in China were affected by headache disorders,with an age-standardized prevalence rate of 27,582.61/100,000.The age-standardized DALY rate for all headache disorders was 487.15/100,000.Between 1990 and 2021,the number of prevalent cases increased by 37.78%,while the prevalence of all headache disorders,migraine,and TTH increased by 6.92%,7.57%,and 7.86%,respectively.The highest prevalence was observed in the 30-34 age group(39,520.60/100,000).Migraine accounted for a larger proportion of DALYs attributable to headache disorders,whereas TTH has a greater impact on its prevalence.In 2021,the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang(617.85/100,000)and Shanghai(542.86/100,000).Conclusion The prevalence of headache disorders is increasing in China.Effective health education,improve diagnosis and treatment are essential,particularly for middle-aged working populations and women of childbearing age.展开更多
BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as th...BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as the arms,abdomen,face,neck,head,and genital area.There are only a few reports of the RLS variant affecting the head.AIM To assess the epidemiological,clinical,and other aspects of the RLS variant affecting the head.METHODS We conducted a retrospective study of 17 adult patients(>18 years)who met the RLS criteria and simultaneously experienced RLS-like symptoms in the head.RESULTS The median age at which symptoms appeared was 41.6 years.Males and females were equally affected(1.1:1).All 17 patients had uncomfortable sensations in the lower legs.Insomnia or disturbed sleep was the most common comorbidity(n=16,88.2%).However,headache was the most common presenting or primary symptom(n=10,70.5%).Dizziness or an abnormal sensation in the head was the second most common presenting symptom(5 patients,29.4%).Other presenting features were leg pain,backache,and generalized body pain.All patients responded favorably to dopaminergic medications.CONCLUSION If RLS-related unpleasant sensations and pain are felt in the head,they may be misinterpreted as headache,dizziness,or psychosomatic symptoms.RLS and headaches in a subset of patients may be two phenotypic manifestations of the same disorder.展开更多
文摘Objective： To investigate the masseter inhibitory tension-type headache （TTH）. Methods： MIR was studied in 21 sex matched to the study cohort. Median age of patients was reflex （MIR） and its eventual changes in patients with episodic patients with episodic TTH and 30 healthy subjects, with age and 17.0 years （ranged 16-49 years）, median duration of disease 12 months （1-5 years）, and median frequency of headache 7.5 d per month. Results： The second period of suppression （$2） of MIR was reduced in intensity and duration in 10% of controls and 66.7% （confidence interval （CI） 45.3%-85%; P〈0.05） of patients with episodic TTH （X2=74.9; P〈0.001）. In 3 （14.3%） of patients with episodic TTH, S2 was completely absent. No significant correlation between the duration of disease and headache frequency was found. Conclusion： Our results confirm the link between episodic TTH and reduction or absence of S2. Teenage patients with episodic TTH may exhibit marked pathological changes in S2 in contrast to older individuals.
文摘 Background and purpose: Vascular and tension-type headache is most commonly encountered, and SI17 therapy has been tested to treat headache with good results. The efficacy of SI17 therapy for vascular and tension-type headache was compared and the effect of SI17 therapy on pancreatic polypeptide (PP) was studied. Materials and methods: 29 cases of vascular headache (20 cases in acute attack during the trial) and 27 cases of tension-type headache (19 cases in acute attack) were enrolled in the study. Plasma PP level before and 4th day after treatment was measured by radioimmunoassay. Results: SI17 therapy is better for the treatment of vascular headache. Vascular headache with higher PP level and tension-type headache with normal PP level had good therapeutic results. Conclusion: The clinical efficacy is better for vascular headache with the increase of vagus tension and for tension-type headache with normal vagus tension.
基金the National Key Research and Development Program of China:Research on“the Pattern Dominating Disease”of Postmarket Evaluation on Two Classic Chinese Herbal Formulas based on Basket Design(No.2018YFC1707407)。
文摘We present the rationale and design of a master protocol study that clarifies the effectiveness and safety of Chinese herbal formulas on Qi-stagnation and blood-stasis pattern(QBP).Three randomized controlled trials(RCTs)and real-world observational studies.Based on three registry cohorts of stable angina,tension-type headache and primary dysmenorrhea,patients with QBP will be enrolled in RCTs to receive either Xuefu Zhuyu(血府逐瘀,XFZY)oral liquid or a placebo,while patients with non-QBP will be enrolled in the observational studies and experience follow-up.1414 patients(RCTs:574;observational studies:840)will be recruited at seven centers in China over a 3-year period.The primary outcome is the visual analog scale of pain intensity.Adverse events will also be reported.The analysis will be undertaken separately in each sub-study,and then an overall analysis combining multiple subgroups will be performed to comprehensively investigate the effect of XFZY oral liquid.This study will provide high-quality evidence of XFZY oral liquid for QBP patients and show a paradigm of post-marketing evaluation of the effectiveness and safety for Chinese medicine following the notion of the pattern dominating different disease research models.
文摘Objective:To observe the clinical efficacy of acupuncture plus auricular point sticking for tension-type headache(TTH).Methods:A total of 90 TTH patients were divided into an acupuncture group,an auricular point sticking group and an observation group by random number table method,with 30 cases in each group.Patients in the observation group received acupuncture plus auricular point sticking for treatment,while those in the acupuncture group only received acupuncture and those in the auricular point sticking group only received auricular point sticking for treatment.The headache attack frequency and the scores of visual analog scale(VAS),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were observed before treatment,after treatment and 3 months after treatment.The clinical efficacy was evaluated at the follow-up of 3 months after treatment.Results:At follow-up,there were significant differences in clinical efficacy among the three groups(P<0.01 or P<0.05),and the clinical efficacy ranking from high to low was the observation group,the acupuncture group and the auricular point sticking group.After treatment and at follow-up,the VAS score,headache attack frequency,SAS and SDS scores in the three groups were significantly lower than those before treatment(all P<0.01).The above four results in the observation group were lower than those in the acupuncture group and the auricular point sticking group at the same time point(all P<0.01);VAS score in the acupuncture group was lower than that in the auricular point sticking group(both P<0.05).At follow-up,the headache frequency in the acupuncture group was lower than that in the auricular point sticking group(P<0.05).Conclusion:Either using acupuncture and auricular point sticking together or separately can reduce the headache degree of TTH patients,reduce the number of headache attacks,and relieve anxiety and depression.The efficacy of acupuncture plus auricular point sticking is most significant.
基金Chung-Yeon Central Institute(Research Program 2020)。
文摘Objective:To investigate the clinical efficacy and safety of miniscalpel-needle(MSN)treatment for tension-type headache(TTH).Method:Seven medical databases were searched to identify randomized controlled trials(RCTs)evaluating the effect and safety of MSN treatment.All articles published up to November 15,2018 were retrieved.A meta-analysis was conducted for the included studies,and the risk of bias was assessed.Primary outcomes were visual analogue scale(VAS)or numeric rating scale(NRS)score.Secondary outcomes were clinical effective rates including total effective rate(TER),markedly effective rate(MER),and totally cured rate(TCR)determined by improvement in clinical symptoms or VAS scores,the frequency of adverse events(AEs)that occurred during the study,and participant quality of life(QOL).Results:Seven RCTs involving 724 participants were included.MSN treatment showed significantly higher MER and TCR[relative risk(RR)1.27,95%confidence interval(Cl)1.01 to 1.61;RR 1.31,95%Cl 1.09 to 1.57,respectively],but not TER(RR 1.03,95%Cl 0.96 to 1.10)compared to acupuncture.MSN treatment plus conventional treatment showed significant lower VAS and higher TER,MER,and TCR(mean difference-3.54,95%Cl-3.80 to-3.28;RR 1.14,95%Cl 1.06 to 1.23;RR 2.31,95%Cl 1.50 to 3.58;RR 3.01,95%Cl 2.25 to 4.02,respectively)compared to conventional treatment.Conclusions:According to current evidence,MSN treatment as a monotherapy or as an adjunctive treatment to other existing treatments might have benefits on treating TTH.However,since the number and the sample size of studies included were both small and the methodological quality was poor,the findings of this review should be interpreted with great caution,and our confidence in the results is low.A high quality RCT using objective outcomes should be performed on this topic.
基金Supported by the International Cooperation Program of Science and Technology Department of Sichuan Province,China(No.2016HH0007)。
文摘Objective: To explore the demographic and disease-related factors associated with acupuncture response in patients with chronic tension-type headache(CTTH). Methods: Using data from the randomized clinical trial(218 cases) consisting of 4 weeks of baseline assessment, 8 weeks of treatment, and 24 weeks of follow-up, participants were regrouped into responders(at least a 50% reduction in monthly headache days at week 16 compared with baseline) and non-responders. Twenty-three demographic and disease-related factors associated with acupuncture response in 183 participants were analyzed by multivariable logistic regression. Results: One hundred and nineteen(65.0%) participants were classified as responders. Four factors were significantly independently associated with acupuncture response, including treatment assignment, headache intensity at baseline, and 2 domains [general health(GH) and social functioning(SF)] from the 36-Item Short Form Health Survey quality of life questionnaire. Treatment assignment was associated with nonresponse: participants receiving true acupuncture were 3-time more likely to achieve a CTTH response than those receiving superficial acupuncture [odds ratio(OR) 0.322, 95% confidence interval(CI) 0.162 to 0.625, P=0.001]. Compared with patients with mild-intensity headache, patients with moderate-intensity headache were twice as likely to respond to acupuncture(OR 2.001, 95% CI 1.020 to 4.011, P=0.046). The likelihood of non-response increased by 4.5% with each unit increase in the GH grade(OR 0.955, 95% CI 0.917 to 0.993, P=0.024) while decreased by 3.8% with each unit increase in the SF grade(OR 1.038, 95% CI 1.009 to 1.069, P=0.011). Conclusions: Greater headache intensity, lower GH score, and higher SF score were associated with better acupuncture responses in CTTH patients. These 3 factors require independent validation as predictors of acupuncture effectiveness in CTTH.
文摘目的观察王氏额针治疗紧张型头痛的临床有效性和安全性。方法回顾分析120例紧张型头痛患者,将采用额针治疗的60例患者纳入观察组,将采用常规针刺治疗的60例患者纳入对照组,连续治疗3周。对比两组的临床疗效、疼痛视觉模拟量表(visual analogue scale,VAS)评分、中医证候积分、头痛发作频率及持续时间、健康调查简表(the MOS item short from health survey,SF-36)评分,记录不良反应。结果观察组的有效率92.98%(53/57),明显高于对照组的77.59%(45/58)(P<0.05);同一时间点比较,观察组患者的头痛VAS评分、中医证候总积分均明显低于对照组(P<0.01);与对照组比较,观察组治疗后降低头痛的发作频率,缩短疼痛持续时间,均优于对照组(P<0.01);治疗后随访3个月,观察组患者躯体疼痛、精神健康评分明显高于对照组,差异有统计学意义(P<0.01),生命活力、社会功能评分明显高于对照组,差异有统计学意义(P<0.05),其余各项评分均差异无统计学意义(P>0.05)。结论王氏额针能有效改善紧张型头痛患者的头痛程度,提高生活质量,安全有效,值得推广。
基金supported by the National Key Research and Development Program of China(2018YFC1315301).
文摘Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021.Methods Using data from the Global Burden of Disease Study(GBD)2021,the number of prevalent cases,prevalence rate,disability-adjusted life years(DALYs),and age-standardized DALY rates were analyzed by sex,age group,and province for headache disorders and their subtypes(migraine and tension-type headache[TTH])between 1990 and 2021.Percentage changes during this period were also estimated.Results In 2021,approximately 426 million individuals in China were affected by headache disorders,with an age-standardized prevalence rate of 27,582.61/100,000.The age-standardized DALY rate for all headache disorders was 487.15/100,000.Between 1990 and 2021,the number of prevalent cases increased by 37.78%,while the prevalence of all headache disorders,migraine,and TTH increased by 6.92%,7.57%,and 7.86%,respectively.The highest prevalence was observed in the 30-34 age group(39,520.60/100,000).Migraine accounted for a larger proportion of DALYs attributable to headache disorders,whereas TTH has a greater impact on its prevalence.In 2021,the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang(617.85/100,000)and Shanghai(542.86/100,000).Conclusion The prevalence of headache disorders is increasing in China.Effective health education,improve diagnosis and treatment are essential,particularly for middle-aged working populations and women of childbearing age.
文摘BACKGROUND Restless legs syndrome(RLS)is characterized by an urge to move with an unpleasant sensation in the lower limbs.RLS typically affects the legs.However,it can also affect several other body regions,such as the arms,abdomen,face,neck,head,and genital area.There are only a few reports of the RLS variant affecting the head.AIM To assess the epidemiological,clinical,and other aspects of the RLS variant affecting the head.METHODS We conducted a retrospective study of 17 adult patients(>18 years)who met the RLS criteria and simultaneously experienced RLS-like symptoms in the head.RESULTS The median age at which symptoms appeared was 41.6 years.Males and females were equally affected(1.1:1).All 17 patients had uncomfortable sensations in the lower legs.Insomnia or disturbed sleep was the most common comorbidity(n=16,88.2%).However,headache was the most common presenting or primary symptom(n=10,70.5%).Dizziness or an abnormal sensation in the head was the second most common presenting symptom(5 patients,29.4%).Other presenting features were leg pain,backache,and generalized body pain.All patients responded favorably to dopaminergic medications.CONCLUSION If RLS-related unpleasant sensations and pain are felt in the head,they may be misinterpreted as headache,dizziness,or psychosomatic symptoms.RLS and headaches in a subset of patients may be two phenotypic manifestations of the same disorder.
