Primary Headache in the Neurology Department of the Bouake Teaching Hospital (Ivory Coast): Epidemiological, Clinical and Therapeutic Aspects

The survey conducted at the Bouaké Teaching Hospital in Ivory Coast examined the epidemiological, clinical and therapeutic aspects of primary headache (migraine and tension-type headache). This prospective survey involved 66 adult patients, mainly women (75.76%), with an average age of 42 years. Patients consulted for chronic headaches, and many had received previous treatment, mainly analgesics and amitriptyline, for prophylaxis. A diagnostic discrepancy of 25.76% was found between the initial diagnoses made by junior neurologists and those established after re-evaluation according to ICHD-3 criteria. The majority of patients received treatment for attacks (mainly NSAIDs) and prophylaxis (mainly amitriptyline), but triptans, recommended for crisis treatment, were rarely prescribed. A high number of patients suffered from depressive symptoms (60%) and anxiety (67%) according to HAD scores, indicating a significant psychological impact of headaches. Three months after treatment, 71.21% of patients showed an improvement of more than 50% in terms of headache frequency and intensity. The study suggests a number of recommendations for improving headache management in Ivory Coast, including better training of doctors in diagnostic criteria and improved access to medication.