BACKGROUND This study determines the prevalence and particularities of headache and pain with neuropathic characteristics (NC) in a large French group of patients with pituitary adenoma (PA). METHODS Analysis of validated self-administered questionnaires, radiological characteristics, and treatment strategies of PA was performed. RESULTS Of the 221 sent questionnaires, 146 could be used for statistical analysis, 50% of which were completed by women. Among responders, 58.9% had pain: 30.1% migraine, 15.7% pain with NC, and 13.1% other types of pain. Migraine was more common in patients with PA than in the general population (30.1% vs 21.3%, p=0.010) and attacks received appropriate treatment for less than 20% of these patients. Furthermore, the prevalence of chronic migraine was much higher than in the general population (6.8% vs 2.2%, p=0.003). Neuropathic pain was also more frequent in PA patients than in the general population (15.8% vs 6.9%, p<0.001). Neuropathic pain was most often located in the extremities and was frequently described as an "electric shock", "numbness", or "pins-and-needles". Multivariate analyses linked migraine to younger age, anxiety, pain with NC, and a visible tumor on MRI, regardless of its invasiveness or secretory nature. CONCLUSIONS Migraine headaches and neuropathic pain are more frequent and disabling in PA patients than in the general population. Both types of pain are comorbid in PA patients and are poorly treated. Migraine is associated with the presence of a tumor. Thus, biological mechanisms of this relationship need to be characterized to design optimal treatments for these individuals.

中文翻译：

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垂体腺瘤患者疼痛特征的横断面研究

背景本研究确定了法国大量垂体腺瘤 (PA) 患者中头痛和具有神经病理性特征 (NC) 的疼痛的患病率和特殊性。方法 对经过验证的自我管理问卷、放射学特征和 PA 的治疗策略进行分析。结果 发送的221份问卷中，146份可用于统计分析，其中50%由女性完成。在应答者中，58.9% 有疼痛：30.1% 偏头痛，15.7% NC 疼痛，13.1% 其他类型的疼痛。PA 患者的偏头痛比一般人群更常见（30.1% 对 21.3%，p=0.010），并且这些患者中不到 20% 的偏头痛得到了适当的治疗。此外，慢性偏头痛的患病率远高于一般人群（6.8% 对 2.2%，p=0.003）。PA患者的神经性疼痛也比一般人群更常见（15.8% vs 6.9%，p<0.001）。神经性疼痛最常位于四肢，常被描述为“电击”、“麻木”或“针刺”。多变量分析将偏头痛与年轻、焦虑、NC 疼痛和 MRI 可见肿瘤联系起来，无论其侵袭性或分泌性质如何。结论 与一般人群相比，PA 患者的偏头痛和神经性疼痛更常见且致残。两种类型的疼痛在 PA 患者中都是共病的，并且治疗效果不佳。偏头痛与肿瘤的存在有关。因此，需要表征这种关系的生物学机制，以便为这些个体设计最佳治疗方法。