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Chronic cluster headache: a French clinical descriptive study
  1. A Donnet1,
  2. M Lanteri-Minet2,
  3. E Guegan-Massardier3,
  4. G Mick4,
  5. N Fabre5,
  6. G Géraud5,
  7. C Lucas6,
  8. M Navez7,
  9. D Valade8,
  10. on behalf of the Société Française d’Etude des Migraines et Céphalées (SFEMC)
  1. 1
    Department of Neurology, Clinical Neuroscience Federation, La Timone Hospital, Marseille, France
  2. 2
    Department of Evaluation and Treatment of Pain, Clinical Neuroscience Federation, Pasteur Hospital, Nice, France
  3. 3
    Department of Neurology, Clinical Neuroscience Federation, Charles Nicole Hospital, Rouen, France
  4. 4
    Department of Evaluation and Treatment of Pain, Neurological Hospital, Lyon, France
  5. 5
    Neurological Department, Rangueil Hospital, Toulouse, France
  6. 6
    Neurological Department, Salengro Hospital, Lille, France
  7. 7
    Department of Evaluation and Treatment of Pain, Bellevue Hospital, St Etienne, France
  8. 8
    Emergency Headache Centre, Lariboisière Hospital, Paris, France
  1. Dr A Donnet, Service de Neurochirurgie, Hôpital La Timone, 264 Boulevard Saint-Pierre, 13385 Marseille Cedex, France; anne.donnet{at}mail.ap-hm.fr

Abstract

Background: Cluster headache (CH) is a relatively rare disease and episodic CH is more frequent than chronic CH. Few studies have described the characteristics of patients with chronic CH.

Methods: This was a descriptive study carried out by eight tertiary care specialist headache centres in France participating in the Observatory of Migraine and Headaches (OMH). From 2002 to 2005, OMH collected data from 2074 patients with CH, of whom 316 had chronic CH. From January to June 2005, 113 patients with chronic CH were interviewed using standardised questionnaires during a consultation.

Results: The male to female ratio was 4.65:1. Median age was 42 years. The majority of patients were smokers or former smokers (87%). 46% had primary chronic CH (chronic at onset) and 54% secondary chronic CH (evolving from episodic CH). Most patients had unilateral pain during attacks and 7% had sometimes bilateral pain during an attack. 48% reported a persisting painful state between attacks. Symptoms anteceding pain onset (mainly discomfort/diffuse pain, exhaustion, mood disorders) and auras were reported by 55% and 20% of patients, respectively. The functional impact of chronic CH was estimated as severe by 74% of patients, and 75.7% suffered from anxiety, as assessed by the Hospital Anxiety and Depression scale. There was no substantial difference in clinical presentation between primary and secondary CH.

Discussion: This study confirms the existence of auras and interictal signs and symptoms in patients with chronic CH, and male sex and smoking as CH risk factors. Primary and secondary chronic CH appear equally prevalent. Male sex does not appear to favour the shift from episodic to chronic CH.

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Footnotes

  • Funding: This study was funded by a grant from GlaxoSmithKline.

  • Competing interests: None.

  • Abbreviations:
    CH
    cluster headache
    HAD scale
    Hospital Anxiety and Depression scale
    HIS
    International Headache Society
    OMH
    Observatory of Migraine and Headaches

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