Background: Cluster headache (CH) is a relatively rare but severe disease. The episodic form is more frequent than the chronic form. Few studies have described the characteristics of chronic CH patients.
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 CH patients, of whom 316 had chronic CH. From January to June 2005, 113 patients with chronic CH were interviewed using standardized 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 pain on both sides. 48% reported a persisting painful state between the attacks. Symptoms anteceding pain onset (mainly discomfort/diffuse pain, exhaustion, mood disorders) and auras were reported by respectively 55% and 20% of patients. The functional impact of chronic CH was estimated severe by 74% of patients and 75.7% suffered from anxiety based on HAD scale. There was no substantial difference in clinical presentation between primary and secondary CH.
Discussion: This study confirms the existence of auras and inter-ictal signs and symptoms in patients with chronic CH, and male sex and smoking as CH risk factors. Primary and secondary chronic CH appears equally prevalent. Male sex does not appear to favour the shift to chronic CH
- Chronic cluster headache
- clinical features
- functional impact
- prodromal symptoms