Chronic cluster headache: a French clinical descriptive study

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.

Illicit drugs and cluster headache: An inevitable discussion

“…At first glance, these findings seem in line with the well-documented abuse of nicotine (80% smokers as compared to 35% in the general population) (2), relatively high coffee consumption and the finding that 26% of cluster patients regularly use cannabis (3). There are conflicting data regarding alcohol consumption, with clinicians and smaller studies reporting significant abuse and a recent study by Schu¨rks et al, who report the opposite (4).…”

Aura in Cluster Headache: A Cross‐Sectional Study

“…Consistent with the findings from previous studies,3, 4, 13 the most frequent aura symptoms were visual, which in our study started in most cases prior to the headache. Dysarthria and dysphasia, most often during the headache phase, was reported by 27.3% and 22.7% participants, respectively, which seems much higher than the 4.5%–8% reported in previous studies 2, 4, 5, 13…”

“…Dysarthria and dysphasia, most often during the headache phase, was reported by 27.3% and 22.7% participants, respectively, which seems much higher than the 4.5%–8% reported in previous studies 2, 4, 5, 13…”

“…Migraine‐like aura symptoms have been reported in up to 23% of cluster headache patients 2, 3, 4, 5. For many clinicians, this seems much higher than to their clinical impression.…”

Unhealthy Mental States Are Positively Associated with Subjective Pain or Fatigue in Specific Body Sites among High School Teachers in Japan

“…There also have a report that drug induced headaches are affiliated with anxiety [30]. Another study has been found that 43% in patients with chronic cluster headache had higher depression scores than those who did not [31]. Moreover, there have been reports patients with anxiety and depression were frequently observed to have chronic daily headaches [32].…”