Lifetime prevalence and concordance risk of cluster headache in the Swedish twin population

Ekbom, Karl; Svensson, Dan A.; Pedersen, Nancy L.; Waldenlind, Elisabet

doi:10.1212/01.wnl.0000233786.72356.3e

Cited by 60 publications

(42 citation statements)

References 35 publications

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“…TTH affects 60-80% of the population while migraine has a prevalence of 15% (male 7.6%, female 18.3%). 8 Cluster headache is uncommon (0.1%) 14,15 but often misdiagnosed and mismanaged. 16 Medication-overuse headache (MOH) is a secondary headache disorder and often co-exists with primary headache disorders, and is often described with them.…”

Section: Primary Headache Disordersmentioning

confidence: 99%

Headache disorders: differentiating and managing the common subtypes

Ahmed

2012

British Journal of Pain

108

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Headache is an extremely common symptom and collectively headache disorders are among the most common of the nervous system disorders, with a prevalence of 48.9% in the general population.1 Headache affects people of all ages, races and socioeconomic status and is more common in women. Some headaches are extremely debilitating and have significant impact on an individual’s quality of life, imposing huge costs to healthcare and indirectly to the economy in general. Only a small proportion of headache disorders require specialist input. The vast majority can be effectively treated by a primary care physician or generalist with correct clinical diagnosis that requires no special investigation. Primary headache disorders – migraine, tension headache and cluster headache – constitute nearly 98% of all headaches; however, secondary headaches are important to recognise as they are serious and may be life threatening. This article provides an overview of the most common headache disorders and discusses the red flag symptoms that help identify serious causes that merit urgent specialist referral. The current pathway of headache care in the UK is discussed with a view to proposing a model that might fit well in the financially constrained National Health Service (NHS) and with new NHS reforms. The role of the national society, the British Association for the Study of Headache, and the patient organisations such as Migraine Trust in headache education to the professionals and the general public in shaping headache care in the UK is described. The article concludes by summarising evidence-based management of common headache diagnoses.

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Section: Primary Headache Disordersmentioning

confidence: 99%

Headache disorders: differentiating and managing the common subtypes

Ahmed

2012

British Journal of Pain

108

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“…Segregation analysis in the study suggested an autosomal dominant pattern of inheritance for CH. However, more recent studies have shown concordance rates for monozygous twin pairs to be much lower than would be expected for autosomal dominant inheritance, on the order of two in 12 co-twins displaying recurrence of CH [35]. Although this still represents a 15-fold increased risk compared with the general population, the low twin concordance suggests a more complex set of genetic factors underlying familial clustering [36••].…”

Section: Geneticsmentioning

confidence: 99%

Epidemiology of cluster headache

Broner

Cohen²

2009

Current Science Inc

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Cluster headache was first described over 300 years ago, but in the last century our knowledge of the disorder has exploded through both clinical observation and epidemiological data. Although some of the data are conflicting and more need to be obtained, much is known about the disorder. This article reviews the data to date on the prevalence and incidence of the disorder, population differences including gender and race, genetics, comorbid conditions, risk factors for development of the disorder, prognosis, and socioeconomic burden.

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“…Der Clusterkopfschmerz ist eine seltene primäre Kopfschmerzerkrankung, seine Inzidenz variiert zwischen 30 und 381/100.000 in der Bevölkerung [16]. Das Alter der Erstmanifestation ist variabel, bei den meisten Patienten manifestiert sich der Clusterkopfschmerz zwischen dem 20. und 30.…”

Section: Clusterkopfschmerzunclassified

Kopfschmerzen im Alter

Reinisch

Schankin

Felbinger

et al. 2008

Schmerz

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Chronic headache is still a frequent problem in old age, affecting about 10% of all women and 5% of all men older than 70 years. The incidence of primary headache decreases with advancing age, while that of secondary headache increases. The clinical characteristics of migraine can also change with age; for example, vegetative symptoms are less prominent, and less intense migrainous pain localized predominantly in the neck is frequently reported. Migraine aura can also be experienced more frequently in isolation, without a headache. Hypnic headache is a rare primary headache syndrome that occurs almost exclusively in the elderly. Most of the secondary headache syndromes that occur more frequently in old age present clinically as tension-type headache. Examples of rather common reasons for secondary headache syndromes in the elderly are intracranial space-occupying lesions, ophthalmological problems and autoimmune diseases such as giant cell arteritis. Elderly patients are especially likely to have a number of illnesses at any one time for which they take various medications each day, so that headaches can also quite often be caused by their medication or by withdrawal of these. As a result of such multimorbidity the homeostasis is disturbed in such patients, leading to various conditions that can entail concomitant headaches (sleep apnoea syndrome, dialysis headache, headache attributed to arterial hypertension or hypothyroidism). Familiar facial neuralgias, such as trigeminal neuralgia or postherpetic neuralgia following manifest herpes zoster affecting the face, become markedly more frequent with age. In general, in the treatment of headaches in the elderly it is essential to pay careful attention to potential interactions with the multiple drugs needed because of other diseases; in addition, the comorbidities themselves have to be taken into account, especially depression, anxiety and cognitive impairment, necessitating multimodal, interdisciplinary therapy plans.

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Lifetime prevalence and concordance risk of cluster headache in the Swedish twin population

Abstract: As many as 1 per 500 of the general population are affected by cluster headache. Twin concordance seems low, but genetic factors may play a role for familial clustering.

Cited by 60 publications

References 35 publications

Headache disorders: differentiating and managing the common subtypes

Headache disorders: differentiating and managing the common subtypes

Epidemiology of cluster headache

Kopfschmerzen im Alter

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