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Episodic Cluster Headache in a Community: Clinical Features and Treatment

Published online by Cambridge University Press:  18 September 2015

C.M. Riess
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
W.J. Becker*
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
M. Robertson
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.
*
Foothills Hospital, 1403 - 29lh Street N.W., Calgary, Alberta, Canada T2N 2T9
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Abstract:

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Objective:

To study the clinical features and treatment given to episodic cluster headache patients in the Calgary region.

Patients:

Fifty-one (51) patients who responded to a media campaign, had previously been diagnosed by their family physicians, and who met International Headache Society (IHS) criteria for episodic cluster headache, formed the population for this study.

Methods:

The media campaign consisted of newspaper advertisements and radio publicity including physician interviews and talk shows. Patients were required to complete a 200-item questionnaire detailing clinical features and treatment of their cluster headache syndrome. Each patient was also interviewed by our research nurse for clarification and proper completion of questionnaire.

Results:

Fifty-one percent (51%) of our patients had short headache attacks lasting one hour or less. Almost one-half (45%) had three or four attacks per 24 hour period. Eighty-six percent (86%) had been referred to a neurologist. Sixty-nine percent (69%) had never used oxygen, but of those who had, onehalf were still using it. Sumatriptan by injection had been tried by 26% of patients and of these, 93% considered it effective. Subcutaneous dihydroergotamine had been tried by 8%. For prophylaxis, 41% had tried methysergide, 31% prednisone, and 4% verapamil. Many patients had been prescribed migraine prophylactic drugs which are ineffective for cluster headache, and some had also undergone dental procedures or nasal and sinus surgeries.

Conclusion:

Many cluster headache patients had not, to their knowledge, been prescribed or used the best symptomatic and prophylactic treatments for cluster headache. This should be addressed through educational programs and through making up-to-date information on the treatment of cluster headache readily available to physicians and patients.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1998

References

REFERENCES

1.Headache Classification Committee of the International Headache Society. Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 1988; 8 (Suppl 7): 3538.Google Scholar
2.Levi, R, Edman, GV, Ekbom, K, Waldenlind, E. Episodic cluster headache II. High tobacco and alcohol consumption in males. Headache 1992,32: 184187.CrossRefGoogle ScholarPubMed
3.Mathew, NT. Cluster headache. Neurology 1992; 42 (Suppl 2): 2231.Google ScholarPubMed
4.Mathew, NT. Advances in cluster headache. Neurol Clin 1990; 8(4): 867890.CrossRefGoogle ScholarPubMed
5.Blau, JN. Behaviour during a cluster headache. Lancet 1993; 342: 723725.CrossRefGoogle ScholarPubMed
6.Solomon, SS, Lipton, RB, Newman, LC. Prophylactic therapy of cluster headaches. Clin Neuropharm 1991; 14(2): 116130.CrossRefGoogle ScholarPubMed
7.Kudrow, L. Diagnosis and treatment of cluster headache. Med Clin North Am 1991; 75(3): 579594.CrossRefGoogle ScholarPubMed
8.Krabbe, AA. Cluster headache: a review. Acta Neurol Scan 1986; 74: 19.CrossRefGoogle ScholarPubMed
9.Kumar, KL, Cooney, TG. Headaches. Med Clin North Am 1995; 79(2): 261286.CrossRefGoogle ScholarPubMed
10.Gabai, IJ, Spierings, ELH. Diagnosis and management of cluster headaches. Nurse Pract 1990; 15(10): 3236.CrossRefGoogle ScholarPubMed
11.Spierings, ELH, Vincent, AJPE. Familial cluster headache: occurrence in three generations. Neurology 1992; 42: 13991400.CrossRefGoogle ScholarPubMed
12.Russell, MB, Andersson, PG, Thomsen, LL. Familial occurrence of cluster headache. J Neurol Neurosurg Psychiatry 1995; 58: 341343.CrossRefGoogle ScholarPubMed
13.Sjaastad, O, Shen, J-M, Stovner, LJ, Elsas, T. Cluster headache in identical twins. Headache 1993; 33: 214217.CrossRefGoogle ScholarPubMed
14.Russell, MB, Andersson, PG, Iselius, L. Cluster headache is an inherited disorder in some families. Headache 1996; 36: 608612.CrossRefGoogle ScholarPubMed
15.Kudrow, L, Kudrow, DB. Inheritance of cluster headache and its possible link to migraine. Headache 1994; 34: 400407.CrossRefGoogle ScholarPubMed
16.Swanson, JW, Yanagihara, T, Stang, PE, et al. Incidence of cluster headaches: a population-based study in Olmstead County, Minnesota. Neurology 1994; 44: 433437.CrossRefGoogle Scholar
17.Kudrow, L. Cluster Headache. Oxford University Press. New York, 1980.Google Scholar
18.McGuigan, JE. Peptic ulcer and gastritis. In: Isselbacher, , Braunwald, , Wilson, et al., eds. Harrison’s Principles of Internal Medicine, Thirteenth Edition. New York, McGraw-Hill Inc., 1994.Google Scholar
19.Fogan, L. Treatment of cluster headache: a double-blind comparison of oxygen vs. air inhalation. Arch Neurol 1985; 42: 362363.CrossRefGoogle Scholar
20.Sabato, FD, Fusco, BM, Pelaia, P. Giacovazzo, M. Hyperbaric oxygen therapy in cluster headache. Pain 1993; 52: 243245.CrossRefGoogle ScholarPubMed
21.Drummond, PD, Anthony, M. Extracranial vascular responses to sublingual nitroglycerin and oxygen inhalation in cluster headache patients. Headache 1985; 25: 7074.CrossRefGoogle ScholarPubMed
22.Silberstein, SD, Schulman, EA, McFadden Hopkins, M. Repetitive intravenous DHE in the treatment of refractory headache. Headache 1990; 30: 334339.CrossRefGoogle ScholarPubMed
23.Mather, PJ, Silberstein, SD, Schulman, EA, McFadden Hopkins, M. The treatment of cluster headache with repetitive intravenous dihydroergotamine. Headache 1991; 31: 525532.CrossRefGoogle ScholarPubMed
24.The Sumatriptan Cluster Headache Study Group. Treatment of acute cluster headache with sumatriptan. N Engl J Med 1991; 325: 322326.CrossRefGoogle Scholar
25.Hardebo, JE. Subcutaneous sumatriptan in cluster headache: a time study of the effect on pain and autonomic symptoms. Headache 1993; 33: 1821.CrossRefGoogle ScholarPubMed
26.Monstad, EK, Prusinski, A, Cole, JA, Pilgrim, AJ, Noronha, D. Subcutaneous sumatriptan in the acute treatment of cluster headache: a dose comparison study. Acta Neurol Scand 1993; 88: 6369.Google Scholar
27.Gabai, IJ, Spierings, ELH. Prophylactic treatment of cluster headache with verapamil. Headache 1989; 29: 167168.CrossRefGoogle ScholarPubMed
28.Sjaastad, O. Cluster headache syndrome. W B Saunders Company Ltd. London, 1992.Google Scholar
29.Green, MW. Cluster headaches. How to recognize and treat them. Post Grad Med 1983; 73(6): 6771.CrossRefGoogle Scholar
30.Bittar, G, Graff-Radford, SB. A retrospective study of patients with cluster headaches. Oral Surg Oral Med Oral Pathol 1992; 73: 519525.CrossRefGoogle ScholarPubMed
31.Heyck, H. “Cluster” – Kopfschmertz (Bing-Horton Syndrom?). Forstschr Neurol Psychiatr 1976; 44: 3750.Google Scholar
32.Nappi, G, Manzoni, GC. Guidelines of Headache. London: John Libbey Eurotext. 1993.Google Scholar