Cluster headache beyond the pain phase: A prospective study of 500 attacks

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Cluster headache beyond the pain phase: A prospective study of 500 attacks
Key Take-Away: 

A cluster headache, a destructive trigeminal autonomic cephalalgia is responsible for causing severe unilateral periorbital or temporal pain that can last for about 15 minutes to 3 hours. But it is not the only pain which is the characterization of CH, many other manifestations like preictal, ictal, and postictal as well occur along with pain. The study involves the illustration of these symptoms nature, prevalence and duration among CH patients.

To illustrate the prevalence, duration of symptoms and nature in the preictal, ictal, and postictal phases of a cluster headache (CH).


A prospective, observational study with fifty-seven patients with episodic or chronic CH was conducted. The patients described the clinical characteristics of up to 10 CH attacks/patient as per a questionnaire involving 33 CH and migraine-related symptoms. This questionnaire divided into a preictal phase, ictal phase, and postictal phase. All patients were documented whether the provided symptom was present and if possible evaluated the span of the manifestation for each phase.


A total of 500 CH attack reports were collected. Patients in the preictal phase showed common symptoms like mood change, concentration difficulties and restlessness occurred 20 min before 46.0% of attacks. Autonomic and local painful symptoms were seen 10 minutes before 35% and 54.6% of attacks, respectively. Patients in the postictal phase resolved pain and autonomic symptoms over 20 minutes along with side effects; decreased energy (39.0%), concentration difficulties (27.6%) and fatigue (36.2%) last for about 60 minutes.


Preictal and postictal symptoms are prevalent in CH, describing that CH attacks are not composed of a pain condition alone. Considering the introduction of CH attacks is unsolved, studies of preictal and postictal symptoms could contribute to the perception of CH pathophysiology and, possibly, early, abortive treatment approaches.



Link of the source:

Original title of article:

Cluster headache beyond the pain phase: A prospective study of 500 attacks.


Agneta Snoer et al.

Exploratory, Cluster Headache, Head, Prospective Study
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