Occurrence of Migraine-like features in cluster headache

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Occurrence of Migraine-like features in cluster headache

The sensation of short, painful headaches, at the same time of the day or night for weeks, are indications of cluster headache (CH). In the majority of cases, CH can be treated, if diagnosed correctly; however, right diagnosis is the matter of concern. Certain Migraine-Like Features (MLF) (vomiting, photophobia, phonophobia or nausea etc.) appear along with CH and may delay the diagnosis of CH.

Therefore, to find the precision of the fact, a retrospective cohort study was conducted in an Italian case series of CH patients to investigate the occurrence of MLF and its influence in the clinical phenotype of CH. The patients referred to the Parma Headache Centre between 1975 and 2013 were taken for the study. A total 785 patients were involved in which 569 were men and rest were women. A team of neurologists analyzed the patients by employing ICHD3-beta criteria. Further, patients with one or more migraine like symptoms were classified as CH with MLF. The remaining cases were classified as CH without MLF.

Of 785 patients, MLF was reported in 362 patients only (250 men;112 women) with lower male/female ratio and mean age of headache onset. Rest of 423 patients were diagnosed without MLF. The attack duration of CH was also higher among patients with MLF. But in women with MLF, the number of attacks were lower. In cases of CH sub-type diagnosis, comorbid migraine or a prior head injury existence, CH presence in first-degree relatives, cluster bouts duration and frequency, no significant difference was found. Smoking and alcohol intake was also evaluated among patients. Smoking was less frequent among patients with MLF, on the other hand, no difference was reported in alcohol intake. Moreover, men with MLF exhibited a higher number of cranial autonomic symptoms with the maximum proportion of rhinorrhea, lacrimation, facial sweating, conjunctival injection and miosis. Further, men and women with MLF equally exhibited higher rates of ptosis. Whereas, the rest of the symptoms like pain intensity, pain side and restlessness were equally presented by both MLF and without MLF groups.

Overall, it can be concluded that the CH patients suffering from MLF were significant. Furthermore, MLF is also known to relate to some specific clinical and demographic characteristics of CH patients. However, whether these characteristics affect the diagnosis, therapy remains to be determined.


The journal of headache and pain

Link to the source:


The original title of the article:

Cluster headache with accompanying migraine-like features


Marco Russo et al.

Exploratory, Headache, Migraine, Head, Retrospective cohort study
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