Abstract
Objective: To determine the temporal changes of headache characteristics and the pattern of remission in cluster headache.
Background: There is little knowledge about the natural course of cluster headache, especially the age, pattern and characteristics of remission.
Design/Methods: We screened patients who were diagnosed with CH in Samsung Medical Center between 1997 and 2010. Patients who 1) have agreed to collect personal information, and 2) lost follow-up at least for 5 years were considered eligible for the study. Eligible patients were contacted via telephone or cellular phone. Headache characteristics and temporal changes during the disease course were interviewed.
Remission was defined with two of the followings: 1) symptom-free for more than twice of the longest interval of bouts, and 2) symptom-free for the past 5 years.
Results: Finally, 42 patients were included in the analysis. Strictly unilateral location was reported in 40 (95.0%) at initial visit, but decreased to 22 (77.8%) during the disease course. Circadian and circannual rhythmicity was present in 23 (62.2%) and 23 (63.9%) at baseline, but decreased to 15 (40.5%) and 17 (48.6%) during the disease course. Autonomic symptom was prominent in 35 (100%) at initial visit, but 27 (77.1%) at the follow-up. Final course was determined as active (n=28, 66.7%) and remission (n=14, 33.3%), while no chronification was identified. In remitted patients, their last bouts occurred at median age of 38 (range, 36–52) years. Patients with remission were older and had a shorter disease duration than the active group. Remitted patients had less prominent circannual and circadian rhythmicity at baseline. There were no uniform pattern of remission.
Conclusions: Distinct features of cluster headache decrease with time. Although there was no single predictor of remission, patients with remission had less circadian and circannual rhythmicities and suffered less bouts in a reduced disease course. Pattern of remission was diverse.
Disclosure: Dr. Lee has nothing to disclose. Dr. Choi has nothing to disclose. Dr. Shin has nothing to disclose. Dr. Park has nothing to disclose. Dr. Chung has nothing to disclose.
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Use of Whole-Genome Sequencing for Mitochondrial Disease Diagnosis
Dr. Robert Pitceathly and Dr. William Macken