J Clin Neurol.  2019 Jul;15(3):334-338. 10.3988/jcn.2019.15.3.334.

Differences in Characteristics and Comorbidity of Cluster Headache According to the Presence of Migraine

Affiliations
  • 1Department of Neurology, Ewha Womans University College of Medicine, Seoul, Korea.
  • 2Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Neurology, Presbyterian Medical Center, Jeonju, Korea.
  • 4Department of Neurology, Eulji Hospital, Eulji University, Seoul, Korea.
  • 5Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 6Department of Neurology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Korea.
  • 7Department of Neurology, Severance Hospital, Seoul, Korea.
  • 8Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
  • 9Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
  • 10Department of Neurology, Korea University College of Medicine, Seoul, Korea.
  • 11Department of Neurology, Chungnam National University College of Medicine, Daejeon, Korea.
  • 12Department of Neurology, Gyeongsang National University College of Medicine, Jinju, Korea.
  • 13Department of Neurology, Chung-Ang University Hospital, Seoul, Korea.
  • 14Department of Neurology, Inje University College of Medicine, Seoul, Korea.
  • 15Department of Neurology, Seoul Medical Center, Seoul, Korea. dowonc@naver.com
  • 16Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea. neuroahn@naver.com

Abstract

BACKGROUND
AND PURPOSE: Cluster headache (CH) can present with migrainous symptoms such as nausea, photophobia, and phonophobia. In addition, an overlap between CH and migraine has been reported. This study aimed to determine the differences in the characteristics of CH according to the presence of comorbid migraine.
METHODS
This study was performed using data from a prospective multicenter registry study of CH involving 16 headache clinics. CH and migraine were diagnosed by headache specialists at each hospital based on third edition of the International Classification of Headache Disorders (ICHD-3). We interviewed patients with comorbid migraine to obtain detailed information about migraine. The characteristics and psychological comorbidities of CH were compared between patients with and without comorbid migraine.
RESULTS
Thirty (15.6%) of 192 patients with CH had comorbid migraine, comprising 18 with migraine without aura, 1 with migraine with aura, 3 with chronic migraine, and 8 with probable migraine. Compared to patients with CH without migraine, patients with CH with comorbid migraine had a shorter duration of CH after the first episode [5.4±7.4 vs. 9.0±8.2 years (mean±standard deviation), p=0.008], a lower frequency of episodic CH (50.0% vs. 73.5%, p=0.010), and a higher frequency of chronic CH (13.3% vs. 3.7%, p=0.033). Psychiatric comorbidities did not differ between patients with and without comorbid migraine. The headaches experienced by patients could be distinguished based on their trigeminal autonomic symptoms, pulsating character, severity, and pain location.
CONCLUSIONS
Distinct characteristics of CH remained unchanged in patients with comorbid migraine with the exception of an increased frequency of chronic CH. The most appropriate management of CH requires clinicians to check the history of preceding migraine, particularly in cases of chronic CH.

Keyword

chronic cluster headache; cluster headache; comorbidity; migraine; treatment
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