Cluster headache without autonomic symptoms: why is it different?
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Published on: June 2, 2014
Isabel P Martins1, Raquel G Gouveia, Elsa Parreira
1Centro de Estudos Egas Moniz, Instituto de Medicina Molecular, Lisbon Faculty of Medicine, Hospital de Santa Maria, Lisboa, Portugal.
Background:
Some patients with otherwise typical cluster headache (CH) have persistent attacks free of cranial autonomic symptoms (CAS). The factors responsible for this atypical presentation are not known.
Objectives:
To identify factors associated to the absence of CAS in patients with CH.
Methods:
A prospective series of 157 patients with the diagnosis of CH was analyzed, comparing 148 typical CH patients with 9 CH patients without CAS.
Results:
Patients without CAS reported significantly less intense attacks (P = .003) when compared to those with CAS. There was also a tendency (not reaching statistical significance) for a higher frequency of females and chronic CH among those without CAS. Otherwise, there were no differences between the two groups (in age, duration of illness, follow-up time, attack duration or frequency, nor side or site of pain). A logistic regression analysis showed that only pain intensity could explain the difference between the two groups, since the other explanatory variables were also associated with different intensity of attacks.
Conclusions:
These results support the hypothesis that CH without cranial autonomic symptoms represents a milder form of CH.
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