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Cluster headache--course over ten years in 189 patients
G C Manzoni1, G Micieli, F Granella
1University Centre for Adaptive Disorders and Headache, Department of Neurology, University of Parma, Italy.
Cephalalgia : an International Journal of Headache
|September 1, 1991
Summary
Cluster headache is a long-term neurological disorder. While episodic cluster headache often worsens, chronic forms may improve, and recovery is not induced by prophylactic drugs.
Area of Science:
- Neurology
- Clinical Medicine
Background:
- Cluster headache is a debilitating neurological disorder characterized by severe head pain.
- Understanding the long-term course and prognosis of cluster headache is crucial for patient management.
Purpose of the Study:
- To investigate the long-term course and outcomes of episodic and chronic cluster headache.
- To identify factors associated with disease progression and remission.
Main Methods:
- Retrospective analysis of 189 cluster headache patients diagnosed between 1976 and 1986.
- Classification of patients into episodic and chronic forms based on disease course during the year of onset.
- Interview-based assessment of disease evolution and outcomes.
Main Results:
- Episodic cluster headache (n=140) predominantly maintained its form (80.7%), with some shifting to chronic (12.9%) or combined (6.4%) patterns.
- Chronic cluster headache (n=49) showed persistence (52.4%), transformation to episodic (32.6%), or combined (14.3%) forms.
- Ten percent of patients achieved remission (no attacks for ≥3 years).
- Factors associated with poor outcome in episodic forms included later onset, male gender, and disease duration over 20 years.
Conclusions:
- Cluster headache is typically a long-duration, potentially lifelong condition.
- Episodic cluster headache tends to progress, while chronic forms may improve to an episodic pattern.
- Prophylactic medications do not appear to induce recovery or remission.