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Diagnostic Delay and Its Predictors in Cluster Headache
Byung-Su Kim1, Pil-Wook Chung2, Byung-Kun Kim3
1Department of Neurology, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, South Korea.
Frontiers in Neurology
|February 28, 2022
Summary
Younger patients with cluster headache (CH) face longer diagnostic delays, impacting their disease burden. Improved diagnostic criteria and education have reduced delays over time.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Cluster headache (CH) is a rare, debilitating primary headache disorder.
- Delayed diagnosis of CH exacerbates patient suffering and disease burden.
Purpose of the Study:
- To investigate the diagnostic delay in cluster headache patients.
- To identify predictors of diagnostic delay and its clinical impact.
Main Methods:
- Analysis of data from a 4-year prospective multicenter CH registry.
- Diagnosis of CH based on International Classification of Headache Disorders (ICHD)-3 criteria.
- Assessment of diagnostic delay as time from onset to diagnosis, categorized into tertiles.
Main Results:
- Mean diagnostic delay was 5.7 years; younger patients (<20 years) had higher delays.
- Episodic, chronic, and probable CH were associated with longer diagnostic delays.
- Increased diagnostic delay correlated with higher prevalence of suicidal ideation and HIT-6 scores.
Conclusions:
- Younger age of onset is a significant predictor of delayed CH diagnosis.
- Improved diagnostic criteria (ICHD) and patient education have reduced diagnostic delays over time.
- Reducing diagnostic delay is crucial for mitigating the disease burden of cluster headache.
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