Agneta Snoer1, Nunu Lund2, Rasmus Beske2, Andreas Hagedorn2, Rigmor Højland Jensen2, Mads Barloese2. 1. From the Danish Headache Center, Department of Neurology (A.S., N.L., R.B., A.H., R.J., M.B.), Rigshospitalet-Glostrup, University of Copenhagen; and Department of Clinical Physiology and Nuclear Medicine (M.B.), Center for Functional and Diagnostic Imaging, Hvidovre Hospital, Copenhagen, Denmark. agneta.henriette.snoer.02@regionh.dk. 2. From the Danish Headache Center, Department of Neurology (A.S., N.L., R.B., A.H., R.J., M.B.), Rigshospitalet-Glostrup, University of Copenhagen; and Department of Clinical Physiology and Nuclear Medicine (M.B.), Center for Functional and Diagnostic Imaging, Hvidovre Hospital, Copenhagen, Denmark.
Abstract
OBJECTIVE: To describe the nature, prevalence, and duration of symptoms in the preictal, ictal, and postictal phases of cluster headache (CH) attacks. METHODS: Fifty-seven patients with episodic or chronic CH participated in this prospective, observational study. In a questionnaire concerning 33 CH and migraine-related symptoms, patients reported the clinical features of up to 10 CH attacks/patient. The questionnaire was divided into 3 sections: a preictal phase, ictal phase, and postictal phase. For each phase, patients documented whether the given symptom was present, and if possible estimated the duration of the symptom. RESULTS: In total, 500 CH attack descriptions were obtained. In the preictal phase, general symptoms (most frequently concentration difficulties, restlessness, and mood changes) occurred 20 minutes prior to 46.0% of attacks. Local painful and autonomic symptoms were observed 10 minutes prior to 54.6% and 35% of attacks, respectively. Postictally, pain and autonomic symptoms resolved over 20 minutes, leaving patients with fatigue (36.2%), decreased energy (39.0%), and concentration difficulties (27.6%), lasting a median of 60 minutes. CONCLUSIONS: Preictal and postictal symptoms are very frequent in CH, demonstrating that CH attacks are not composed of a pain phase alone. Since the origin of CH attacks is unresolved, studies of preictal and postictal symptoms could contribute to the understanding of CH pathophysiology and, potentially, early, abortive treatment strategies.
OBJECTIVE: To describe the nature, prevalence, and duration of symptoms in the preictal, ictal, and postictal phases of cluster headache (CH) attacks. METHODS: Fifty-seven patients with episodic or chronic CH participated in this prospective, observational study. In a questionnaire concerning 33 CH and migraine-related symptoms, patients reported the clinical features of up to 10 CH attacks/patient. The questionnaire was divided into 3 sections: a preictal phase, ictal phase, and postictal phase. For each phase, patients documented whether the given symptom was present, and if possible estimated the duration of the symptom. RESULTS: In total, 500 CH attack descriptions were obtained. In the preictal phase, general symptoms (most frequently concentration difficulties, restlessness, and mood changes) occurred 20 minutes prior to 46.0% of attacks. Local painful and autonomic symptoms were observed 10 minutes prior to 54.6% and 35% of attacks, respectively. Postictally, pain and autonomic symptoms resolved over 20 minutes, leaving patients with fatigue (36.2%), decreased energy (39.0%), and concentration difficulties (27.6%), lasting a median of 60 minutes. CONCLUSIONS: Preictal and postictal symptoms are very frequent in CH, demonstrating that CH attacks are not composed of a pain phase alone. Since the origin of CH attacks is unresolved, studies of preictal and postictal symptoms could contribute to the understanding of CH pathophysiology and, potentially, early, abortive treatment strategies.
Authors: Henrik W Schytz; Faisal M Amin; Rigmor H Jensen; Louise Carlsen; Stine Maarbjerg; Nunu Lund; Karen Aegidius; Lise L Thomsen; Flemming W Bach; Dagmar Beier; Hanne Johansen; Jakob M Hansen; Helge Kasch; Signe B Munksgaard; Lars Poulsen; Per Schmidt Sørensen; Peter T Schmidt-Hansen; Vlasta V Cvetkovic; Messoud Ashina; Lars Bendtsen Journal: J Headache Pain Date: 2021-04-08 Impact factor: 7.277
Authors: Mathias De Brouwer; Nicolas Vandenbussche; Bram Steenwinckel; Marija Stojchevska; Jonas Van Der Donckt; Vic Degraeve; Jasper Vaneessen; Filip De Turck; Bruno Volckaert; Paul Boon; Koen Paemeleire; Sofie Van Hoecke; Femke Ongenae Journal: BMC Med Inform Decis Mak Date: 2022-03-31 Impact factor: 2.796
Authors: J C A Edvinsson; A Viganò; A Alekseeva; E Alieva; R Arruda; C De Luca; N D'Ettore; I Frattale; M Kurnukhina; N Macerola; E Malenkova; M Maiorova; A Novikova; P Řehulka; V Rapaccini; O Roshchina; G Vanderschueren; L Zvaune; A P Andreou; K A Haanes Journal: J Headache Pain Date: 2020-06-05 Impact factor: 8.588