Episodic cluster headache in a community: clinical features and treatment.
OBJECTIVE
To study the clinical features and treatment given to episodic cluster headache patients in the Calgary region.


METHODS
Fifty-one (51) patients who responded to a media campaign, had previously been diagnosed by their family physicians, and who met International Headache Society (IHS) criteria for episodic cluster headache, formed the population for this study.


METHODS
The media campaign consisted of newspaper advertisements and radio publicity including physician interviews and talk shows. Patients were required to complete by 200-item questionnaire detailing clinical features and treatment of their cluster headache syndrome. Each patient was also interviewed by our research nurse for clarification and proper completion of questionnaire.


RESULTS
Fifty-one percent (51%) of our patients had short headache attacks lasting one hour or less. Almost one-half (45%) had three or four attacks per 24 hour period. Eighty-six percent (86%) had been referred to a neurologist. Sixty-nine percent (69%) had never used oxygen, but of those who had, one-half were still using it. Sumatriptan by injection had been tried by 26% of patients and of these, 93% considered it effective. Subcutaneous dihydroergotamine had been tried by 8%. For prophylaxis, 41% had tried methysergide, 31% prednisone, and 4% verapamil. Many patients had been prescribed migraine prophylactic drugs which are ineffective for cluster headache, and some had also undergone dental procedures or nasal and sinus surgeries.


CONCLUSIONS
Many cluster headache patients had not, to their knowledge, been prescribed or used the best symptomatic and prophylactic treatments for cluster headache. This should be addressed through educational programs and through making up-to-date information on the treatment of cluster headache readily available to physicians and patients.
Riess
C M
CM
Department of Clinical Neurosciences, University of Calgary, Canada.
Becker
W J
WJ
Robertson
M
M
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage; D003027:Cluster Headache / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D004087:Dihydroergotamine / Q000008:administration & dosage*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000008:administration & dosage; D010820:Physicians / Q000706:statistics & numerical data; D011788:Quality of Life; D012890:Sleep; D018170:Sumatriptan / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D014081:Tooth Extraction; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D000700:Analgesics; D014662:Vasoconstrictor Agents; D004087:Dihydroergotamine; D018170:Sumatriptan; D010100:Oxygen