title: Differences in clinical characteristics and frequency of accompanying migraine features in episodic and chronic cluster headache.
abstract: BACKGROUND
  Data on clinical differences between episodic (eCH) and chronic cluster headache (cCH) and accompanying migraine features are limited.
  
  
  METHODS
  History and clinical features of 209 consecutive cluster headache patients (144 eCH, 65 cCH; male:female ratio 3.4 : 1) were obtained in a tertiary headache centre by face-to-face interviews. Relationship between occurrence of accompanying symptoms, pain intensity, comorbid migraine, and circannual and circadian rhythmicity was analysed.
  
  
  RESULTS
  99.5% of patients reported a minimum of one ipsilateral cranial autonomic symptom (CAS); 80% showed at least three CAS. A seasonal rhythmicity was observed in both eCH and cCH. A comorbid headache disorder occurred in 25%. No significant difference was detected between patients with comorbid migraine and without regarding occurrence of phonophobia, photophobia or nausea during cluster attacks. Patients with comorbid migraine reported allodynia significantly (p = 0.022) more often during cluster attacks than patients without comorbid migraine.
  
  
  CONCLUSIONS
  Occurrence of CAS and attack frequency, as well as periodic patterns of attacks, are relatively uniform in eCH and cCH. Multiple CAS are not related to pain intensity. Allodynia during cluster attacks is a frequent symptom. The unexpectedly high rate of accompanying migrainous features during cluster attacks cannot be explained by comorbid migraine.
authors.affiliation: Department of Neurology and Headache Centre, University Duisburg-Essen, Hufelandstrasse 55, 45147 Essen, Germany. Charly.Gaul@gmx.de
authors.forename: C
authors.initials: C
authors.lastname: Gaul
authors.forename: N
authors.initials: N
authors.lastname: Christmann
authors.forename: D
authors.initials: D
authors.lastname: Schröder
authors.forename: R
authors.initials: R
authors.lastname: Weber
authors.forename: H
authors.initials: H
authors.lastname: Shanib
authors.forename: H C
authors.initials: HC
authors.lastname: Diener
authors.forename: D
authors.initials: D
authors.lastname: Holle
mesh_terms: D000328:Adult; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology* / Q000503:physiopathology; D002908:Chronic Disease; D002940:Circadian Rhythm / Q000502:physiology; D003027:Cluster Headache / Q000453:epidemiology* / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D012001:Hyperacusis / Q000453:epidemiology / Q000503:physiopathology; D006930:Hyperalgesia / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology* / Q000503:physiopathology; D020795:Photophobia / Q000453:epidemiology / Q000503:physiopathology; D012621:Seasons; D012720:Severity of Illness Index