title: Clinical profile of cluster headaches in China - a clinic-based study.
abstract: BACKGROUND
  The clinical profile of cluster headache in Chinese patients have not been fully studied.
  
  
  METHODS
  The classification and clinical features of 120 consecutive patients with cluster headache (105 males, 15 females; mean age, 34.9 ± 10.5 years) visiting at International Headache Center from May 2010 to August 2012 were analyzed.
  
  
  RESULTS
  Patients came from 16 different regions of China. Mean age at onset of cluster headache was 26.7 ± 10.9 years. Only 13 patients (10.8%) had previously been diagnosed with cluster headache. Mean time to diagnosis from first symptoms was 8.2 ± 7.1 years (range, 0-35 years). Chronic cluster headache was observed in only 9 patients (7.5%). The most commonly reported location of cluster headache was temporal region (75.0%), followed by retro-orbital region (68.3%), forehead (32.5%), vertex (32.5%) and occipital (22.5%). Lacrimation was the most consistently reported autonomic feature (72.5%). During acute attacks, 60.0% of patients experienced nausea, and 41.7% experienced photophobia and 40.8% experienced phonophobia. In addition, 38.3% reported restless behavior and 45.8% reported that physical activity exacerbated the pain. None of patients experienced visual or other kinds of aura symptoms before cluster attacks. We found that 38.3% of patients had <1 cluster period and 35.8% for 1-2 cluster periods per year with these periods occurring less frequently during the summer than during other seasons. Cluster duration was 1-2 months in 32.5% of patients. During cluster periods, 73.3% of patients had 1-2 attacks per day, and 39.2% experienced cluster attacks ranging in duration from 1 h to less than 2 h. The duration of attacks were 1.5 (1-2.25) hours for males and 1.5 (1-3) for females respectively. The World Health Organization quality of life-8 questionnaire showed that cluster headache reduced life quality.
  
  
  CONCLUSIONS
  Compared to Western patients, Chinese patients showed a relatively low prevalence of chronic cluster headaches, pain sites mainly focused on areas distributed by the first division of the trigeminal nerve, a low frequency of restlessness and absent aura. These clinical features may be more common in Eastern populations, including mainland Chinese, Japanese and Taiwanese patients, than in Western patients.
authors.affiliation: International Headache Center, Department of Neurology, Chinese PLA General Hospital, Fuxing Road 28 Haidian District, Beijing 100853, China.
authors.forename: Zhao
authors.initials: Z
authors.lastname: Dong
authors.forename: Hai
authors.initials: H
authors.lastname: Di
authors.forename: Wei
authors.initials: W
authors.lastname: Dai
authors.forename: Meiyan
authors.initials: M
authors.lastname: Pan
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
authors.forename: Jingyao
authors.initials: J
authors.lastname: Liang
authors.forename: Mingjie
authors.initials: M
authors.lastname: Zhang
authors.forename: Zhibin
authors.initials: Z
authors.lastname: Zhou
authors.forename: Ruozhuo
authors.initials: R
authors.lastname: Liu
authors.forename: Shengyuan
authors.initials: S
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003027:Cluster Headache / Q000145:classification / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D055815:Young Adult