COEXISTENCE OF MIGRAINE AND CLUSTER HEADACHE - REPORT OF 10 CASES ANDPOSSIBLE PATHOGENETIC IMPLICATIONS

We report on 10 patients suffering from two types of primary headache, migraine and cluster, diagnosed according to IHS criteria, end select ed from headache patients attending two Italian headache centers. We b riefly review the literature on coexisting migraine and cluster headac he, considering the time relationships between these two headaches. Th e present series seems not to confirm the hypothesis that migraine tra nsforms into cluster headache since both headaches persist together in the patients. The series is of clinical interest particularly with re gard to diagnosis and to treatment strategies. Furthermore. while migr aine and cluster headache comorbidity must be confirmed by population- based epidemiological studies, the possibility arises that the two con ditions may be linked pathophysiologically: common genetic factors or functional alterations in the same central neurological circuits may p lay a role in the pathogenesis of both disorders.