EPISODIC CLUSTER HEADACHE IN A COMMUNITY - CLINICAL-FEATURES AND TREATMENT

Objective: To study the clinical features and treatment given to episo dic cluster headache patients in the Calgary region. Patients: Fifty-o ne (51) patients who responded to a media campaign, had previously bee n diagnosed by their family physicians, and who met International Head ache Society (IHS) criteria for episodic cluster headache, formed the population for this study. Methods: The media campaign consisted of ne wspaper advertisements and radio publicity including physician intervi ews and talk shows. Patients were required to complete a 200-item ques tionnaire detailing clinical features and treatment of their cluster h eadache syndrome. Each patient was also interviewed by our research nu rse for clarification and proper completion of questionnaire. Results: Fifty-one percent (51%) of our patients had short headache attacks la sting one hour or less. Almost one-half (45%) had three or four attack s per 24 hour period. Eighty-six percent (86%) had been referred to a neurologist. Sixty-nine percent (69%) had never used oxygen, but of th ose who had, one-half were still using it. Sumatriptan by injection ha d been tried by 26% of patients and of these, 93% considered it effect ive. Subcutaneous dihydroergotamine had been tried by 8%. For prophyla xis, 41% had tried methysergide, 31% prednisone, and 4% verapamil. Man y patients had been prescribed migraine prophylactic drugs which are i neffective for cluster headache, and some had also undergone dental pr ocedures or nasal and sinus surgeries. Conclusions: Many cluster heada che patients had not, to their knowledge, been prescribed or used the best symptomatic and prophylactic treatments for cluster headache. Thi s should be addressed through educational programs and through making up-to-date information on the treatment of cluster headache readily av ailable to physicians and patients.