A follow-up study of 60 patients after an assumed first period of cluster headache

During 1981-96 a series of 60 consecutive out-patients was examined in rela tion to an assumed first period of cluster headache (CH). On follow up in 1 998 we found that six were deceased at a mean age of 56.5 years (range 45-7 4 years), of whom one had a definitive CH diagnosis and five had one docume nted headache period only. Six patients were lost to follow up because they could not be reached. In the final group for evaluation (n = 49) it was fo und that 13 (26.5%) patients had had one cluster period only during a mean observation time of 8.9 years. Out of 36 patients with a definitive CH diag nosis according to International Headache Society (IHS) criteria, 31 patien ts had episodic CH, four patients had primary chronic CH and one patient ha d secondary chronic CH. Of the patients with a definitive CH diagnosis, 83% on follow up had had a recurrence of a second period of CH within 3 years or continuous attacks (chronic/semichronic CH) from the onset. Evidently so me patients may suffer from one cluster period only. In our patient materia l only 17% had a second cluster period after 3 years.