Clinical characteristics of pre-attack symptoms in cluster headache: A large series of Korean patients,Cephalalgia

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Clinical characteristics of pre-attack symptoms in cluster headache: A large series of Korean patients
Cephalalgia ( IF 4.9 ) Pub Date : 2020-10-21 , DOI: 10.1177/0333102420966983
Soohyun Cho ₁ , Soo-Jin Cho ₂ , Mi Ji Lee ₃ , Jeong Wook Park ₄ , Min Kyung Chu ₅ , Heui-Soo Moon ₆ , Pil-Wook Chung ₆ , Jong-Hee Sohn ₇ , Byung-Su Kim ₈ , Daeyoung Kim ₉ , Jae-Moon Kim ₉ , Jae Myun Chung ₁₀ , Kyungmi Oh ₁₁ , Jin-Young Ahn ₁₂ , Chin-Sang Chung ₃ , Byung-Kun Kim ₁

Affiliation

Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Neurology, Uijeongbu St. Mary's Hospital, Catholic University of Korea College of Medicine, Uijeongbu, Korea.
Department of Neurology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Neurology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
Department of Neurology, Chungnam National University College of Medicine, Daejeon, Korea.
Department of Neurology, Inje University College of Medicine, Seoul, South Korea.
Department of Neurology, Korea University College of Medicine, Seoul, Korea.
Department of Neurology, Seoul Medical Center, Seoul, Korea.

Background

Previous studies have reported notable differences in demographic and clinical features of cluster headache between Western and Asian populations, including lower prevalence of the chronic type and in women. Recently, prodromal symptoms of migraine and pre-attack symptoms of cluster headache have drawn attention regarding their potential pathophysiological implications and pre-emptive treatment. However, pre-attack symptoms of cluster headache have not been studied in the Asian population.

Methods

A total of 136 patients with cluster headache (21 first-onset, 110 episodic, and five chronic cases) were recruited in this multi-center study between October 2018 and December 2019. We evaluated the characteristics of pre-attack symptoms in a current bout using a structured questionnaire. Univariable and multivariable logistic regression analyses were performed to evaluate the factors associated with presence of pre-attack symptoms.

Results

Pre-attack symptoms were reported in 71.3% of our patients with cluster headache. When present, pre-attack symptoms occurred at a median of 20 minutes (range 1–120) before the attack. The prevalence of local and painful, local and painless sensory, autonomic, and general symptoms was 58.8%, 14.7%, 11.0%, and 30.1%, respectively. Multivariable logistic regression analysis revealed that higher number of bouts was associated with higher prevalence of pre-attack symptoms (OR = 1.464, p = 0.044).

Conclusions

Pre-attack symptoms were frequently observed in Korean patients with cluster headache, which was consistent with previous Western studies.

中文翻译：

丛集性头痛发作前症状的临床特征：韩国大系列患者

背景

先前的研究报告了西方和亚洲人群丛集性头痛的人口统计学和临床特征的显着差异，包括慢性类型和女性的患病率较低。最近，偏头痛的前驱症状和丛集性头痛的发作前症状引起了人们对其潜在病理生理意义和先发制人治疗的关注。然而，尚未在亚洲人群中研究丛集性头痛的发作前症状。

方法

2018 年 10 月至 2019 年 12 月期间，这项多中心研究共招募了 136 名丛集性头痛患者（21 名首发、110 名发作性和 5 名慢性病例）。我们评估了当前发作中发作前症状的特征使用结构化问卷。进行单变量和多变量逻辑回归分析以评估与发作前症状存在相关的因素。

结果

71.3% 的丛集性头痛患者报告了发作前症状。当出现时，发作前症状发生在发作前的中位数 20 分钟（范围 1-120）。局部和疼痛、局部和无痛感觉、自主神经和全身症状的患病率分别为 58.8%、14.7%、11.0% 和 30.1%。多变量逻辑回归分析显示，较高的发作次数与较高的发作前症状发生率相关（OR = 1.464，p = 0.044）。