Diagnostic delay of cluster headache: A cohort study from the Danish Cluster Headache Survey

Cephalalgia ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Hans-Henrik Frederiksen ◽  
Nunu LT Lund ◽  
Mads CJ Barloese ◽  
Anja S Petersen ◽  
Rigmor H Jensen
Keyword(s):  
Cluster Headache ◽  
Age Of Onset ◽  
Diagnostic Delay ◽  
Onset Age ◽  
Independent Variables ◽  
Disease Awareness ◽  
Headache Onset ◽  
Diagnostic Pitfalls ◽  
Headache Patients ◽  
Demographic Features

Aim To investigate the influence of clinical and demographic features on diagnostic delay in cluster headache patients, in order to discuss diagnostic pitfalls and raise disease awareness. Methods A large, well-characterized cohort of 400 validated cluster headache patients from the Danish Cluster Headache Survey, diagnosed according to ICHD-II, were investigated. ANOVA was applied to investigate differences in diagnostic delay between groups. Selected independent variables were assessed in relation to diagnostic delay using a gamma regression model. Results Diagnostic delay was significantly reduced for each decade of cluster headache onset from 1950–2010 ( p < 0.001). Onset after 1990 was associated with shorter diagnostic delay (OR = 0.28, p < 0.001), whereas attack duration > 180 minutes (OR = 1.62, p < 0.034), migraine-like features (OR = 1.30, p < 0.043) and nocturnal attacks (OR = 1.39, p < 0.021) were associated with prolonged diagnostic delay. Further, diagnostic delay decreased with age of onset (age < 20: 13.8 years, age 20–40: 5.4 years and age > 40: 2.1 years, p < 0.001). Conclusion Diagnostic delay was reduced for every decade investigated, whereas some atypical cluster headache features were associated with prolonged diagnostic delay. Better medical education and more disease awareness are needed to prevent misdiagnosis and prolonged diagnostic delay.

Old Age of Onset in Cluster‐Headache Patients

2005 ◽  
Vol 45 (5) ◽  
pp. 615-616 ◽  
Author(s):  
Marthe Fischera ◽  
Kerstin Anneken ◽  
Stefan Evers
Keyword(s):  
Cluster Headache ◽  
Old Age ◽  
Age Of Onset ◽  
Headache Patients

Cluster headache: Is age of onset important for clinical presentation?

Cephalalgia ◽  
2014 ◽  
Vol 34 (9) ◽  
pp. 664-670 ◽  
Author(s):  
Jasna Zidverc-Trajkovic ◽  
Kristina Markovic ◽  
Aleksandra Radojicic ◽  
Ana Podgorac ◽  
Nadezda Sternic
Keyword(s):  
Cluster Headache ◽  
Age Of Onset ◽  
Late Onset ◽  
Nasal Congestion ◽  
Demographic Data ◽  
Correct Diagnosis ◽  
Diagnostic Delay ◽  
Age Groups ◽  
Point Of View ◽  
Cross Sectional

Background The age of onset of cluster headache (CH) attacks most commonly is between 20 and 40 years old, although CH has been reported in all age groups. There is increasing evidence of CH with early or late onset and a different course of the disorder. The aim of the study was to analyze the influence of the age of onset on clinical features, disorder course, and therapy effectiveness in CH patients. Methods A retrospective and cross-sectional analysis was performed on 182 CH patients divided into three groups according to the age of onset. The first group consisted of patients with the first CH attack before 20 years of age, the second group was patients with age of onset between 20 and 40 years of age, and the third group was patients with age of onset after 40 years of age. Demographic data, features of CH periods and attacks, and the response to standardized treatment were compared among the groups. Results Patients with CH onset after 40 years of age reported a lower number of autonomic features and less frequently had conjunctival injection and nasal congestion/rhinorrhea phenomena during their attacks. Diagnostic delay was the longest in the patients with CH onset before 20 years of age. Conclusion The influence of the age of onset of CH is intriguing for further studies and could possibly extend the knowledge about CH pathophysiology. From a clinical point of view, the differences in CH presentation are insufficient to preclude a correct diagnosis and treatment because the same criteria could be applied regardless of patient age.

Vidian Neurectomy for Management of Chronic Cluster Headache

Neurosurgery ◽  
2018 ◽  
Vol 84 (5) ◽  
pp. 1059-1064 ◽  
Author(s):  
Shao-Cheng Liu ◽  
Ming-Chang Kao ◽  
Yun-Chen Huang ◽  
Wan-Fu Su
Keyword(s):  
Cluster Headache ◽  
Chronic Cluster Headache ◽  
Preliminary Evaluation ◽  
Sphenopalatine Ganglion ◽  
Attack Frequency ◽  
Pain Disability Index ◽  
Pain Disability ◽  
Vidian Neurectomy ◽  
Headache Onset ◽  
Attack Intensity

Abstract BACKGROUND Management of chronic cluster headache (CCH) remains a challenging endeavor, and the optimal surgical approach for medically refractory CCH remains controversial. OBJECTIVE To conduct a preliminary evaluation of the efficacy and safety of vidian neurectomy (VN) in patients with medically refractory CCH. METHODS Between March 2013 and December 2015, 9 CCH patients, all of whom had failed to respond to conservative therapy, underwent VN with a precise nerve cut and maximal preservation of the sphenopalatine ganglion. Data included demographic variables, cluster headache onset and duration, mean attack frequency, mean attack intensity, and pain disability index measures pre- and through 12-mo postsurgery. RESULTS Seven of the 9 cases (77.8%) showed immediate improvement. Improvement was delayed by 1 mo in 1 patient, after which the surgical effects of pain relief were maintained throughout the follow-up period. One patient (11.1%) did not improve after surgery. One year after VN, patients’ mean attack frequency, mean attack intensity, and pain disability index decreased by 54.5%, 52.9%, and 56.4%, respectively. No patient experienced treatment-related side effects or complications. CONCLUSION VN is an effective treatment method for CCH patients. Precise Vidian nerve identification and maximal preservation of the sphenopalatine ganglion may achieve good surgical outcomes and dramatically improve quality of life among patients, without significant adverse events.

Somatosensory Evoked Potentials In Cluster Headache Patients Under Histamine Stimulation

Cephalalgia ◽  
1987 ◽  
Vol 7 (6_suppl) ◽  
pp. 347-348
Author(s):  
V. Gallai ◽  
C. Firenze ◽  
L. Mattelli ◽  
G. Mazzotta ◽  
F. Del Gatto
Keyword(s):  
Cluster Headache ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Histamine Stimulation ◽  
Headache Patients

scholarly journals Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study

BMC Neurology ◽  
2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Delphine Magis ◽  
Marie-Aurélie Bruno ◽  
Arnaud Fumal ◽  
Pierre-Yves Gérardy ◽  
Roland Hustinx ◽  
...  
Keyword(s):  
Cluster Headache ◽  
Nerve Stimulation ◽  
Fdg Pet ◽  
Occipital Nerve Stimulation ◽  
Occipital Nerve ◽  
Headache Patients

scholarly journals A Natural History Comparison of SOD1-Mutant Patients with Amyotrophic Lateral Sclerosis between Chinese and German Populations

2021 ◽  
Author(s):  
Lu Tang ◽  
Johannes Dorst ◽  
Lu Chen ◽  
Xiaolu Liu ◽  
Yan Ma ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Large Scale ◽  
Age Of Onset ◽  
Diagnostic Delay ◽  
Chinese Patients ◽  
Common Mutation ◽  
Progression Rate ◽  
Causative Gene ◽  
Sod1 Mutant ◽  
Lateral Sclerosis

Abstract Background: The gene coding the Cu/Zn superoxide dismutase ( SOD1 ) was the first-identified causative gene of amyotrophic lateral sclerosis (ALS), and the second most common genetic cause for ALS worldwide. The promising therapeutic approaches targeting SOD1 mutations are on the road. The purpose of the present study was to compare the mutational and clinical features of Chinese and German patients with ALS carrying mutations in SOD1 gene, which will facilitate the strategy and design of SOD1 -targeted trials.Methods: Demographic and clinical characteristics were collected from two longitudinal cohorts in China and Germany. Chinese and German patients carrying SOD1 mutations were compared with regard to mutational distribution, age of onset, site of onset, body mass index (BMI) at diagnosis, diagnostic delay, progression rate, and survival.Results: A total of 66 Chinese and 84 German patients with 69 distinct SOD1 mutations were identified. The most common mutation in both populations was p.His47Arg. It was found in 8 Chinese and 2 German patients and consistently showed a slow progression of disease in both countries. Across all mutations, Chinese patients showed a younger age of onset (43.9 vs 49.9 years, p=0.002), a higher proportion of young-onset cases (62.5% vs 30.7%, p<0.001) and a lower BMI at diagnosis (22.8 vs 26.0, p<0.001) compared to German patients. Although riluzole intake was less frequent in Chinese patients (28.3% vs 81.3%, p<0.001), no difference in survival between populations was observed (p=0.90). Across both cohorts, female patients had a longer diagnostic delay (15.0 vs 11.0 months, p=0.01) and a prolonged survival (248.0 vs 60.0 months, p=0.005) compared to male patients.Conclusions: Our data demonstrate the distinct mutational and clinical spectrums of SOD1 -mutant patients in Asian and European populations. Clinical phenotypes seem to be primarily influenced by mutation-specific, albeit not excluding ethnicity-specific factors. Further large-scale transethnical studies are needed to clarify determinants and modifiers of SOD1 phenotypes.

scholarly journals Association between family history and the onset age of essential hypertension in Han population in Shanghai China

2019 ◽  
Author(s):  
li anle ◽  
Qian Peng ◽  
Yue Qin Shao ◽  
Yi Ying Zhang ◽  
Fang Xiang
Keyword(s):  
Essential Hypertension ◽  
Family History ◽  
Genetic Factors ◽  
Nuclear Family ◽  
Age Of Onset ◽  
Control Group ◽  
Case Group ◽  
Onset Age ◽  
Han Population ◽  
The Difference

Abstract Importance Genetic factors are important influencing factors of essential hypertension, and family history (FH) is an important marker of genetic factors. Objective To explore the association between family history and the onset age of essential hypertension in Han population in Shanghai China. Methods According to l:l matched pairs design，342 precursor of hypertension and 342 controls were selected and investigate their nuclear family members in the case-control study. The diagnostic information of hypertension in all relatives of these two groups was investigated. The method of genetic epidemiology research was used to explore the effect of family history. Results The average prevalence of hypertension was 23.32%. The prevalence of hypertension of first-degree relatives was 33.99%; the prevalence of second- degree relatives was 17.60%; the prevalence of third-degree relatives was 13.51%. All prevalence of hypertension of case group relatives were significantly higher than that of control group relatives. The average onset age in population with positive FH is 48.74±11.16 years old, and the average onset age in population with negative FH is 54.38±9.87 years old. The difference about two FH groups showed statistically significant (t=4.589, P<0.001). The average onset age of offspring with father, mother, grandpa, grandma, maternal grandpa or maternal grandma positive was respectively 48.42± 11.16, 49.16±11.12, 39.55±11.95, 39.88±11.90, 43.67±9.77 or 43.64±10.21 years old; and the average onset age of children with father, mother, grandpa, grandma, maternal grandpa or maternal grandma negative was respectively 51.90± 10.81, 51.17±11.04, 51.07±10.59, 51.08±10.60, 50.50±11.09 or 50.57±11.06 years old. The difference about two groups showed statistically significant. Conclusion Family history has a positive effect on the occurrence of hypertension, and lead to earlier age of onset of offspring. The effects are different among parent and grandparent in Han in Shanghai China.

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