Cluster-Tic Syndrome
Between April and July 2010, a total of 437 subjects filled out the LUCA questionnaire. A total of 291 subjects were finally contacted for a telephone interview and included in the study, and 244 patients received a final cluster headache diagnosis based on the ICHD-2 criteria. Baseline characteristics of 291 included patients were compared with 146 excluded patients. Interviewed subjects were significantly older (P = .018), but absolute differences were small (47.3 vs 44.5 years). There were no significant differences with respect to gender, episodic or chronic cluster headache, proportions of patients using anticluster headache medication (prophylactic and acute), or the proportion of patients with a physician diagnosis of cluster headache. Eleven subjects (4.5%) of these 244 cluster headache patients also met ICHD-2 criteria for trigeminal neuralgia (Table 2).
Trigeminal neuralgia occurred ipsilateral to cluster headache in all 11 patients. Six patients (55%) reported that the onset of cluster headache had preceded the onset of trigeminal neuralgia, sometimes by several years; one patient reported trigeminal neuralgia before the onset of cluster headache, and the remaining patients (n = 4) did not remember which symptoms had come first. Eight patients (73%) reported that trigeminal neuralgia frequency followed the annual rhythmicity of cluster headache; the other 3 patients (27%) stated that both types of attacks occurred independently. The distribution of trigeminal neuralgia was as follows: 7 (63%) patients reported symptoms exclusively in the ophthalmic branch; 2 patients (18%) had symptoms in the ophthalmic and maxillary branches; in 2 patients (18%), only the maxillary branch was affected. None of the patients reported symptoms in the mandibular branch. Trigeminal neuralgia attack frequency varied from 10 times a day to 5 or 10 times a year. Efficacy of verapamil on trigeminal neuralgia and cluster headache was reported by 4 patients (36%), the remaining patients reported no efficacy of cluster headache treatment on the trigeminal neuralgia attacks. No patients had received specific trigeminal neuralgia medication. Seven of 11 patients reported that they had undergone a cerebral magnetic resonance imaging (MRI) scan for their headaches, of whom 5 reported that there were no abnormalities and 2 patients did not remember. Four patients stated they had never had a cerebral MRI scan.
Results
Between April and July 2010, a total of 437 subjects filled out the LUCA questionnaire. A total of 291 subjects were finally contacted for a telephone interview and included in the study, and 244 patients received a final cluster headache diagnosis based on the ICHD-2 criteria. Baseline characteristics of 291 included patients were compared with 146 excluded patients. Interviewed subjects were significantly older (P = .018), but absolute differences were small (47.3 vs 44.5 years). There were no significant differences with respect to gender, episodic or chronic cluster headache, proportions of patients using anticluster headache medication (prophylactic and acute), or the proportion of patients with a physician diagnosis of cluster headache. Eleven subjects (4.5%) of these 244 cluster headache patients also met ICHD-2 criteria for trigeminal neuralgia (Table 2).
Trigeminal neuralgia occurred ipsilateral to cluster headache in all 11 patients. Six patients (55%) reported that the onset of cluster headache had preceded the onset of trigeminal neuralgia, sometimes by several years; one patient reported trigeminal neuralgia before the onset of cluster headache, and the remaining patients (n = 4) did not remember which symptoms had come first. Eight patients (73%) reported that trigeminal neuralgia frequency followed the annual rhythmicity of cluster headache; the other 3 patients (27%) stated that both types of attacks occurred independently. The distribution of trigeminal neuralgia was as follows: 7 (63%) patients reported symptoms exclusively in the ophthalmic branch; 2 patients (18%) had symptoms in the ophthalmic and maxillary branches; in 2 patients (18%), only the maxillary branch was affected. None of the patients reported symptoms in the mandibular branch. Trigeminal neuralgia attack frequency varied from 10 times a day to 5 or 10 times a year. Efficacy of verapamil on trigeminal neuralgia and cluster headache was reported by 4 patients (36%), the remaining patients reported no efficacy of cluster headache treatment on the trigeminal neuralgia attacks. No patients had received specific trigeminal neuralgia medication. Seven of 11 patients reported that they had undergone a cerebral magnetic resonance imaging (MRI) scan for their headaches, of whom 5 reported that there were no abnormalities and 2 patients did not remember. Four patients stated they had never had a cerebral MRI scan.