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Topic: CH symptoms--review article (Read 385 times) |
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Bob_Johnson
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CH symptoms--review article
« on: Sep 2nd, 2006, 10:33am » |
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Note the % for individual symptoms.
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Headache. 2006 Sep;46( :1246-54.
Cluster headache: clinical presentation, lifestyle features, and medical treatment.
Schurks M, Kurth T, de Jesus J, Jonjic M, Rosskopf D, Diener HC.
Background.-Cluster headache (CH) is a rare but severe headache form with a distinct clinical presentation. Misdiagnoses and mismanagement among these patients are high. Objective.-To characterize clinical features and medical treatment in patients with CH. Methods.-We established a cohort of 246 clinic-based and non-clinic-based CH patients. The diagnosis of CH was verified according to International Headache Society (IHS) criteria. We used standardized questionnaires to assess associated factors as well as success or failure of treatments. Results.-The majority (75.6%) was not treated before at our clinic-77.6% were males; 74.8% had episodic CH, 16.7% had chronic CH, in the remaining patients, the periodicity was undetermined because they were newly diagnosed. Cranial autonomic features were present in 98.8%, nausea and vomiting in 27.8%, and photophobia or phonophobia in 61.2% of CH patients. Most (67.9%) reported restlessness during attacks and 23% a typical migrainous aura preceding the attacks. The rate of current smoking was high (65.9%). Half of the patients reported that alcohol (red wine in 70%) triggered CH attacks. Eighty-seven percent reported the use of drugs of first choice (triptans 77.6%, oxygen 71.1%) with sumatriptan subcutaneous injection being the most effective drug for acute therapy (81.2%). The most frequently used preventive medications were verapamil (70.3%) and glucocorticoids (57.7%) with equally high effectiveness. Conclusions.-Apart from the IHS criteria additional features like nausea/vomiting and migrainous aura may guide the diagnosis of CH. A large number of CH patients do not receive adequate treatments. (Headache 2006;46:1246-1254).
PMID: 16942468
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Bob Johnson
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George_J
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Re: CH symptoms--review article
« Reply #1 on: Sep 2nd, 2006, 11:45am » |
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Very enlightening, Bob. I found particularly interesting the numbers experiencing vomiting (I don't myself) and photo or phonophobia. (No photophobia, but phonophobia.)
In your opinion is this a large-enough sample to establish, or at least to indicate, typical clusters of CH symptoms including variants?
The conclusion that many who have CH do not receive adequate treatment certainly dovetails with anecdotal evidence here.
Again, very interesting. Thank you.
Regards,
George
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Ah! The foreigners put on such airs
Wearing the tangerine suits
And their harlequin eyes.
The pain they inspire
Draws in harmonica melodies
And the feathers of birds
Which flame up at their touch.
It all comes to light in the sheer
Debonair.
(Ellen)
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SophiaK
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Re: CH symptoms--review article
« Reply #2 on: Sep 2nd, 2006, 12:00pm » |
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I wonder about those red wine triggers and if this happens with home made red wine. Home made would not have sulfites. Sulfites are know to cause headaches. I wonder if wines from other countries are required to state on the lable if there are sulfites in them.
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Bob_Johnson
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Re: CH symptoms--review article
« Reply #3 on: Sep 2nd, 2006, 12:10pm » |
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My statistics are too weak to make a judgment about how far these data can be applied--but I suspect reliable conclusions would require both more people and even data collected from a variety of populations.
Re. Wine. Red wine has been analyzed and found to have something like 300-400 chemical compounds--or some such amazing number. Point being, there are so many chemical triggers potentially operating that it's not possible to saying that a single compound is the issue.
Studies coming out of Europe concluded that white wine was not a problem for CH but red wine and distilled spirits were triggers. Because of the chemical complexities involved, no attempt was made to identify the causal compounds.
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Bob Johnson
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Mr H
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Re: CH symptoms--review article
« Reply #4 on: Sep 6th, 2006, 8:17pm » |
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Two sips of red wine is enough to trigger HA's with me. Spirits often trigger, but for some reason, cider never causes any problems - especially the locally-made, 'real' cider, made out of 100% apple juice and no chemicals! 
I do get very sensitive to loud noises [phonophobia] when a HA is due [I'm chronic btw]. Never vomit though!
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BigCoffinHunter
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Re: CH symptoms--review article
« Reply #5 on: Sep 6th, 2006, 11:18pm » |
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I've never vomited, but I do get nauseous at the very peak of a hit. Like I'll lean over the toilet and cough and want to puke, but won't. It's pretty much a relief, since that tells me that it's past the halfway point, and I can almost see the light at the end of the tunnel.
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Chonas
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Re: CH symptoms--review article
« Reply #6 on: Sep 7th, 2006, 7:26am » |
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on Sep 6th, 2006, 11:18pm, BigCoffinHunter wrote:| I've never vomited, but I do get nauseous at the very peak of a hit. Like I'll lean over the toilet and cough and want to puke, but won't. It's pretty much a relief, since that tells me that it's past the halfway point, and I can almost see the light at the end of the tunnel. |
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It also happens to me exactly that way.
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Here we go again...
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