Migrainous features in cluster headache
         Wäber C and Knopf A
         Department of Neurology, Medical University of Vienna,
         Vienna, Austria
         Objectives:    To assess in patients with cluster headache (CH) the
         prevalence of headache characteristics and associated symptoms usu-
         ally related to migraine.
         Background:    CH is a headache disorder clearly defined by ICHD-Il
         criteria. Nevertheless diagnosis is delayed in many patients. One rea-
         son for this delay might be the presence of migrainous features dur-
         ing CH attacks.
         Methods:  We are currently performing the first survey on CH in
         Austria including 76 patients (18% women, mean age 43 ± 10 years)
         with CH according to ICHD-Il up to now. All patients completed a
         structured questionnaire. In this presentation, we will focus on
         migrainous features comprising pulsating pain, aggravation by or
         avoidance of physical activity, nausea, vomiting, photophobia, pho-
         nophohia and aura symptoms in CH attacks.
         Results:  Seventy-eight percei1t of the patients had episodic CH and
         22% had chronic CH. Three percent gave a personal history and
         almost 38% a family history of migraine. During a cluster period
         the patients experienced 16 ± 10 attacks per week with a mean dura-
         tion of 69 ± 60 minutes. Pulsating pain was experienced at least in
         some attacks by 47% of the patients. Headache was aggravated by
         physical activity in 26% and 43% experienced a need for rest. Con-
         sidering that 88% of the patients reported restlessness suggests that
         aggravation by physical activity and/or the wish to rest was present
         together with restlessness in at least some of the attacks. Nausea,
         vomiting, photophobia and phonophohia were reported by 41%,
         24%, 49% and 46%, of the patients. Unilateral photo- or phonopho-
         hia was experienced by 37%. Aura occurred in 28% of the patients
         and visual symptoms were reported most frequently namely by 20%.
         The prevalence of migrainous symptoms was not related to a per-
         sonal or family history of migraine.
         Conclusions:   Migrainous symptoms are common in CH and not
         related to a personal or family history of migraine. Even though ftc-
         quency and duration of attacks clearly differentiate CH from
         migraine, the presence of migrainous symptoms in CH might cause
         misdiagnoses in patients with infrequent or long-lasting attacks.

(Cephalalgia, 29 Suppl. 1, 2009)