Cluster Headache in older women. (article).

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Posted by drummer ( on May 14, 2000 at 07:02:15:

New-Onset Cluster Headache in Older Women May Resemble Migraine

SAN DIEGO, CA, May 11 (Reuters Health) - Study findings presented at the 52nd annual meeting of the American Academy of Neurology document that middle-age and elderly women may develop new-onset cluster headache.

Dr. Amnon Mosek, from the Sourasky Medical Center, Tel Aviv, Israel, pointed out that cluster headache is commonly considered predominantly a disorder of young men; however, its prevalence in other age and gender groups has not been studied. To investigate, he and colleagues reviewed the charts of 142 patients diagnosed with cluster headache at the three largest headache clinics in Israel.

Overall, 26 (19%) patients with cluster headache were women. In seven women, the headache started after 50 years of age. The mean age at onset of the cluster headache in these women was 61 years. In all of them, the pain was severe, strictly unilateral and accompanied by at least one autonomic symptom.

Five patients had one to two attacks in a day, while the other two experienced up to eight episodes of pain in 1 day. The average duration of the pain was 70 minutes, and pain recurred daily for an average of 7 weeks. In two patients, the periodicity of the pain was not yet determined, Dr. Mosek said. In the remaining patients, the headache periods recurred every 1 to 4 years.

Oxygen inhalation reduced the pain in two of four patients. Three patients were unsuccessfully treated with indomethacin, up to 150 mg per day. Preventive treatment with lithium carbonate, calcium-channel blockers, prednisone and valproic acid produced inconsistent results.

Dr. Mosek said that the characteristics of the pain occurring with cluster headaches in the women in his study and its manner of occurrence were similar to those reported in the young male population. He also noted that the late onset of the cluster headaches resembles new-onset migraine in menopausal women. Although the role of female sex hormones is not known in the pathophysiology of cluster headache, his group speculates that these hormones may play a role in new onset of cluster headaches in middle-aged and older women.

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