What are the most common prodromal symptoms of cluster headache?

The prodromal symptoms of cluster headache might provide clues to the pathophysiology of migraine. A prospective study presented at #EAN2020 evaluated prodromal symptoms occurring minutes or hours before the headache.

Characterizing the pre-ictal and post-ictal symptoms of cluster headache (CH) could contribute to the understanding of CH pathophysiology and, potentially, early, abortive treatment strategies.1

Two-thirds of patients with CH had prodromal symptoms

Byung-Kun Kim, Seoul, Korea, therefore investigated prodromal symptoms occurring minutes or hours before a CH attack in 136 patients with CH in a prospective, multicenter, observational study in Korea.

The patients were evaluated using a structured questionnaire to find out about 20 symptoms and signs reported by previous studies as pre-attack symptoms.

The most common prodromal symptoms were local painful symptoms

Dr Kim found that two-thirds of the patients had prodromal symptoms and these were most commonly local painful symptoms. General symptoms, such as fatigue were less common, and local painless sensory symptoms and local autonomic symptoms, such as conjunctival injection, were relatively uncommon.

The presence of prodromal symptoms was independently associated with a higher number of CH episodes.

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1. Snoer A, et al. Neurology 2018;91:e822–31.