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. 2019 Jul;15(3):334-338.
doi: 10.3988/jcn.2019.15.3.334.

Differences in Characteristics and Comorbidity of Cluster Headache According to the Presence of Migraine

Tae Jin Song #  1 , Mi Ji Lee #  2 , Yun Ju Choi  3 , Byung Kun Kim  4 , Pil Wook Chung  5 , Jung Wook Park  6 , Min Kyung Chu  7 , Byung Su Kim  8 , Jong Hee Sohn  9 , Kyungmi Oh  10 , Daeyoung Kim  11 , Jae Moon Kim  11 , Soo Kyoung Kim  12 , Kwang Yeol Park  13 , Jae Myun Chung  14 , Heui Soo Moon  5 , Chin Sang Chung  2 , Jin Young Ahn  15 , Soo Jin Cho  16
Affiliations

Differences in Characteristics and Comorbidity of Cluster Headache According to the Presence of Migraine

Tae Jin Song et al. J Clin Neurol. 2019 Jul.

Abstract

Background and purpose: Cluster headache (CH) can present with migrainous symptoms such as nausea, photophobia, and phonophobia. In addition, an overlap between CH and migraine has been reported. This study aimed to determine the differences in the characteristics of CH according to the presence of comorbid migraine.

Methods: This study was performed using data from a prospective multicenter registry study of CH involving 16 headache clinics. CH and migraine were diagnosed by headache specialists at each hospital based on third edition of the International Classification of Headache Disorders (ICHD-3). We interviewed patients with comorbid migraine to obtain detailed information about migraine. The characteristics and psychological comorbidities of CH were compared between patients with and without comorbid migraine.

Results: Thirty (15.6%) of 192 patients with CH had comorbid migraine, comprising 18 with migraine without aura, 1 with migraine with aura, 3 with chronic migraine, and 8 with probable migraine. Compared to patients with CH without migraine, patients with CH with comorbid migraine had a shorter duration of CH after the first episode [5.4±7.4 vs. 9.0±8.2 years (mean±standard deviation), p=0.008], a lower frequency of episodic CH (50.0% vs. 73.5%, p=0.010), and a higher frequency of chronic CH (13.3% vs. 3.7%, p=0.033). Psychiatric comorbidities did not differ between patients with and without comorbid migraine. The headaches experienced by patients could be distinguished based on their trigeminal autonomic symptoms, pulsating character, severity, and pain location.

Conclusions: Distinct characteristics of CH remained unchanged in patients with comorbid migraine with the exception of an increased frequency of chronic CH. The most appropriate management of CH requires clinicians to check the history of preceding migraine, particularly in cases of chronic CH.

Keywords: chronic cluster headache; cluster headache; comorbidity; migraine; treatment.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

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