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. 2022 Nov;42(13):1420-1424.
doi: 10.1177/03331024221113207. Epub 2022 Jul 13.

COVID-19 vaccination-triggered cluster headache episodes with frequent attacks

Roemer B Brandt  1 , Rosa-Lin H Ouwehand  1 , Michel D Ferrari  1 , Joost Haan  1   2 , Rolf Fronczek  1
Affiliations

COVID-19 vaccination-triggered cluster headache episodes with frequent attacks

Roemer B Brandt et al. Cephalalgia. 2022 Nov.

Abstract

Background: The pathophysiology of cluster headache and how cluster episodes are triggered, are still poorly understood. Recurrent inflammation of the trigeminovascular system has been hypothesized. It was noted that some long-term attack-free cluster headache patients suddenly developed a new cluster episode shortly after COVID-19 vaccination.

Methods: Cases are described from patients with cluster headache who reported a new cluster episode within days after COVID-19 vaccination. All cases were seen in a tertiary university referral center and a general hospital in the Netherlands between March 2021 and December 2021, when the first COVID-19 vaccinations were carried out in The Netherlands. Clinical characteristics of the previous and new cluster episodes, and time between the onset of a new cluster episode and a previous COVID-19 vaccination were reported.

Results: We report seven patients with cluster headache, who had been attack-free for a long time, in whom a new cluster episode occurred within a few days after a COVID-19 vaccination.

Interpretation: COVID-19 vaccinations may trigger new cluster episodes in patients with cluster headache, possibly by activating a pro-inflammatory state of the trigeminocervical complex. COVID-19 vaccinations may also exacerbate other neuroinflammatory conditions. .

Keywords: COVID-19 vaccination; Cluster headache; headache.

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Conflict of interest statement

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: RBB reports support for conference visits from Allergan; RF reports consultancy and lecture fees from Novartis, Teva, Allergan, Lilly and TEVA, and independent support from the Dutch Brain Foundation, Leiden University Fund and Innovation Fund Dutch Healthcare Providers; RHO, JH and MDF report no relevant conflict of interest.

References

    1. Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol 2018; 17: 75–83. - PubMed
    1. Iyengar S, Ossipov MH, Johnson KW. The role of calcitonin gene–related peptide in peripheral and central pain mechanisms including migraine. Pain 2017; 158: 543–559. - PMC - PubMed
    1. Rozen TD, Fishman RS. Cluster headache in the United States of America: demographics, clinical characteristics, triggers, suicidality, and personal burden. Headache 2012; 52: 99–113. - PubMed
    1. Vollesen ALH, Snoer A, Beske RP, et al.. Effect of infusion of calcitonin gene-related peptide on cluster headache attacks: A randomized clinical trial. JAMA Neurol 2018; 75: 1187–1197. - PMC - PubMed
    1. Naber WC, Fronczek R, Haan J, et al.. The biological clock in cluster headache: A review and hypothesis. Cephalalgia 2019; 39: 1855–1866. - PubMed

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