Demographic characteristics, attack and period features,and responses to attack and prophylactic treatments in cluster headache patients

Objective: Cluster headache (CH), a primary headache disorder affecting approximately 4 in every 1000 individuals, is characterized by severe pain and significant impairment of functionality. Due to the limited awareness of CH, patients frequently receive incorrect diagnoses and face delays in accessing appropriate treatment. The aim of this study is to retrospectively assess the clinical characteristics of CH patients monitored at our center, identify their previous misdiagnoses, and examine their responses to administered treatments. Method: The study included CH patients followed at the Neurology Department of Akdeniz University Faculty of Medicine, who met the diagnostic criteria for cluster headaches outlined in the third edition of the International Classification of Headache Disorders published in 2018. Demographic data, clinical characteristics, treatment responses, and diagnosis delays were analyzed. Statistical analyses were conducted to evaluate factors influencing treatment efficacy and outcomes. Results: A total of 89 CH patients were included in the study, with a male- to-female ratio of 10:1. The average age at onset was 28.5 years, and the average delay in diagnosis was determined to be 6.2 years. Oxygen therapy and sumatriptan injections were notably effective, showing high consistent response rates of 80.9% and 85.7%, respectively. Other treatments, such as nasal lidocaine and frovatriptan, exhibited variable effectiveness. The most commonly used prophylactic treatments, verapamil and methylprednisolone, had consistent response rates of 78.95% and 79.31%, respectively. Additionally, it was found that 82.8% of the patients initially received incorrect diagnoses such as migraine or sinusitis. Conclusion: The findings of this study emphasize the need to increase awareness in the diagnosis and treatment processes of CH. Oxygen therapy and sumatriptan injections stand out as highly effective treatment options for managing CH attacks. Prophylactic treatments like verapamil and methylprednisolone also significantly impact effectiveness. Management of CH requires customized treatment plans tailored to the individual characteristics and responses of patients. Future research should focus on the long-term efficacy and safety of treatments and contribute to the continuous improvement of treatment strategies.