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Cluster‐Tic Syndrome: A Cross‐Sectional Study of Cluster Headache Patients
Author(s) -
Wilbrink Leopoldine A.,
Weller Claudia M.,
Cheung Carlo,
Haan Joost,
Ferrari Michel D.
Publication year - 2013
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12161
Subject(s) - cluster headache , trigeminal neuralgia , medicine , cluster (spacecraft) , neuralgia , cross sectional study , anesthesia , neuropathic pain , migraine , pathology , computer science , programming language
Objective To determine the prevalence and nature of trigeminal neuralgia in a large group of cluster headache patients. Background Cluster‐tic syndrome is a rare headache syndrome in which trigeminal neuralgia and cluster headache co‐occur. The existence of cluster‐tic syndrome as a separate entity is questioned, and figures on prevalence of simultaneous existence of cluster headache and trigeminal neuralgia are not available. Methods As part of a nationwide study on headache mechanisms in cluster headache (Leiden University Medical Centre Cluster headache Neuro Analysis programme), we collected clinical data of 244 cluster headache patients using a semistructured telephone interview in a cross‐sectional design. Results In 11 (4.5%) cluster headache patients, attacks fulfilling International Headache Society criteria for trigeminal neuralgia were also present. In all cases, trigeminal neuralgia occurred ipsilateral to cluster headache and in the majority (82%) in the ophthalmic branch. In 8 of these 11 patients (73%), the frequency and time pattern of trigeminal neuralgia seemed to parallel cluster headache and was likely a part of the cluster headache spectrum. In the 3 remaining patients, cluster headache and trigeminal neuralgia were unrelated in time and appeared to occur independently. Conclusion Trigeminal neuralgia co‐occurred in 11/244 (4.5%) of cluster headache patients. In only 3 (1.2%) patients, trigeminal neuralgia seemed to occur independently from cluster headache episodes. Trigeminal neuralgia (‐like) attacks in cluster headache patients are most of the time part of the cluster headache spectrum and should then probably not be treated separately. A shared underlying pathophysiological mechanism of cluster headache and trigeminal neuralgia is not supported by this study.