Evaluation of the new ICHD-III beta cluster headache criteria.

AIM: In the revised criteria of the International Classification of Headache Disorders (ICHD-III beta) the following items are added to the diagnostic criteria of cluster headache: ipsilateral sensation of fullness in the ear and ipsilateral forehead/facial flushing. We evaluated the possible additional value of these symptoms for diagnosing cluster headache. METHODS: In this cross-sectional cohort study of (potential) cluster headache patients we investigated these additional symptoms using a Web-based questionnaire. Patients not fulfilling the ICHD-II criteria for cluster headache but fulfilling the ICHD-III beta criteria were interviewed. RESULTS: Response rate was 916/1138 (80.5%). Of all 573 patients with cluster headache according to ICHD-II criteria, 192 (33.5%) reported ipsilateral ear fullness and 113 (19.7%) facial flushing during attacks. There was no difference in reporting ipsilateral ear fullness and facial flushing between patients who received a diagnosis of cluster headache and patients who did not. None of the patients who did not fulfill all ICHD-II criteria could be categorized as cluster headache according to the ICHD-III beta criteria. CONCLUSION: The results of this study do not support the addition of ear fullness and facial flushing to the new ICHD-III beta criteria.

[Aura-related symptoms associated with cluster headache: outcomes of a LUCA substudy]. / Aurasymptomen bij clusterhoofdpijn: resultaten van een deelonderzoek in de LUCA-studie.

OBJECTIVE: To describe the prevalence of aura in a Dutch cluster headache (CH) population. DESIGN: Cross-sectional, epidemiological study. METHOD: As part of a large-scale study into headaches conducted in Leiden (the Netherlands), patients experiencing headaches were identified by means of questionnaires on a headache website. One group of patients with CH was approached by telephone and an interview on aura-related symptoms was performed by means of a standardized questionnaire. The presence of migraine co-morbidity was also investigated. RESULTS: Of the interviewed CH patients, 22 out of 244 (9.0%) had aura-related symptoms preceding a CH attack, which were predominantly visual in nature. The majority (72.7%) of these patients did not have migraine co-morbidity. CONCLUSION: Aura-related symptoms can occur in CH without migraine co-morbidity. In clinical practice, it should be taken into account that the presence of an aura does not always indicate migraine.