AUTHOR=Al-Hashel Jasem , Ibrahim Ismail , Youssry Doaa , Ahmed Samar Farouk , Goadsby Peter 

TITLE=Cluster Headache in Kuwait: A Hospital-Based Study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2019.00573

DOI=10.3389/fneur.2019.00573

ISSN=1664-2295

ABSTRACT=Background: Cluster headache (CH) is a relatively uncommon primary headache disorder. Few studies in our region described CH. We aimed to study demographics, clinical characteristics and treatment modalities of CH patients referred to Headache Clinic in Kuwait.
Materials and Methods: This cross-sectional study included all CH patients who are referred to headache clinic. The diagnosis of CH based on the CH diagnostic criteria of the Headache Classification Committee of the IHS, 3rd edition (beta version) (ICHD-3-beta). The demographics, clinical characteristics and treatment modalities of CH patients were recorded.
Results: 46 patients were diagnosed with CH which constituted (1.7 %) of all headache patients and (0.1 %) of all visits to Neurology clinic. Male: Female ratio was 15.3:1. Mean age was 40.1 ± 10.7 years and mean age at onset was 29 years (20-49). Family history was positive in (6.5%). Smoking was seen in (63.0%) of patients while (6.5 %) reported alcohol intake. CH was episodic in (84.4%) and chronic in (15.2%). Seasonal predilection was seen in all patients; the most frequent season was Autumn (47.8%). The mean duration of the cluster bouts was 6 weeks (2 to 12 weeks). The mean duration of the attack was 60 minutes (15 to 180 minutes). Number of attacks per day ranged from 2 to 10 attacks with a mean of 5 attacks/day. The median of attack severity by Visual Analog Scale (VAS) was 8.5 (7-10). The time taken to diagnose the patients ranged from less than 1 year to 12 years with a mean of 4 years. Chronic CH have a statically significant relation with smoking (P = 0.036), older age (P = 0.027) and longer time taken to diagnosis (P = 0.026) compared to episodic CH.
Conclusion: Our results coincided with other clinical studies regarding the prevalence and clinical characteristics of CH. However, it was different in the highest proportion between men and women and in a less positive family history. Smoking is a significant risk factor for chronicity in patients with CH in addition to advanced age, a higher age at onset of the disease and a longer time of diagnosis.