Cluster headache | Paroxysmal hemicrania | SUNCT* and SUNA¶ | Hemicrania continua | |
Sex predominance | Male (4:1) | No (1:1) | Female (1.7:1) | Female (2:1) |
Pain | ||||
Type | Stabbing | Stabbing or throbbing | Stabbing or burning | Stabbing, throbbing, burning, or aching |
Severity | Excruciating | Excruciating | Severe to excruciating | Mild to severe |
Site | Orbital or temporal | Orbital or temporal | Orbital or temporal | Orbital, frontal, and/or temporal |
Typical attack frequency | 1 every other day to 8 daily | 5 to 40 daily | 1 to 200 daily | Continuous (with exacerbations) |
Duration of attack | 15 to 180 minutes | 2 to 30 minutes | 1 second to 10 minutes | Months to years (untreated) |
Autonomic features?Δ | Yes | Yes | Yes (conjunctival injection and lacrimation prominent with SUNCT) | Yes |
Restlessness and/or agitation? | Yes | Yes | Sometimes | Yes |
Associated migrainous features?◊ | Yes | Yes | Rare | Frequent |
Triggers | Alcohol | Stress, exercise, alcohol | Tactile stimuli (eg, touching face, shaving, brushing teeth) | Alcohol |
Indomethacin responsive? | No | Yes | No | Yes |
Abortive treatment | Triptans (intravenous or nasal) Oxygen | None | Lidocaine (intravenous) for frequent and debilitating symptoms | None |
Prophylactic treatment | Verapamil Glucocorticoids Galcanezumab Lithium Topiramate | Indomethacin Verapamil NSAIDs | Lamotrigine Oxcarbazepine Topiramate Gabapentin | Indomethacin |
SUNCT: short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing; SUNA: short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms; NSAIDs: nonsteroidal anti-inflammatory drugs.
* Both conjunctival injection and lacrimation are present.
¶ May have either conjunctival injection or lacrimation but not both.
Δ Cranial autonomic symptoms: conjunctival injection, lacrimation, nasal congestion or rhinorrhea, facial sweating, miosis and/or ptosis, palpebral edema; symptoms are ipsilateral to the headache.
◊ Migraine-like features may include associated nausea, vomiting, photophobia, or phonophobia.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟