Evaluation of premonitory spontaneous and nitroglycerin triggered symptoms among patients with cluster headache and migraine.

Abstract

BackgroundOur knowledge of the presence and type of premonitory symptoms in patients with cluster headache is limited.MethodsPremonitory symptom presence and type in a clinical cohort of cluster headache and migraine was collated retrospectively from clinical notes, alongside a cluster headache nitroglycerin triggered experimental group and an age-matched migraine nitroglycerin experimental group. Demographic data and premonitory symptoms in cluster headache and migraine patients were analysed. The primary focus was on premonitory symptom presence and phenotype in cluster headache patients, with secondary analysis exploring associated factors and comparing spontaneous and nitroglycerin-triggered symptoms in cluster headache and migraine cohorts.ResultsAmong 164 cluster headache patients, 122/164 (74%) males, aged 45.9 ± 13.8 years (mean ± SD), 66/164 (40%) had chronic cluster headache and 32/164 (20%) had also comorbid migraine. Among them, 85% exhibited premonitory symptoms for which the presence was associated with oxygen treatment. No significant differences were found in symptom frequency between cluster headache and migraine cohorts or within spontaneous and nitroglycerin-triggered symptoms.ConclusionsThis study highlights recognizable spontaneous and nitroglycerin-triggered premonitory symptoms in cluster headache and factors potentially impacting cluster headache management, which may aid in tailoring treatment strategies for both conditions through the use of treatment prediction and early intervention.