Sjöstrand C, Russell M B, Ekbom K, Hillert J, Waldenlind E
Department of Neurology, Karolinska Institute, Karolinska University Hospital, Huddinge, Sweden.
Cephalalgia. 2005 Nov;25(11):1068-77. doi: 10.1111/j.1468-2982.2005.00964.x.
Familial cluster headache (CH) was analysed in 21 Swedish families. Diagnosis was made according to The International Classification of Headache Disorders 2004. We identified 55 affected, of whom 42 had episodic or chronic CH, one had probable CH and 12 had atypical symptoms. The atypical cases did not fulfil the diagnostic criteria for CH, but had clinical symptoms with more resemblance to CH than to migraine or other trigeminal autonomic cephalgia syndromes. The overall male : female ratio was 1.8:1. The overall mean age at onset was significantly lower in the second/third generation than in the first generation (mean age at onset 22 vs. 31 years, SD +/- 7 vs. 13 years; P < 0.01). This may be anticipation or selection bias, since individuals with late age at onset from the second/third generation may not yet have symptoms. The prevalence of migraine was 24% (13/55), i.e. similar to the prevalence in the general population. The high incidence of atypical CH cases in the Swedish families with other members affected with CH may suggest that the spectrum of CH is broader than previously thought. We suggest that atypical CH in CH families may represent an expanded spectrum of the disease with a common aetiology, i.e. a common genetic background.
对21个瑞典家庭中的家族性丛集性头痛（CH）进行了分析。诊断依据《2004年国际头痛疾病分类》做出。我们确定了55名患者，其中42例患有发作性或慢性丛集性头痛，1例可能为丛集性头痛，12例有非典型症状。这些非典型病例不符合丛集性头痛的诊断标准，但临床症状与丛集性头痛的相似性高于偏头痛或其他三叉自主神经性头痛综合征。总体男女比例为1.8:1。第二代/第三代的总体平均发病年龄显著低于第一代（平均发病年龄22岁对31岁，标准差±7对13岁；P<0.01）。这可能是遗传早现或选择偏倚，因为第二代/第三代中发病年龄较晚的个体可能尚未出现症状。偏头痛的患病率为24%（13/55），即与普通人群的患病率相似。在有其他成员患丛集性头痛的瑞典家庭中，非典型丛集性头痛病例的高发病率可能表明丛集性头痛的范围比以前认为的更广。我们认为，丛集性头痛家族中的非典型丛集性头痛可能代表了具有共同病因（即共同遗传背景）的该疾病的扩展范围。
