Manzoni G C, Micieli G, Granella F, Tassorelli C, Zanferrari C, Cavallini A
University Centre for Adaptive Disorders and Headache, Department of Neurology, University of Parma, Italy.
Cephalalgia. 1991 Sep;11(4):169-74. doi: 10.1046/j.1468-2982.1991.1104169.x.
One-hundred-and-eighty-nine cluster headache patients, referred to Parma and Pavia Headache Centres between 1976 and 1986 with a disease duration of over 10 years, were interviewed about the course of cluster headache. They were classified as episodic (n = 140) or chronic (n = 49) cluster headache patients on the basis of course during the year of onset. Episodic patients showed the following outcome: maintenance of an episodic form (primary episodic form) in 80.7% of cases, shift towards a chronic form (secondary chronic form) in 12.9% and shift towards an intermediate pattern ("combined" form) in 6.4%. In chronic patients, cluster headache was still chronic (primary chronic form) at the moment of observation in 52.4% of cases, while it turned into an episodic form ("secondary" episodic form) in 32.6% and into a "combined" form in 14.3%. Nineteen patients (10%) had had no attacks for at least three years at the moment of examination. We can conclude from our data that: cluster headache is a disease of long duration, perhaps lifelong; episodic cluster headache tends to worsen; chronic cluster headache may easily turn into a better prognostic episodic form; prophylactic drugs are unable to induce recovery. The following factors seem related to a poor outcome: a later onset, the male gender and a disease duration of over 20 years for the episodic forms.
189例丛集性头痛患者于1976年至1986年间转诊至帕尔马和帕维亚头痛中心，病程超过10年，就丛集性头痛的病程接受了访谈。根据发病当年的病程，他们被分为发作性（n = 140）或慢性（n = 49）丛集性头痛患者。发作性患者的转归如下：80.7%的病例维持发作性形式（原发性发作性形式），12.9%转变为慢性形式（继发性慢性形式），6.4%转变为中间型（“合并”型）。在慢性患者中，52.4%的病例在观察时丛集性头痛仍为慢性（原发性慢性形式），而32.6%转变为发作性形式（“继发性”发作性形式），14.3%转变为“合并”型。19例患者（10%）在检查时至少三年未发作。从我们的数据可以得出以下结论：丛集性头痛是一种病程较长的疾病，可能终生患病；发作性丛集性头痛有加重趋势；慢性丛集性头痛可能容易转变为预后较好的发作性形式；预防性药物无法促使康复。以下因素似乎与不良转归有关：发病较晚、男性以及发作性形式病程超过20年。
