1 Department of Clinical Neuroscience, Division of Neurology, Karolinska University Hospital Solna, Stockholm, Sweden.
2 Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Cephalalgia. 2018 Jun;38(7):1286-1295. doi: 10.1177/0333102417731773. Epub 2017 Sep 14.
Background The aim of this study was to investigate clinical features of a cluster headache cohort in Sweden and to construct and test a new scale for grading severity. Methods Subjects were identified by screening medical records for the ICD 10 code G44.0, that is, cluster headache. Five hundred participating research subjects filled in a questionnaire including personal, demographic and medical aspects. We constructed a novel scale for grading cluster headache in this cohort: The Cluster Headache Severity Scale, which included number of attacks per day, attack and period duration. The lowest total score was three and the highest 12, and we used the Cluster Headache Severity Scale to grade subjects suffering from cluster headache. We further implemented the scale by defining a cluster headache maximum severity subgroup with a high Cluster Headache Severity Scale score ≥ 9. Results A majority (66.7%) of the patients reported that attacks appear at certain time intervals. In addition, cluster headache patients who were current tobacco users or had a history of tobacco consumption had a later age of disease onset (31.7 years) compared to non-tobacco users (28.5 years). The Cluster Headache Severity Scale score was higher in the patient group reporting sporadic or no alcohol intake than in the groups reporting an alcohol consumption of three to four standard units per week or more. Maximum severity cluster headache patients were characterised by higher age at disease onset, greater use of prophylactic medication, reduced hours of sleep, and lower alcohol consumption compared to the non-cluster headache maximum severity group. Conclusion There was a wide variation of severity grade among cluster headache patients, with a very marked impact on daily living for the most profoundly affected.
背景 本研究旨在调查瑞典集群性头痛患者的临床特征，并构建和验证一种新的严重程度分级量表。
方法 通过筛选 ICD-10 编码 G44.0（即集群性头痛）的病历，确定研究对象。500 名参与研究的受试者填写了一份问卷，内容包括个人、人口统计学和医学方面的信息。我们构建了一种新的集群性头痛严重程度分级量表：集群性头痛严重程度量表，其中包括每日发作次数、发作和周期持续时间。最低总分为 3 分，最高为 12 分，我们使用集群性头痛严重程度量表对患有集群性头痛的患者进行分级。我们进一步通过定义集群性头痛严重程度量表评分≥9 的高集群性头痛严重程度亚组来实施该量表。
结果 大多数（66.7%）患者报告说发作会在特定时间间隔出现。此外，当前吸烟或有吸烟史的集群性头痛患者发病年龄较晚（31.7 岁），而非吸烟者发病年龄较早（28.5 岁）。报告偶尔或不饮酒的患者集群性头痛严重程度量表评分高于报告每周饮用三至四个标准单位或更多酒精的患者。与非集群性头痛严重程度最高组相比，集群性头痛严重程度最高组的患者发病年龄更高，预防性药物使用更多，睡眠时间更少，饮酒量更少。
结论 集群性头痛患者的严重程度分级差异很大，对病情最严重的患者的日常生活影响非常显著。
