Riess C M, Becker W J, Robertson M
Department of Clinical Neurosciences, University of Calgary, Canada.
Can J Neurol Sci. 1998 May;25(2):141-5. doi: 10.1017/s0317167100033758.
To study the clinical features and treatment given to episodic cluster headache patients in the Calgary region.
Fifty-one (51) patients who responded to a media campaign, had previously been diagnosed by their family physicians, and who met International Headache Society (IHS) criteria for episodic cluster headache, formed the population for this study.
The media campaign consisted of newspaper advertisements and radio publicity including physician interviews and talk shows. Patients were required to complete by 200-item questionnaire detailing clinical features and treatment of their cluster headache syndrome. Each patient was also interviewed by our research nurse for clarification and proper completion of questionnaire.
Fifty-one percent (51%) of our patients had short headache attacks lasting one hour or less. Almost one-half (45%) had three or four attacks per 24 hour period. Eighty-six percent (86%) had been referred to a neurologist. Sixty-nine percent (69%) had never used oxygen, but of those who had, one-half were still using it. Sumatriptan by injection had been tried by 26% of patients and of these, 93% considered it effective. Subcutaneous dihydroergotamine had been tried by 8%. For prophylaxis, 41% had tried methysergide, 31% prednisone, and 4% verapamil. Many patients had been prescribed migraine prophylactic drugs which are ineffective for cluster headache, and some had also undergone dental procedures or nasal and sinus surgeries.
Many cluster headache patients had not, to their knowledge, been prescribed or used the best symptomatic and prophylactic treatments for cluster headache. This should be addressed through educational programs and through making up-to-date information on the treatment of cluster headache readily available to physicians and patients.
研究卡尔加里地区发作性丛集性头痛患者的临床特征及治疗情况。
51名患者参与了本研究，这些患者响应了媒体宣传活动，此前已由其家庭医生诊断，且符合国际头痛协会（IHS）发作性丛集性头痛的标准。
媒体宣传活动包括报纸广告和电台宣传，其中有医生访谈和脱口秀。患者需完成一份200项的问卷，详细说明其丛集性头痛综合征的临床特征和治疗情况。每位患者还接受了我们研究护士的访谈，以澄清问题并确保问卷正确填写。
51%的患者头痛发作时间短，持续1小时或更短。近一半（45%）的患者每24小时发作三到四次。86%的患者曾被转诊至神经科医生处。69%的患者从未使用过氧气，但在使用过氧气的患者中，有一半仍在使用。26%的患者尝试过注射舒马曲坦，其中93%认为其有效。8%的患者尝试过皮下注射双氢麦角胺。在预防性治疗方面，41%的患者尝试过甲基麦角新碱，31%尝试过泼尼松，4%尝试过维拉帕米。许多患者被开了对丛集性头痛无效的偏头痛预防性药物，一些患者还接受了牙科手术或鼻科及鼻窦手术。
许多丛集性头痛患者并不知晓自己是否被开了或使用了针对丛集性头痛的最佳对症和预防性治疗方法。这一问题应通过教育项目以及向医生和患者提供关于丛集性头痛治疗的最新信息来解决。
