Magazine article Clinical Psychiatry News

Cluster Headache Presents Differently in Never-Smokers

Magazine article Clinical Psychiatry News

Cluster Headache Presents Differently in Never-Smokers

Article excerpt

LOS ANGELES -- Cluster headache, a severe, one-sided headache that occurs in cyclical patterns or clusters, is highly associated with smoking, but when it presents in people without any lifetime tobacco exposure, there are key differences--possibly because of a different underlying pathology.

At the American Academy of Neurology annual meeting, Todd D. Rozen, MD, of the Mayo Clinic in Jacksonville, Fla., presented a new analysis from the United States Cluster Headache Survey, an online survey of 1,134 patients with cluster headache, of whom only 12% reported neither personal tobacco use nor a parent who smoked. Dr. Rozen is a coauthor on the original survey, which collected data for a 2-month period in late 2008, and has published several analyses using the survey's data (Headache. 2012 Jan;52[1]:99-113).

The latest analysis "is the first study that looks at the true non-tobacco exposed versus tobacco-exposed cluster headache populations, and they're different," he said in an interview. People with cluster headaches who never smoked, and who did not grow up in a smoking household, tend to develop cluster headache at a younger age, have a more episodic pattern of disease and are less likely to present with agitation and suicidal ideation compared with those who smoke, smoked, or had a parent who smoked, Dr. Rozen found.

Patients not exposed to tobacco developed cluster headache at a younger age than exposed subjects, with a significantly higher percentage reporting onset in their 20s and 30s, while tobacco-exposed people were more likely to see onset at aged 40 years or older.

And there were other important differences. The tobacco naive were more likely to have a family history of migraine (65% vs. 50%, P equal to .002). They were significantly more likely to have headache cycles that varied throughout the year rather than being concentrated during specific months or seasons (52% vs. …

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