SAN DIEGO, May 10 (Reuters Health) - Cluster headaches--sudden, excruciating
episodes of pain around one eye--are more common in men, and usually start
before the age of 30. But new findings presented at the 52nd annual meeting of
the American Academy of Neurology show that middle-aged and elderly women may
also develop new-onset cluster headaches.
Dr. Amnon Mosek and colleagues at the Sourasky Medical Center in Tel Aviv,
Israel, reviewed the charts of 142 patients diagnosed with cluster headaches at
the three largest headache clinics in Israel.
The causes of cluster headache are not well known, Mosek, director of his
institution's headache clinic, said. The few large-scale population studies that
estimate the prevalence of cluster headache show that the disorder is not
common, ranging from 0.09% to 0.4% in men and 0.009% to 0.08% in women.
Cluster headaches were thought to be six times more common in men. But this
small study found that 26 patients (19%) with cluster headaches were women. In
seven women, the headache started after 50 years of age. The mean age at onset
of the cluster headache in these women was 61 years. Five patients had one to
two attacks in a day, while the other two experienced up to eight episodes of
pain in one day. The average duration of the pain was 70 minutes, repeating
daily for an average period of 7 weeks. In two patients, the periodicity of the
pain was not yet determined, Mosek said. In the remaining patients, the headache
periods recurred every 1 to 4 years.
Oxygen inhalation reduced the pain in two of four patients. Three patients
were unsuccessfully treated with the drug indomethacin. Preventive treatments
with lithium carbonate, calcium channel blockers, prednisone, and valproic acid
produced inconsistent results.
Mosek said that the characteristics of the pain occurring with cluster
headaches in the women in his study and its manner of occurrence were similar to
those reported in young males. He also noted that the late onset of the cluster
headaches resembles new-onset migraine in menopausal women. The researchers
speculate that changes in female hormones may play a role in the new onset of
cluster headaches in middle-aged and older women.
