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Age of CH onset study


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Cluster headache: Is age of onset important for clinical presentation?; Zidverc-Trajkovic J, Markovic K, Radojicic A, Podgorac A, Sternic N; Cephalalgia (Jan 2014)

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BACKGROUND The age of onset of cluster headache (CH) attacks most commonly is between 20 and 40 years old, although CH has been reported in all age groups. There is increasing evidence of CH with early or late onset and a different course of the disorder. The aim of the study was to analyze the influence of the age of onset on clinical features, disorder course, and therapy effectiveness in CH patients.

METHODS A retrospective and cross-sectional analysis was performed on 182 CH patients divided into three groups according to the age of onset. The first group consisted of patients with the first CH attack before 20 years of age, the second group was patients with age of onset between 20 and 40 years of age, and the third group was patients with age of onset after 40 years of age. Demographic data, features of CH periods and attacks, and the response to standardized treatment were compared among the groups.

RESULTS Patients with CH onset after 40 years of age reported a lower number of autonomic features and less frequently had conjunctival injection and nasal congestion/rhinorrhea phenomena during their attacks. Diagnostic delay was the longest in the patients with CH onset before 20 years of age.

CONCLUSION The influence of the age of onset of CH is intriguing for further studies and could possibly extend the knowledge about CH pathophysiology. From a clinical point of view, the differences in CH presentation are insufficient to preclude a correct diagnosis and treatment because the same criteria could be applied regardless of patient age.

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Just a side note on this study:

My onset age was about 13 or 14 yrs of age.  I had a short cycle (1 - 2 mos).  I know it was CH in hindsight because of the extreme pain, and I remember banging my head into the floor.

Fast forward to age 50.  After one year of misdiagnosis and unproductive major sinus surgery, I was diagnosed with 'primary chronic cluster headache'. 

No headaches from puberty to age 50.  Go figure!

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