Cluster Headache Characteristic In Women And Men: A Comparative Study At A District Hospital In Western India
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Abstract
Introduction: Cluster headache(CH) is a stereotypic headache disorder characterized by short lasting attacks of severe unilateral head pain with associated autonomic symptoms. Cluster headache has been considered as a disorder of men, with a male to female ratio of 4-5:1.
Aim: to study the clinical characteristics of cluster headache in women as compared to male.
Method: A cross-sectional study was carried out at District Hospital, Barmer, Rajasthan from January 2018 to September 2019. Consecutive Patients attending Headache clinic at Department of Psychiatry were selected and after taking written informed consent were included in the study. International Headache Society (IHS) criteria for cluster headache was applied onto them.
Results: out of 1450 headache patients 22 women and 88 men were identified. The mean age of onset of cluster headache in female patients was 29.35 ± 12.35 as compared to 30.25 ± 10.18 (p=0.1781) years in men. Both men and women had developed their first ever cluster headache by the age of 20, But women had a second peak, noted around the age of 45-50 year. Episodic cluster headache(ECH) was present in 68 % (n=15) of women and 73.8 % (n=65) of men. Miosis and ptosis were slightly less common in women than in men (miosis 14% v 28.4 %; ptosis 45.4% v 57.9%). Lacrimation (women 81.8%, men 86.3%), and nasal congestion/ rhinorrhea (women 86.3%, men 85.2%), were almost equally prevalent in women and men.
Conclusion:- Cluster headache is primarily a disorder of men, and most of its characteristics have been identified by observing male patients. The predominant cluster headache subtype in both our women and men was episodic(ECH) . In our study we found a ≈2:1 ratio of female patients with episodic(ECH) to chronic cluster headache(CCH), In our study, women and men had an equal mean number of attacks a day. . Migraine like symptoms seem to be highly prominent in patients with cluster headache, especially in women. Female patients in our study had more nausea and vomiting than our men.
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