AAN 2025 | Pre-cluster symptoms in patients with cluster headaches: implications for diagnosis and treatment
Jr-Wei Wu, MD, Taipei Veterans General Hospital, Taipei, Taiwan, discusses his research on pre-cluster symptoms in patients with cluster headaches. Approximately two-thirds of patients in this cohort experienced pre-cluster symptoms before the development of cluster headaches, and there was a link between these symptoms and treatment response. This research has significant implications for diagnosis, patient preparation, and treatment strategies. This interview took place at the 77th American Academy of Neurology (AAN) Annual Meeting in San Diego, CA.
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Transcript
In fact, my specialty is doing the cluster headache and my team is focused on the cluster headache in either etiology, epidemiology, symptomatology, and even neuroimaging and treatment. And in my presentations two years ago in the AAN, we found that we collected about 168 patients with a cluster headache. This is a large cohort. And in our patients, we found that about two-thirds of patients had pre-cluster symptoms...
In fact, my specialty is doing the cluster headache and my team is focused on the cluster headache in either etiology, epidemiology, symptomatology, and even neuroimaging and treatment. And in my presentations two years ago in the AAN, we found that we collected about 168 patients with a cluster headache. This is a large cohort. And in our patients, we found that about two-thirds of patients had pre-cluster symptoms. That is a symptom before the development of cluster bouts. And we found about 60% of cluster headache patients could predict the upcoming bout based on these unique symptoms. So we identify a new phase of cluster headache which can help patients to prepare and to predict their upcoming bout. And moreover, our findings also find the links between the pre-cluster phase and the treatment response. We found that in patients with pre-cluster symptoms, if they have a pre-cluster symptom of prosleep and cranial autonomic symptom. That means you have a tear, rhinorrhoea, and also congestion before a cluster bout, and these patients may be more responsive to the preventive treatment of verapamil. So this unique stage is not only can help diagnosis, can help our patient to prepare the upcoming bout, they also have the implications in the treatment and might have some implications in future treatment strategies. That’s our research on the pre-cluster symptoms.
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