• Margarita Sánchez Del Rio, Rogelio Leira, Patricia Pozo-Rosich, José Miguel Laínez, Rocío Alvarez, and Julio Pascual.
• Service of Neurology, Ruber International Hospital, Madrid, Spain.
• Eur. Neurol. 2014 Jan 1; 72 (3-4): 209-12.

ObjectivesTo analyze the trajectory to diagnosis and information provided in a series of cluster headache (CH) patients from five headache clinics.MethodsCH patients were asked to fill in an ad hoc questionnaire.ResultsSeventy-five patients (mean age 41.5 years, 67 males) completed the questionnaire. Patients had visited during an average of 4.9 years a mean of 4.6 physicians who had obtained 2.5 neuroimaging procedures per patient before getting a diagnosis of CH. Sixty-three (84%) had received no diagnosis (21 cases; 28%), while 43 (57%) had been given an average of 2.1 alternative diagnoses. Migraine, trigeminal neuralgia and sinusitis were the most frequent mistakes. After diagnosis, 55% had subjectively received poor/very poor information on CH. Ninety-five percent had poor or incorrect information about the nature of the disease, or acute (70%) and preventive (61%) treatments. Etiology (90%), management options (36%) and potential adverse events of medications (29%) were their main information demands.ConclusionsAlthough CH is an invalidating and clinically clear-cut disorder suffered by around 1/1,000 people, it is still frequently unrecognized and/or mistaken for other disorders, which calls for a better knowledge and education in the diagnosis of the main primary headaches.© 2014 S. Karger AG, Basel.

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