Clinical characteristics and diagnostic delay in cluster headache in Egypt.

Background: Early diagnosis of CH is a cornerstone and it is important to detect causes leading to diagnostic delay. Limited published data exist regarding CH in Egypt, and with no data showing characteristics of CH or causes of diagnostic delay .

Aim: To investigate clinical characteristics, for CH and detect causes of diagnostic delay in Egypt.

Methodology: A cross-sectional study was conducted including all patients (age: 18-60 years) with primary headache disorders in Egypt with CH patients consecutively recruited over 1 year. Demographic and clinical characteristics as well as rate of diagnostic delay were collected.

Results: This registry included 1187 patients with primary headaches over a year. CH accounted for 1.9% . The majority of CH patients were males (82%), and a mean age of 37.9 ± 10 years. The mean age of disease onset was 25 ± 8 years. Sixty-five percent had episodic CH, while 34.8% had chronic CH. Most of the patients (95.7%) had strictly unilateral pain (right side 52.2%, left side 43.5%). Autonomic features were rhinorrhea (91%), ptosis (87%), and lacrimation (78%). Migrainous features were found in 26% of patients. Bout duration of CH lasted on an average of 1-4 months. Time interval of diagnostic delay ranged from 0.5 to 29 years, with a mean diagnostic delay of 9.8 ± 7.9 years.

Conclusion: This study showed that CHs present 1.9% of primary headache disorders in Egypt, with males more affected than females. the incidence of smoking was higher among CH patients. Marked diagnostic delay was found which necessitate an action toward raising awareness.