Abstract Details

Title Deep phenotyping using cranial autonomic symptoms in migraine and cluster headache

Topic Headache

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 192

Objective

We aimed to analyze the difference in cranial autonomic symptoms (CAS) between migraine without aura (MoA), migraine with aura (MA), and cluster headache (CH).

Background

CAS are important features of cluster headache (CH) but are also common in migraine. However, the prevalence and severity of CAS between CH, MA and MoA warrants further investigation.

Design/Methods We prospectively collected data of patients with CH and migraine using a standardized questionnaire that included nine different symptoms and a CAS severity score. The severity of each symptom, including conjunctival injection, lacrimation, nasal congestion, rhinorrhea, eyelid edema, and forehead/facial sweating was graded into four categories- absent, mild, moderate, severe.

Results We recruited 26 MA, 76 MoA, and 20 CH patients. More than half of MA and CH patients had ≥ 3 CAS (MoA vs. MA vs. CH: 44.7% vs. 61.5% vs. 85.0%,p=0.006). CH had both a higher CAS number and severity score when compared to migraine (CH vs. migraine number 4.8 ± 2.1 vs. 2.7 ± 2.6, p<0.001; severity 6.1 ± 3.6 vs. 2.7 ± 2.6,p<0.001). In migraine, MA had a higher CAS number than MoA (MA vs. MoA: 3.6 ± 2.7 vs. 2.3 ± 2.0,p=0.034), but there was no difference in the severity score. The % of patients that reported conjunctival injection and lacrimation were significantly higher in CH (75% for both symptoms) compared to both MA (conjunctival injection 34.6%, lacrimation 42.6%) and MoA (31.6% for both symptoms; p< 0.05 for all between-group comparisons). Among patients with migraine, rhinorrhea, ptosis and ear fullness were more commonly reported in MA than MoA (p<0.05 for each comparison).

Conclusions

CAS are more common and severe in CH than in migraine; and more frequently reported in MA compared to MoA. Deep phenotyping of CAS can improve diagnostic accuracy and helps with the understanding of the pathophysiology of CH, MA and MoA.

Authors/Disclosures
Jr-Wei Wu, MD, FAAN (Taipei Veterans General Hospital) PRESENTER	Dr. Wu has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Pfizer . Dr. Wu has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie . Dr. Wu has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for International Headache Society (IHS). The institution of Dr. Wu has received research support from National Science and Technology Council . The institution of an immediate family member of Dr. Wu has received research support from National Science and Technology Council .
Chia-Chun Chiang, MD (Mayo Clinic)	Dr. Chiang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Chiang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aruene Corporation . Dr. Chiang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pfizer. Dr. Chiang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie. Dr. Chiang has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. The institution of Dr. Chiang has received research support from American Heart Association. The institution of Dr. Chiang has received research support from Lundbeck. The institution of Dr. Chiang has received research support from Pfizer.
	No disclosure on file

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