EHMTI-0064. The prevalence of cluster headache in the elderly is higher in women than in men

Introduction

Cluster headache (CH) is considered a disorder of young men, which predominantly begins at age 20-to-40 years.

Aims

We evaluated the gender distribution in patients with CH aged 65 years and older.

Methods

For the last 15 years we have observed 261 patients suffering from CH. Out of these cases, 43 patients (16.5% of the whole population) were over 65 years.

Results

In this group of elderly patients, 24 were females and 19 were males. We diagnosed 4 patients with CH (only one bout, according to the International Classification of Headache Disorder), 25 with episodic CH, and 14 with chronic CH. The onset occurred in ages 35-44 years for 21.4% of cases, in ages 45-54 for 16.7%, in ages 55-64 for 28.6% and after the age of 65 years for 33.3%. Notably, in the latter subgroup, the females significantly prevailed, accounting for 78.6% of cases. Out of the patients aged over 65 years the prevalence of chronic CH was remarkably higher (25.6%) than in previous ages (9.5%).

Conclusions

The increasing number of elderly patients with CH could be related to an inadequate recognition of this headache disorder, which has been believed for a long time to affect mainly young subjects. Apparently peculiar to female distribution, an increased frequency of CH appears to occur in middle-age and elderly patients. To our knowledge, we report the patient with the oldest age at onset (a 93-year-old woman) and the largest case series of CH elderly patients published in the literature to date.

No conflict of interest.