Developing a diagnostic tool for the early diagnosis of cluster headache

Background: Cluster headache (CH), the most common of the trigeminal autonomic cephalalgias (TAC) is a rare, severe condition. CH is characterized by unilateral V1 trigeminal distribution pain, ipsilateral cranial autonomic features and tendency to circadian and circannual periodicity. Although CH has very distinct features the patients face delays in diagnosis, misdiagnosis and mismanagement.

Objective: The project aims to pilot a new diagnostic tool to help primary care doctors and physicians in emergency departments to correctly diagnose CH.

Diagnostic tool: The new diagnostic tool will include: visual and verbal component that will facilitate differentiation of CH and other primary headache disorders; in addition few key questions that differentiate CH from migraine will be included in the diagnostic tool.

Method: Patients will be recruited from the Hull Headache Clinic. A cohort of CH patients will be invited to participate and patients with migraine will be used as control group. The diagnosis will be based on the International Headache Society Criteria. We aim to apply the new diagnostic tool on at least 100 participants in each group for validation and the sensitivity and specificity for each component will be evaluated.

Results: We aim to produce an A4 sheet for the new diagnostic tool to be available at the GP practices and emergency departments to assist in diagnosing CH.

Conclusions: The new tools of diagnosis have the potential to improve the delays in diagnosis, misdiagnosis and mismanagement.