A group of scientists of the University of Copenhagen revealed that cluster headache (CH) is not only associated with pain but also with preictal and postictal symptoms.

The effects of ictal and related states on cluster headache prevalence, nature and symptoms were assessed via an observational, prospective analysis which involved fifty-seven patients. These patients were suffering from a chronic or episodic cluster headache. A questionnaire containing 33 migraines, and CH related symptoms were generated. Patients expressed clinical characteristics up to 10 CH attacks/patient. The survey was divided into three phases (preictal, ictal and postictal). The patients provided the information whether the symptoms were present and if present, what was the estimated duration.

A total of 500 CH attacks were observed. The pre-ictal phase appeared 20 minutes before 46% of attacks with symptoms like restlessness, mood changes and concentration difficulty. The autonomic and local painful symptoms were noticed 10 min before 35% and 54.6% attacks, respectively. After 20 minutes, the autonomic symptoms and pain subsided, but postictal problems (concentration problem, fatigue and low energy) lasted for about 60 minutes. The outcomes reflect that the patients with CH not only suffered from pain but also with pre and postictal symptoms. The knowledge about the ictal symptoms in CH may help to understand the pathophysiology of CH and related abortive treatments better.