Cross-sectional study uncovers a 6.4-year diagnostic delay in cluster headache patients, highlighting referral barriers and frequent misdiagnosis as major impediments to timely care.
Key Points
To identify demographic and clinical factors associated with diagnostic delay in cluster headache to promote earlier clinical recognition and timely management.
Conducted a multicenter cross-sectional study recruiting 64 patients with episodic or chronic cluster headache across 6 Portuguese neurology centers.
Administered an online questionnaire evaluating demographics, clinical features, consultations, misdiagnoses, and treatments, analyzing predictors using correlation tests and multiple linear regression.
Mean diagnostic delay was 6.4 ± 8.3 years (range: 0–39 years), with 46.9% of patients experiencing delays exceeding 4 years and 59.4% receiving prior alternative diagnoses, predominantly migraine and sinusitis.
Shorter diagnostic delay was significantly associated with younger age at onset (ρ = –0.45; p < 0.001), attack onset between midnight and 3 am (p = 0.029), and presence of eyelid edema (p = 0.001).
Diagnostic delay strongly correlated with the number of pain episodes before neurology consultation (ρ = 0.92; p < 0.001), while prior use of triptans (p = 0.037) and topiramate (p = 0.012) correlated with longer delays.