Episodic versus chronic cluster headaches

types of cluster headaches

The disease can be divided into two forms according to the duration and frequency of episodes:

• episodic
  • cluster headache attacks occurring in periods lasting from 7 days to one year, separated by pain-free periods lasting at least 3 months
    • cluster periods usually last between 2 weeks and 3 months
  • most headaches start at the same time of year and occur at the same time during the day or night
    
  • six times more common than the chronic form
  • in contrast to cluster headache, there is no male predominance. Onset is usually in adulthood, although childhood cases are reported (2)
    
    
• chronic
  • cluster headache attacks occurring for one year or longer without remission, or with remission periods lasting less than 3 months
  • may arise 'de novo' (previously referred to as primary chronic cluster headache), or evolve from episodic cluster headache (previously secondary chronic cluster headache)
  • in some patients change occurs from chronic cluster headache to episodic cluster headache.
  • seen in around 10-15% of patients with cluster headaches (1,2,3).
  • men are afflicted three times more often than women.

Reference:

• (1) Oragnisation for the understanding of Cluster Headache (OUCH) UK. Cluster headache -The basics.
• (2) The International Classification of Headache Disorders 3rd edition (ICHD-3). Part three: painful cranial neuropathies, other facial pains and other headaches.
• (3) Weaver-Agostoni J. Cluster headache. Am Fam Physician..2013;88(2):122-8.