both sides.(3) Ashkenazi et al. approached six skin areas bilaterally in trigeminal and cervical distributions [frontal (V1), maxillary (V2), mandibular (V3), porterior neck (C2,C3), shoulder (C5), and inner forearm (C8)].(13) In one study, a series of cases, Riederer et al. did not mention the skin areas put to test.(12)
When an analysis approaches the gender distribution through the studies, the males are the majority. Marmura et al. encompass 22 males and 19 females in the study.(3) Ashkenazi et al. interestingly includes 10 males and no females.(13) In the study by Riederer et al. males and females comprise equal parts, but this particular study presents only one man and one woman, making any assumptions regarding gender unreliable.(12)
Taking into account the types of CH, whether episodic or chronic, the literature includes a short series of cases with two episodic cluster headache (ECH) patients.(14) Another study made by Ashkenazi et al. included seven ECH and three chronic cluster headache (CCH) patients.(13) And Marmura et al. describes 22 CCH and 19 ECH patients.(3) The study made by Ladda et al. comprises 8 CCH and 8 ECH patients.(14)
Moving towards the mean duration of disease, Marmura et al. described a 14.1 years duration (12.3 for CCH group and 15.7 for ECH group), Ashkenazi et al. reports a duration from 18 months to 38 years.(3,13) Riederer et al. in his series contemplates one patient with a 13 year history of ECH and another patient with a 20 years history also of ECH.(12)
As a final regard, the prevalence of allodynia in CH patients according to Marmura et al. was 49%; and 40% (28.6% for ECH patients, and 66.7% for CCH patients) according to Ashkenazi et al.(3,13) Although reporting allodynia during the attacks, both patients included by Riederer et al. tested negative for allodynia.(12) Ladda et al. found no allodynia in three patients examined during the attacks, but a significant difference in pain thresholds.(14)
Cluster Headache patients do not represent an insignificant part of all headache patients, and thus this clinical entity cannot go on being considered as a worthless rare headache. The few authors devoted to this relevant matter are mentioned repeatedly, making it evident the need for more research and interest. The prevalence of allodynia in CH is a theme which was neglected until recent times, and the small number of studies demands more attention, and finally more prevalence studies.
Headache Medicine, v.2, n.1, p.33-35, jan./feb./mar. 2011
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