Ghent University Academic Bibliography

Advanced

Diagnostic and therapeutic trajectory of cluster headache patients in Flanders

Elien Van Alboom, Paul Louis, Michel Van Zandijcke UGent, Luc Crevits UGent, Anna Vakaet and Koen Paemeleire UGent (2009) ACTA NEUROLOGICA BELGICA. 109(1). p.10-17
abstract
Objective : A fraction of cluster headache (CH) patients face diagnostic delay, misdiagnosis, undertreatment and mismanagement. Specific data for Flanders are warranted. Methods : Data on CH characteristics, diagnostic process and treatment history were gathered using a self-administered questionnaire with 90 items in CH patients that presented to 4 neurology outpatient clinics. Results : Data for 85 patients (77 men) with a mean age of 44 years (range 23-69) were analysed. 79% suffered from episodic CH and 21% from chronic CH. A mean diagnostic delay of 44 months was reported. 31% of patients had to wait more than 4 years for the CH diagnosis. 52% of patients consulted at least 3 physicians prior to CH diagnosis. Most common misdiagnoses were migraine (45%), sinusitis (23%), tooth/jaw problems (23%), tension-type headache (16%) and trigeminal neuralgia (16%). A significant percentage of patients had never received access to injectable sumatriptan (26%) or oxygen (31%). Most prescribed preventative drugs after the CH diagnosis were verapamil (82%), lithium (35%), methysergide (31%) and topiramate (22%). Despite the CH diagnosis, ineffective preventatives were still used in some, including propranolol (12%), amitriptyline (9%) and carbamazepine (12%). 31% of patients had undergone invasive therapy prior to CH diagnosis, including dental procedures (21%) and sinus surgery (10%). Conclusion : Despite the obvious methodological limitations of this study, the need for better medical education on CH is evident to optimize CH management in Flanders.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
mismanagement, Cluster headache, diagnostic delay, undertreatment, misdiagnosis, Flanders, POPULATION, ZOLMITRIPTAN, SUMATRIPTAN, MANAGEMENT, INJECTION, MIGRAINE
journal title
ACTA NEUROLOGICA BELGICA
Acta Neurol. Belg.
volume
109
issue
1
pages
10 - 17
Web of Science type
Article
Web of Science id
000265197200002
JCR category
CLINICAL NEUROLOGY
JCR impact factor
0.597 (2009)
JCR rank
147/165 (2009)
JCR quartile
4 (2009)
ISSN
0300-9009
language
English
UGent publication?
yes
classification
A1
id
597411
handle
http://hdl.handle.net/1854/LU-597411
date created
2009-04-21 17:39:56
date last changed
2012-10-29 11:22:05
@article{597411,
  abstract     = {Objective : A fraction of cluster headache (CH) patients face diagnostic delay, misdiagnosis, undertreatment and mismanagement. Specific data for Flanders are warranted. 
Methods : Data on CH characteristics, diagnostic process and treatment history were gathered using a self-administered questionnaire with 90 items in CH patients that presented to 4 neurology outpatient clinics. 
Results : Data for 85 patients (77 men) with a mean age of 44 years (range 23-69) were analysed. 79\% suffered from episodic CH and 21\% from chronic CH. A mean diagnostic delay of 44 months was reported. 31\% of patients had to wait more than 4 years for the CH diagnosis. 52\% of patients consulted at least 3 physicians prior to CH diagnosis. Most common misdiagnoses were migraine (45\%), sinusitis (23\%), tooth/jaw problems (23\%), tension-type headache (16\%) and trigeminal neuralgia (16\%). A significant percentage of patients had never received access to injectable sumatriptan (26\%) or oxygen (31\%). Most prescribed preventative drugs after the CH diagnosis were verapamil (82\%), lithium (35\%), methysergide (31\%) and topiramate (22\%). Despite the CH diagnosis, ineffective preventatives were still used in some, including propranolol (12\%), amitriptyline (9\%) and carbamazepine (12\%). 31\% of patients had undergone invasive therapy prior to CH diagnosis, including dental procedures (21\%) and sinus surgery (10\%). 
Conclusion : Despite the obvious methodological limitations of this study, the need for better medical education on CH is evident to optimize CH management in Flanders.},
  author       = {Van Alboom, Elien and Louis, Paul and Van Zandijcke, Michel and Crevits, Luc and Vakaet, Anna and Paemeleire, Koen},
  issn         = {0300-9009},
  journal      = {ACTA NEUROLOGICA BELGICA},
  keyword      = {mismanagement,Cluster headache,diagnostic delay,undertreatment,misdiagnosis,Flanders,POPULATION,ZOLMITRIPTAN,SUMATRIPTAN,MANAGEMENT,INJECTION,MIGRAINE},
  language     = {eng},
  number       = {1},
  pages        = {10--17},
  title        = {Diagnostic and therapeutic trajectory of cluster headache patients in Flanders},
  volume       = {109},
  year         = {2009},
}

Chicago
Van Alboom, Elien, Paul Louis, Michel Van Zandijcke, Luc Crevits, Anna Vakaet, and Koen Paemeleire. 2009. “Diagnostic and Therapeutic Trajectory of Cluster Headache Patients in Flanders.” Acta Neurologica Belgica 109 (1): 10–17.
APA
Van Alboom, E., Louis, P., Van Zandijcke, M., Crevits, L., Vakaet, A., & Paemeleire, K. (2009). Diagnostic and therapeutic trajectory of cluster headache patients in Flanders. ACTA NEUROLOGICA BELGICA, 109(1), 10–17.
Vancouver
1.
Van Alboom E, Louis P, Van Zandijcke M, Crevits L, Vakaet A, Paemeleire K. Diagnostic and therapeutic trajectory of cluster headache patients in Flanders. ACTA NEUROLOGICA BELGICA. 2009;109(1):10–7.
MLA
Van Alboom, Elien, Paul Louis, Michel Van Zandijcke, et al. “Diagnostic and Therapeutic Trajectory of Cluster Headache Patients in Flanders.” ACTA NEUROLOGICA BELGICA 109.1 (2009): 10–17. Print.