Nuchal features of cluster headache.
Solomon S, Lipton RB, Newman LC.
Department of Neurology, Montefiore Medical Center, New York, New York 10467.
Nuchal symptoms were found in the majority of 100 consecutive patients with
cluster headache. In 10%, pain was experienced in the neck with the initial
typical orbitotemporal pain; in 37%, pain radiated from the orbit or temple to
the ipsilateral side of the neck. Sometimes, neck pain heralded the onset of the
attack by a few minutes. During an attack, neck stiffness was reported in 40%
and tenderness in 29%. Movement of the neck, especially flexion, precipitated
cluster headache in 9% of patients. This was particularly true of patients with
chronic cluster headache. Neck movement aggravated the headache in 16 of 100
patients and an equal number reported amelioration of pain by neck movement,
especially extension. The nuchal features did not necessarily accompany every
attack and were usually overshadowed by the severity of the typical headache.
Nevertheless, symptoms referable to the neck occur more commonly than is
generally appreciated.
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