Awareness of cluster headache clinical presentations and management among different healthcare specialties in Egypt: a cross-sectional survey

Abstract Background Cluster headache is one of the most common and disabling autonomic cephalgias, and the delay in its diagnosis results in a significantly negative impact on the patients’ lives. In this study, we aimed to investigate the awareness of cluster headache clinical features and management among different clinical specialties in Alexandria. We conducted a cross-sectional survey with physicians from different specialties who see headache patients and working in hospitals covering the four suppliers of health services in Alexandria (i.e., University, Insurance, Military, and Ministry of Health hospitals). A self-administered questionnaire was developed to collect demographic data, awareness about cluster headache, and clinical practice. Results Of 150 physicians invited, 92 responded to the survey. The mean age of participants was 42.3 ± 11.6 years, and the median duration of clinical practice was 15 (5–20) years. Only 15.2% of the participants were university physicians, and approximately 14.2% were neurologists. Of the whole sample, 48.9% reported they heard about CH, and only 31.5% treated cases with CH. More than half of the sample (52.2%) did not know the distinguishing features of CH. Seasonal/diurnal variation of CH was identified by 52.2%. Only 37% and 31.5% of the participants knew that CH is more severe than migraine and tension-type headache and that it awakens patients from sleep, respectively. Verapamil was the most common (54.3%) prophylactic treatment prescribed. Only 2 participants (2.2%) reported using high flow oxygen as an abortive therapy for CH. Neurologists were significantly more knowledgeable of CH than all other specialties in almost all questions asked ( p < 0.05). Similarly, University physicians were more knowledgeable than physicians from other healthcare services providers ( p < 0.05). The number of years of clinical practice only affected the physicians’ awareness of suicide/depression associated with CH ( p = 0.02) and their prescription of high-flow oxygen (0.034). The referral to specialized headache clinics (17.4%) and to general neurologists (47.8) was low. Conclusion Awareness is poor among physicians in Alexandria about CH, particularly among non-neurologists and physicians from healthcare providers other than university hospitals.