Autonomic dysfunction in cluster headache patients in remission

Background: Cluster headache (CH) is a primary, trigeminal autonomic headache consisting of unilateral attacks of facial pain lasting 15-180 minutes, recurring up to eight times a day, with ipsilateral autonomic features and restlessness. Autonomic symptoms occur as a result of both sympathetic and parasympathetic system involvement. In this study, we aimed to investigate the presence of autonomic involvement in patients with CH interictal period. Methods: The Composite Autonomic Symptom Score-31 (COMPASS-31) was administered to 19 patients with CH during remission and to 19 healthy controls of similar age and sex, and the responses of the two groups were compared. Results: Patients with CH showed orthostatic intolerance, increased secretomotor and pupillomotor complaints and increased COMPASS-31 total score during remission. Conclusions: Patients with CH showed increased orthostatic intolerance, secretomotor and pupillomotor complaints. This suggests that there may be not only cranial autonomic involvement but also systemic autonomic involvement and that this involvement is not only during attacks. Our study will shed light on further studies including objective and advanced investigations that should be performed to show that these complaints are increased in the group with CH.