Background: Prevalence of cluster headache ( CH) is estimated at 56 to 69 per 100,000. Objective: To calculate the CH lifetime prevalence in a sample representative of the Italian general population over age 14 years. Methods: Possible CH cases according to the diagnostic criteria of the 1988 International Headache Society classification were screened from a sample of 10,071 patients ( 5,311 women and 4,760 men; mean age 50.4 years, SD 19.7 years) registered in the lists of seven Parma-based general practitioners (GPs), using a previously validated, specially designed, self-administered questionnaire. Results: Seven thousand five hundred twenty-two subjects (74.7%; 3,971 women and 3,551 men; mean age 50.8 years, SD 19.0 years) responded to the questionnaire in their GP's office (n = 3,338; 1,885 women and 1,453 men) or at home by mail (n = 1,914; 1,030 women and 884 men) or by phone (n = 2,270; 1,056 women and 1,214 men). Of the 111 suspected cases ( 76 women and 35 men), 105 were seen by a neurologist and 6 were contacted on the phone. The diagnosis of CH was confirmed in 21 ( 9 women and 12 men), including 7 already followed at the authors' center for CH. Seventeen patients had episodic CH, and four ( all men) had chronic CH. The estimated prevalence rate was 279 per 100,000 (95% CI 173 to 427), 227 per 100,000 ( 95% CI 104 to 431) in women, and 338 per 100,000 ( 95% CI 175 to 592) in men. Conclusion: These results point to a higher cluster headache lifetime prevalence than previous reports.
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