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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Clinical characterization of delayed alcohol-induced headache: A study of 1,108 participants

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  • David García-Azorín
  • Laura Aparicio-Cordero
  • Blanca Talavera
  • Andrew Johnson
  • Henrik Winther Schytz
  • Ángel Luis Guerrero-Peral
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OBJECTIVE: To evaluate the International Classification of Headache Disorders (ICHD) criteria and characterize the clinical phenotype of delayed alcohol-induced headache (DAIH).

METHODS: We conducted a cross-sectional study of university students who voluntarily consumed alcohol and experienced headache. Participants completed a survey that included demographic and clinical data. We analyzed the phenotype of the headache, validated ICHD phenotype criteria for DAIH, and analyzed whether participants fulfilled criteria for low cerebrospinal fluid (CSF) pressure headache or migraine.

RESULTS: 1108 participants were included (58% female, mean age 23 years, 41% with prior headache history). Mean alcohol intake was 158 g, spirits were consumed by 60% of the participants, beer by 41% and wine by 18%. The ICHD criteria for DAIH were met in 95% of the participants. Headache duration (mean, 6.7 hours) correlated with total g of alcohol consumed (r=0.62, P=0.03). Pain was bilateral in 85% of patients with predominantly frontal topography (43%). Pain quality was mainly pressing (60%) or pulsatile (39%) and was aggravated by physical activity in 83% of participants. ICHD low CSF pressure headache criteria were fulfilled in 58% of patients, and the migraine criteria were fulfilled by 36%.

CONCLUSIONS: DAIH is a moderate-intensity headache, is typically bilateral, and presents with frontal predominance and a pressing quality. The phenotype of DAIH combines features of both migraine and low CSF pressure headaches.

Original languageEnglish
JournalNeurology
Volume95
Issue number15
Pages (from-to)e2161-e2169
ISSN0028-3878
DOIs
Publication statusPublished - 13 Oct 2020

ID: 60922807