Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health records

Abstract Background The study of the trigeminal autonomic cephalalgias (TAC) has been limited by difficulty aggregating sufficient numbers of patients. We used the Epic Cosmos electronic health record research platform to harness nationwide data from health care systems across the United States usin...

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Main Authors: Leon S. Moskatel, Oyindamola Ogunlaja, Niushen Zhang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Neurology
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Online Access:https://doi.org/10.1186/s12883-025-04314-1
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author Leon S. Moskatel
Oyindamola Ogunlaja
Niushen Zhang
author_facet Leon S. Moskatel
Oyindamola Ogunlaja
Niushen Zhang
author_sort Leon S. Moskatel
collection DOAJ
description Abstract Background The study of the trigeminal autonomic cephalalgias (TAC) has been limited by difficulty aggregating sufficient numbers of patients. We used the Epic Cosmos electronic health record research platform to harness nationwide data from health care systems across the United States using the Epic electronic health record to analyze the prevalence, demographics, comorbid conditions and treatments for the TACs. Methods We queried the Epic Cosmos electronic health record database for patients with diagnoses of hemicrania continua, cluster headache, paroxysmal hemicrania, and SUNCT. Prevalences, demographics were determined from this database and comorbid conditions and treatments for these conditions were analyzed. Results Our study included 152,727 patients with cluster headache, 59,312 patients with paroxysmal hemicrania, 19,321 patients with hemicrania continua, and 6,291 patients with SUNCT. Five-year prevalence of cluster headache was highest (56.7 per 100,000), followed by paroxysmal hemicrania (22.0 per 100,000), hemicrania continua (7.2 per 100,000) and SUNCT (2.3 per 100,000). All four TACs showed a higher prevalence in women. Migraine was common in all four conditions and patients with cluster headache had the highest rates of nicotine, alcohol, and cannabis use disorders. Indomethacin was notably underutilized for the indomethacin-responsive TACs. Conclusion We use a national electronic medical record database to give insight into elements of the TACs that have been previously limited by the relative rarity of these diseases.
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spelling doaj-art-5b61ba83ae7c4bd7a6a8c37887bd16c42025-08-20T03:05:04ZengBMCBMC Neurology1471-23772025-07-012511910.1186/s12883-025-04314-1Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health recordsLeon S. Moskatel0Oyindamola Ogunlaja1Niushen Zhang2Department of Neurology, Stanford UniversityDepartment of Neurology, Stanford UniversityDepartment of Neurology, Stanford UniversityAbstract Background The study of the trigeminal autonomic cephalalgias (TAC) has been limited by difficulty aggregating sufficient numbers of patients. We used the Epic Cosmos electronic health record research platform to harness nationwide data from health care systems across the United States using the Epic electronic health record to analyze the prevalence, demographics, comorbid conditions and treatments for the TACs. Methods We queried the Epic Cosmos electronic health record database for patients with diagnoses of hemicrania continua, cluster headache, paroxysmal hemicrania, and SUNCT. Prevalences, demographics were determined from this database and comorbid conditions and treatments for these conditions were analyzed. Results Our study included 152,727 patients with cluster headache, 59,312 patients with paroxysmal hemicrania, 19,321 patients with hemicrania continua, and 6,291 patients with SUNCT. Five-year prevalence of cluster headache was highest (56.7 per 100,000), followed by paroxysmal hemicrania (22.0 per 100,000), hemicrania continua (7.2 per 100,000) and SUNCT (2.3 per 100,000). All four TACs showed a higher prevalence in women. Migraine was common in all four conditions and patients with cluster headache had the highest rates of nicotine, alcohol, and cannabis use disorders. Indomethacin was notably underutilized for the indomethacin-responsive TACs. Conclusion We use a national electronic medical record database to give insight into elements of the TACs that have been previously limited by the relative rarity of these diseases.https://doi.org/10.1186/s12883-025-04314-1TACHemicrania continuaCluster headacheParoxysmal hemicraniaSUNCTEpidemiology
spellingShingle Leon S. Moskatel
Oyindamola Ogunlaja
Niushen Zhang
Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health records
BMC Neurology
TAC
Hemicrania continua
Cluster headache
Paroxysmal hemicrania
SUNCT
Epidemiology
title Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health records
title_full Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health records
title_fullStr Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health records
title_full_unstemmed Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health records
title_short Prevalence, demographics, comorbidities, and treatment patterns of patients with the trigeminal autonomic cephalalgias: a retrospective analysis of United States electronic health records
title_sort prevalence demographics comorbidities and treatment patterns of patients with the trigeminal autonomic cephalalgias a retrospective analysis of united states electronic health records
topic TAC
Hemicrania continua
Cluster headache
Paroxysmal hemicrania
SUNCT
Epidemiology
url https://doi.org/10.1186/s12883-025-04314-1
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