Clinical, demographic, and lifestyle characteristics of patients with cervicogenic headache: comparison with an age- and sex-matched group of individuals with migraine

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BACKGROUND: Cervicogenic headache (CEH) can be frequently misdiagnosed as migraine. This study aimed to compare clinical, demographic, and lifestyle characteristics of patients with CEH and individuals with migraine. METHODS: The retrospective cross-sectional study included 112 patients with CEH and 112 age- and sex-matched individuals with migraine consulted at a single headache center in 2022-2026. The analysis involved clinical and demographic characteristics, and lifestyle factors, among them dominant sleep posture. RESULTS: Compared with individuals with migraine, patients with CEH were diagnosed with headache at an older age (36.27±11.95 vs. 22.62±11.13 years, p < 0.001), had shorter duration of disease (4.08±5.40 vs. 17.74±11.60 years, p < 0.001), more often reported neck pain, also occurring independently of headache (76.92% vs. 39.56%, p < 0.001), more frequently presented with greater occipital nerve (GON) sensitivity to palpation (85.44% vs. 30.21%, p < 0.001) and vitamin B12 deficiency (56.86% vs. 9.38%, p < 0.001). The CEH group contained a larger proportion of active smokers (43.75% vs. 10.71%, p < 0.001) and belly (prone) sleepers (40.18% vs. 14.29%, p < 0.001) than the migraine group. A multivariate regression analysis identified belly sleeping (OR = 11.10, p = 0.006), smoking (OR = 22.61, p = 0.005), and vitamin B12 deficiency (OR = 8.58, p = 0.005) as independent determinants of CEH. CONCLUSIONS: CEH differs from migraine in terms of selected clinical, demographic, and lifestyle characteristics. Neck pain independent of headache, GON sensitivity to palpation, older age at the onset of headache, and shorter time elapsed from the first manifestation to referral might be diagnostic prompts in suspected CEH. Belly sleeping, vitamin B12 deficiency, and smoking appear as independent determinants of CEH and might be considered in the prevention and management of this condition.

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