St. Paul, Minn. – Fatigue, difficulty concentrating and a stiff neck can be tell-tale signs that a headache is coming, as many migraine sufferers already know. A multi-center study of 97 patients found that 72 percent of those who reported these types of premonitory symptoms experienced a migraine within 72 hours at least half the time. The study is published in the March 25 issue of Neurology, the journal of the American Academy of Neurology.
Being able to predict a migraine may improve chances of preventing or minimizing it, and provides important insights into the disorder, according to the researchers.
Patients with recurring migraine were assigned a hand-held electronic diary and asked to record any non-headache symptoms on a daily basis for three months. Ninety-seven percent of them recorded some type of symptom during the premonitory phase. The most common symptom reported was tiredness (reported in 72 percent), difficulty with concentration (51 percent), and stiff neck (50 percent). As the patients moved into the headache phase, the symptoms became more pronounced.
Learning to recognize the symptoms and combat the migraine before it starts could be a step forward for patients who normally have just two treatment choices: taking preventative medication daily, or taking acute treatments for a migraine that is in progress. A third option to take treatment after an attack began but before pain develops, would be an advantage.
Lead study author Peter J. Goadsby, MD, PhD, with the Institute of Neurology University College in London, said the patients reported that the symptoms stayed throughout the pre-headache phase, the headache phase, and post-headache. He said the study gave researchers insight into the pathophysiology of migraine as an “episodic dysfunction” possibly within the brainstem or diencephalon.
“The results of our study suggest CNS (Central Nervous System) changes starting up to three days before the headache, carrying on through the headache and the postdrome (post headache) gives clinical weight to evidence that electrophysiological changes start more than 24 hours before the headache,” Goadsby said.
The patient group was drawn from clinics in the UK, Denmark and the United States. All patients were 16 years of age or older, and experienced between two and eight migraines a month.
The American Academy of Neurology, an association of more than 19,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer's disease, epilepsy, Parkinson's disease, autism and multiple sclerosis.
For more information about the American Academy of Neurology, visit www.aan.com.
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