Document Detail

The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs.
MedLine Citation:
PMID:  15447695     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study of premonitory symptoms in migraine was performed to document the frequency, duration, and types of symptoms in a large group of migraine patients. BACKGROUND: Prodrome importance continues to be debated. Intervention early in the migraine attack is assuming more importance and necessitates better knowledge of the prodrome. METHODS: A total of 893 migraine patients (IHS 1.1-1.7) were evaluated at first visit. Prodrome frequency, duration, and characteristics were analyzed in the total migraine population IHS 1.1-1.7 and IHS 1.1-1.6 migraine. RESULTS: A total of 32.9% of IHS migraine 1.1-1.6 patients reported prodrome symptoms with an average of 9.42 hours. IHS 1.1-1.7 migraine reported 29.7% and 6.8 hours, respectively. The most commonest symptoms were tiredness, mood change, and gastrointestinal symptoms; all three of these symptoms were present together in 17% of the patients with prodrome. The duration of prodrome was less than 1 hour in 45.1%, 1-2 hours in 13.6%, 2-4 hours in 15.0%, 4-12 hours in 13.1%, and greater than 12 hours in 13.2%. IHS 1.1-1.7 patients showed similar findings. IHS 1.1-1.6 patients with prodrome differed from patients without prodrome in having more triggers as a whole (P <.01), more individual triggers including alcohol (P <.01), hormones (P <.01), light (P <.001), not eating (P <.05), perfume (P <.01), stress (P <.01), and weather changes (P <.05), a longer duration of aura (P <.05), longer time between aura and headache (P <.05), more aura with no headache (P <.05), longer time to peak of headache (P <.05), longer time to respond to triptan (P <.05), longer maximum duration of headache (P <.05), and more headache associated nausea (P <.05), more headache associated running of the nose or tearing of the eyes (P <.05), more postdrome syndrome (P <.05), and longer duration of postdrome syndrome (P <.001). CONCLUSIONS: This study provides a portrait of prodrome in a large cohort of patients. It highlights differences between patients with prodrome and patients not having prodrome, and it draws attention to the potential of preventing the headache phase of the acute migraine attack.
Leslie Kelman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Headache     Volume:  44     ISSN:  0017-8748     ISO Abbreviation:  Headache     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-27     Completed Date:  2005-01-27     Revised Date:  2009-02-02    
Medline Journal Info:
Nlm Unique ID:  2985091R     Medline TA:  Headache     Country:  United States    
Other Details:
Languages:  eng     Pagination:  865-72     Citation Subset:  IM    
Headache Center of Atlanta, GA 30342, USA.
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MeSH Terms
Aged, 80 and over
Cohort Studies
Fatigue / etiology
Gastrointestinal Diseases / etiology
Middle Aged
Migraine Disorders / complications,  physiopathology*
Mood Disorders / etiology
Time Factors
Comment In:
Headache. 2005 May;45(5):615-6; discussion 616-7   [PMID:  15953286 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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