Clinical features of episodic migraine and transformed migraine: a comparative study

Galego, José Carlos Busto; Cipullo, José Paulo; Cordeiro, José Antônio; Tognola, Waldir Antônio

doi:10.1590/s0004-282x2002000600005

Cited by 25 publications

(14 citation statements)

References 11 publications

(26 reference statements)

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“…These data showed a high occurrence of sleep-related migraine in a selected sample of migraineurs with low attack frequency (39% of the total sample of migraineurs), supporting previous literature data documenting that migraine attacks can preferentially occur during night sleep and/or upon awakening (Fox and Davis, 1998;Galego et al, 2002;Gori et al, 2012a;Kelman and Rains, 2005;Solomon, 1992). The relationship between migraine and sleep is complex and pluridirectional (i.e.…”

Section: Discussionsupporting

confidence: 86%

“…A preferential occurrence of attacks at night-time or in the early morning has been widely ascertained in migraine without aura patients. In particular, Galego et al (2002) documented that both episodic (55%) and chronic (62.5%) migraineurs reported waking up in the morning or being woken up during the night by headache, and subsequently Kelman and Rains (2005), in a study carried out in a larger sample of migraineurs (n=1283), found that 71% of patients exhibited morning headache on awakening (in 35% of the whole sample this was a very frequent or frequent occurrence, whereas in 36% it was occasional). Furthermore, a chronobiological study by Solomon (1992) found the occurrence of migraine attacks to be greatest between 6 a.m. and 10 a.m. and subsequent research by Fox and Davis (1998), looking for a circadian periodicity in the time of onset of 3,582 migraine headache attacks experienced by 1,698 patients, documented that onset of migraine without aura was most likely to occur between 4 a.m. and 9 a.m., the likelihood of its occurrence during this interval of time being far greater than at any other time of the day.…”

Section: Introductionmentioning

confidence: 98%

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Preferential occurrence of attacks during night sleep and/or upon awakening negatively affects migraine clinical presentation

Gori¹,

Lucchesi²,

Baldacci³

et al. 2015

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SummaryIt is well known that migraine attacks can preferentially occur during night sleep and/or upon awakening, however the possible implications of this timing on migraine clinical presentation remain unclear. The aim of this study was to assess the possible consequences of sleep-related migraine (defined as ≥75% of migraine attacks occurring during night sleep and/or upon awakening) on the migraine clinical picture (i.e. migraine-related disability, attack severity, use of symptomatic drugs), subjective sleep quality, excessive daytime sleepiness and fatigue. Two hundred consecutive migraine without aura patients were enrolled; patients with comorbid disorders or chronic medication use were excluded. 39% of the migraineurs included in the study received a diagnosis of sleep-related migraine. The mean frequency of migraine attacks (days per month) did not significantly differ between the patients with and those without sleep-related migraine, whereas migraine-related disability (p<0.0001), mean attack severity (p<0.0001), and monthly intake of symptomatic drugs (p<0.0001) were significantly higher in patients with migraine preferentially occurring at night-time and/or upon awakening. Subjective sleep quality and excessive daytime sleepiness did not differ significantly between the two groups, whereas fatigue was significantly more present in the patients with sleep-related migraine (p=0.0001). These data seem to support the hypothesis that patients with sleep-related migraine represent a subset of individuals with a more severe and disabling clinical presentation of migraine and greater impairment of daily functioning, as suggested by the higher degree of fatigue. Migraineurs with night-time attacks Preferential occurrence of attacks during night sleep and/or upon awakening negatively affects migraine clinical presentation also showed a greater use of symptomatic drugs, possibly related to delayed use of symptomatic treatment. The identification of subtypes of patients with a higher disability risk profile could have crucial implications for individually tailored management of migraine patients. KEY WORDS: daytime sleepiness, fatigue, migraine-related disability, sleep-related migraine, subjective sleep quality. IntroductionMigraine is a primary headache disorder, characterized by recurrent attacks, lasting 4-72 hours, of pain, typically described as unilateral, pulsating, moderate or severe, aggravated by routine physical activity, and associated with nausea and/or photophobia and phonophobia (Headache Classification Subcommittee of the International Headache Society, 2004; Headache Classification Committee of the International Headache Society (IHS), 2013). Migraine is a highly disabling condition, ranked by the World Health Organization as the seventh highest cause of disability globally; it has a significant impact on the quality of life of affected subjects and is associated with a high socio-economic burden (Vos et al., 2012;Steiner et al., 2013). Migraine attacks can affect several aspects of a patient'...

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 98%

Preferential occurrence of attacks during night sleep and/or upon awakening negatively affects migraine clinical presentation

Gori¹,

Lucchesi²,

Baldacci³

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Excessive use of analgesics and ergotamine compounds; stress situation in the family or at work; traumatic life events; hypertension, birth control pills; abnormal personality profile and co-morbidity with some disorders such as anxiety and depression are factors linked with this transformation 11 . Galego et al 12 , based on clinical and demographic characteristics of episodic and transformed migraine, observed that earlier beginning of attacks might be a risk factor for transformed migraine. Taking into account the co-morbidity between migraine and depression, it is important for clinical practice to evaluate depressive symptoms as well as how their intensity is developed in patients with EM and TM.…”

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confidence: 99%

Depression and migraine

Galego

Cipullo

Cordeiro

et al. 2004

Arq. Neuro-Psiquiatr.

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The objective of this study was to evaluate both the presence and intensity of depressive symptoms in patients with episodic migraine (EM) and transformed migraine (TM) or chronic migraine, comparing them with a control group. Beck Depression Inventory (BDI) was used for this purpose. The median of BDI score of the control group was significantly lower than the EM and TM groups (p<0.0005). Either the EM or the TM did not show any significant difference in relation to the median of BDI scores (p=0.12). The TM group showed a higher frequency of severe depression when analyzed qualitatively by dependence analysis. Symptoms of severe depression by means of qualitative analysis may strengthen a co-morbidity between depression and transformed migraine. This association might be considered rather a factor of TM perpetuation than a risk factor for the transformation of EM into TM.

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“…In relation to CDH, Galego et al 28 found the emotional stress as the main precipitating factor (75%) of headache to transformed migraine. Stress is also mentioned as a development factor for CDH 6 .…”

Section: Discussionmentioning

confidence: 99%

Chronic daily headache: stress and impact on the quality of life

Galego

Moraes

Cordeiro

et al. 2007

Arq. Neuro-Psiquiatr.

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ABSTRACT-Objective: To evaluate the stress presence and its influence in the quality of life of patients with chronic daily headache (CDH). Method: A hundred patients with at least 18 years old, with primary headache with duration greater than 4 hours a day, and frequency of 15 or more days monthly for at least three months were studied. Lipp´s Inventory of Stress Symptoms and the Medical Outcomes Study Short Form (SF-36) were used. Results: Stress was observed in 90% of the patients; nearly half of them was in the phase almost exhaustion. Patients with stress when compared with the ones with no stress presented significantly lower scores in all the domains of SF-36; except in physical functioning. The resistance phase presented scores significantly higher than almost exhaustion; except for bodily pain. Conclusion: The majority of the patients presented stress with significant reduction in their quality of life. Consequently, the stress could be related with both the development and the maintenance of CDH.KEY WORDS: chronic daily headache, stress, quality of life. SP -Brasil. E-mail: jcgalego@superig.com.br The term chronic daily headache (CDH) comprises a group of headaches that manifests in 15 or more days a month, lasting more than 4 hours, including the headaches associated with the excessive use of medication 1 . The prevalence in the general population ranges from 3 to 5%, and women are the most affected 2-4 . Several factors are related with CDH development: abnormal profi le of the personality; stress; the excessive use of symptomatic medication; arterial hypertension; the use of contraceptives or estrogen replacement and traumatic life events 5 . Excessive use of medication is considered the main progression factor for the CDH stage 6 , however, the stress is mentioned as one of the most frequent factors in precipitating and worsening headache episodes 7,8 . Stress represents the tension sensation, anguish and discomfort that an individual can experiment. Those sensations would be consequence of important emotional events and or physical and mental disorders. Basically, stress development depends on both the interpretation of the triggering factors and the coping strategies. The personality characteristics can also determine the individual's answer to stress 9 . At fi rst, Selye proposed the stress development into three phases: Cefaléia crônica diária: estresse e impacto sobre a qualidade de vida RESUMO- Dr. José Carlos Busto Galego -Rua Professor Nelson I. Bento Lutaif 145 -15091-550 São José do Rio Preto

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Clinical features of episodic migraine and transformed migraine: a comparative study

Cited by 25 publications

References 11 publications

Preferential occurrence of attacks during night sleep and/or upon awakening negatively affects migraine clinical presentation

Preferential occurrence of attacks during night sleep and/or upon awakening negatively affects migraine clinical presentation

Depression and migraine

Chronic daily headache: stress and impact on the quality of life

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