Possible Predictive Factors in the Prognosis of Migraine with Aura

Abstract

In order to identify possible predictive factors in the prognosis of migraine with aura (MA), we conducted a review at 10 to 20 years from referral on a sample of 77 MA patients (51 F, 26 M) consecutively seen for the first time at the University of Parma Headache Center. Based on the date of the last MA attack reported by these patients, we divided them into two study groups: a group of 22 patients "with remission of the disease," i.e. attack-free for at least 2 years at the end of the follow-up study; and a group of 55 patients "without remission of the disease," i.e. still having attacks in the last 2 years of the follow-up study. A comparative analysis of the MA clinical features observed in the two groups at the time of the patients' first visit to our Center enabled us to identify a number of favorable prognostic indicators, namely: a family history of parents with MA, the absence of other associated forms of primary headache, and the absence of both natural and artificial light stimulation as trigger factors.

Prognosis of migraine and tension-type headache

“…4,7,14,27 The significant risk factors from our analyses are in line with the few previous studies of adults. 4,5,7,9,14 High migraine headache frequency and young age at onset have previously been found to be predictive of a worse prognosis both in cohort studies and clinical series. 4,5,7,14 High migraine headache frequency and overuse of medicine has, in clinical patient series, been shown to predict evolution of migraine into chronicity (chronic migraine, chronic tension-type headache, or probable medication overuse headache).…”

“…4,5,7,9,14 High migraine headache frequency and young age at onset have previously been found to be predictive of a worse prognosis both in cohort studies and clinical series. 4,5,7,14 High migraine headache frequency and overuse of medicine has, in clinical patient series, been shown to predict evolution of migraine into chronicity (chronic migraine, chronic tension-type headache, or probable medication overuse headache). 5,9 The reported relationship between poor prognosis and frequent medication use could not be confirmed, which could be due to the limited number of cases, no cases of chronic migraine, and the moderate rate of frequent medication use (11%) in this general population.…”

“…4,5,7,14 High migraine headache frequency and overuse of medicine has, in clinical patient series, been shown to predict evolution of migraine into chronicity (chronic migraine, chronic tension-type headache, or probable medication overuse headache). 5,9 The reported relationship between poor prognosis and frequent medication use could not be confirmed, which could be due to the limited number of cases, no cases of chronic migraine, and the moderate rate of frequent medication use (11%) in this general population. For the majority, we found a favorable outcome of frequent episodic or chronic tension-type headache, 45% experienced remission, 40% had frequent episodic tension-type headache, and 16% experienced chronic tension-type headache.…”

“…15,17,27 Predictive factors for worse prognosis of migraine are high migraine headache frequency, young age at onset, and overuse of medication. [3][4][5][6][7]14,22 The only known sources of information for the prognosis of tension-type headache are follow-up of cohorts with chronic daily headache, 28,29 child cohorts, 19,20,23,25 outpatients with tension-type headache, 30 juvenile outpatients, 10,11 and a case-control study of unspecified chronic daily headache. 31 No follow-up studies have been found for tension-type headache in adults from the general population.…”

Alimentäre Triggerfaktoren bei Migräne und Kopfschmerz vom Spannungstyp

“…Die Häufig-keit, mit der Patienten Nahrungs-und Genussmittel mit Kopfschmerzen in Zusammenhang brachten, schwankt erheblich, und zwar bei Migränepatienten zwischen 12 und 58 sowie bei Patienten mit KST zwischen 0 und 35 [9,11,59,65,66,67,71,80,85,97]. Studien, in denen Migrä-ne mit KST verglichen wurde, fanden entweder ein häufigeres Vorkommen in der Migränegruppe oder keine Unterschiede [9,59,66,71,80].…”