Premonitory and Resolution Symptoms in Migraine: A Prospective Study in 100 Unselected Patients

Abstract

The nosology of migraine premonitory (PS) and resolution (RS) symptoms was studied in 100 migraineurs consulting their general physician. They were asked to fill in, for three attacks, a PS and RS questionnaire. 'True' PS/RS were those experienced the day before (or the day after) the headache had started only if they were not present in a questionnaire completed in a pain-free period. True PS and RS were experienced by 84% and 80%, respectively, of subjects for the first attack. The mean and range (per patient) of PS were 6.8 and 0-21 and of RS 4.7 and 0-15. Anxiety, phonophobia, irritability, unhappiness and yawning were the commonest PS, whereas asthenia, tiredness, somnolence and concentration difficulties were the most common RS. Gender, age and Migraine Disability Assessment scores did not influence PS and RS. Both PS and RS were more frequent in migraine with aura subjects. Patients on preventatives showed a decreased frequency of PS and, to a lesser degree, of RS. Severity of headache was associated with a higher frequency of RS. Individual RS and especially PS were quite consistent after three attacks. Almost two-thirds of the symptoms were noticed in at least two out of three attacks, while more than a half of PS and more than a quarter of RS repeated in three out of three attacks. In conclusion, around 80% of unselected migraineurs experience RS and PS. Migraine with aura and severe pain are risk factors for experiencing PS and RS, while preventatives were protective, especially for PS.

Preictal Symptomatology in Migraines: Diagnostic and Therapeutic Significance

“…Two authors (SG and GB) read the title and abstract of every identified study and critically appraised the full text of potentially eligible studies. Table 1 summarizes the studies of prodrome reported in children and adults with migraines [4][5][6][7][8][9][10][11]. Our search reveals no devoted studies to the diagnostic and therapeutic significance of preictal symptomatology in migraines.…”

“…It shows the prevalence of prodromal symptoms in children and adults with migraine with and without aura [4][5][6][7][8][9][10][11][12]. …”

“…Prospective [6] By general practitioners/A questionnaire study Prodromes were more common in patients with aura and less frequent in patients on preventable medication. The most common individual true premonitory symptom was anxiety.…”

Premonitory-like Symptomatology in Migraine

“…[8][9][10][11][12][13] In addition, the majority of the studies performed so far have only looked at symptoms starting before the prevalence rates of 9-88%. 3,[8][9][10][11][12][13][14][15][16][17][18] See Table 1 for a breakdown of studies to date in the literature looking at premonitory symptom prevalence.…”

“…[9][10][11][12][13][14][15][16] The most common symptoms seem to be fatigue (see red in Table 1), mood change (see blue in Table 1) and yawning (see green in Table 1). These are consistent across the studies.…”