Abstract
BackgroundCranial autonomic symptoms are common in migraine, with eye redness and tearing being the most common ones. Their identification can help to avoid misdiagnosis, predict the disease course, and select the appropriate treatment.MethodsThis was a cross-sectional study of 904 patients who presented with migraine to a headache referral clinic. The participants filled out a questionnaire about their headache characteristics, as well as the presence of cranial autonomic symptoms. A total of 904 patients, 698 women (77.2%) and 206 men (22.8%), were included in the study, with a mean (SD) age of 38.05 (11.76) years.ResultsAbout 70% of subjects with chronic migraine and 56.2% of those with episodic migraine reported one or more cranial autonomic symptoms. The two most commonly reported autonomic symptoms were eye redness (36.06%) and tearing (21.02%). Chronic migraine (43.4% vs. 29.5%), unilateral headache (56.8% vs. 48.7%), and blurred vision (20% vs. 14.7%) were significantly more frequent in migraineurs with cranial autonomic symptoms. Headache intensity and frequency in subjects with cranial autonomic symptoms were significantly higher than in those without cranial autonomic symptoms.ConclusionWe found higher percentages of cranial autonomic symptoms in patients with unilateral headaches, frequent and severe attacks and blurred vision. A diagnosis of cranial autonomic symptoms accompanying migraine may predict more severe disease and the possibility of evolution into chronic migraine.
Highlights
Migraine is a common disabling disorder with a worldwide prevalence of 7 to 18% [1]
Episodic or chronic migraine was diagnosed by an expert neurologist/headache specialist according to the criteria of the International Classification of Headache Disorders-3 (ICHD3) [2]
The severity of autonomic symptoms is related to the intensity of pain, as we found a significant correlation between the number of autonomic symptoms, and intensity or frequency of headaches
Summary
Migraine is a common disabling disorder with a worldwide prevalence of 7 to 18% [1]. The primary characteristics of migraine are a unilateral and/or throbbing headache associated with nausea/vomiting +/− photophobia and phonophobia. Typical migraine attacks can Migraineurs experiencing CAS are more likely to experience unilateral headaches and more severe and frequent attacks [5, 6]. Identification of autonomic symptoms in migraineurs in clinical practice is necessary to avoid misdiagnosis, predict the disease course, and select the appropriate treatment. This study aims to evaluate the frequency and characteristics of CAS in patients with episodic and chronic migraine and their relation to disease course. Cranial autonomic symptoms are common in migraine, with eye redness and tearing being the most common ones. Their identification can help to avoid misdiagnosis, predict the disease course, and select the appropriate treatment
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