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The natural course of migraine attacks. A prospective analysis of untreated attacks compared with attacks treated with a triptan.
Cephalalgia. 2006 Jun; 26(6):712-21.C

Abstract

This study was designed to document prospectively and explore scientifically the natural course of untreated migraine attacks in detail. A new, integrated, time-intensity method for self-assessment of the intensity of symptoms was tested on 18 adult International Headache Society migraineurs who volunteered to refrain from treatment during one attack. The area under the curves (AUC) during 72 h of untreated attacks was compared with attacks treated with a triptan. Migraine attacks are heterogeneous both inter- and intra-individually. In untreated attacks, the pain can stabilize and fluctuate around a plateau with a wavelength of hours. In general, the symptoms of each separate migraine attack follow a similar temporal course, with only moderate deviations. In some cases photo- and/or phonophobia (hyperexcitability) were not experienced at all, despite severe pain and nausea. Moreover, there was sometimes no nausea despite severe pain and hyperexcitability. Vomiting does not always correlate to the intensity of nausea and is not always followed by decreased headache intensity. Treatment with a triptan usually only temporarily distorts the basic pattern of attacks. Hyperexcitability can respond before pain to treatment. These genuine findings of the classic symptoms of migraine attacks support the notion of a mutual underlying pathophysiological mechanism.

Authors+Show Affiliations

Linde M
Gothenburg Migraine Clinic, Gothenberg, Sweden. mattias.linde@neuro.gu.se
Mellberg A
No affiliation info available
Dahlöf C
No affiliation info available

MeSH

AdultAgedComorbidityCross-Over StudiesDisease ProgressionFemaleHumansHyperacusisIncidenceMaleMiddle AgedMigraine DisordersNauseaPain MeasurementPrognosisProspective StudiesRisk AssessmentRisk FactorsSerotonin Receptor AgonistsSeverity of Illness IndexSumatriptanSwedenTreatment OutcomeTryptaminesVasoconstrictor AgentsVomiting

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16686911

Citation

Linde, M, et al. "The Natural Course of Migraine Attacks. a Prospective Analysis of Untreated Attacks Compared With Attacks Treated With a Triptan." Cephalalgia : an International Journal of Headache, vol. 26, no. 6, 2006, pp. 712-21.
Linde M, Mellberg A, Dahlöf C. The natural course of migraine attacks. A prospective analysis of untreated attacks compared with attacks treated with a triptan. Cephalalgia. 2006;26(6):712-21.
Linde, M., Mellberg, A., & Dahlöf, C. (2006). The natural course of migraine attacks. A prospective analysis of untreated attacks compared with attacks treated with a triptan. Cephalalgia : an International Journal of Headache, 26(6), 712-21.
Linde M, Mellberg A, Dahlöf C. The Natural Course of Migraine Attacks. a Prospective Analysis of Untreated Attacks Compared With Attacks Treated With a Triptan. Cephalalgia. 2006;26(6):712-21. PubMed PMID: 16686911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The natural course of migraine attacks. A prospective analysis of untreated attacks compared with attacks treated with a triptan. AU - Linde,M, AU - Mellberg,A, AU - Dahlöf,C, PY - 2006/5/12/pubmed PY - 2006/8/2/medline PY - 2006/5/12/entrez SP - 712 EP - 21 JF - Cephalalgia : an international journal of headache JO - Cephalalgia VL - 26 IS - 6 N2 - This study was designed to document prospectively and explore scientifically the natural course of untreated migraine attacks in detail. A new, integrated, time-intensity method for self-assessment of the intensity of symptoms was tested on 18 adult International Headache Society migraineurs who volunteered to refrain from treatment during one attack. The area under the curves (AUC) during 72 h of untreated attacks was compared with attacks treated with a triptan. Migraine attacks are heterogeneous both inter- and intra-individually. In untreated attacks, the pain can stabilize and fluctuate around a plateau with a wavelength of hours. In general, the symptoms of each separate migraine attack follow a similar temporal course, with only moderate deviations. In some cases photo- and/or phonophobia (hyperexcitability) were not experienced at all, despite severe pain and nausea. Moreover, there was sometimes no nausea despite severe pain and hyperexcitability. Vomiting does not always correlate to the intensity of nausea and is not always followed by decreased headache intensity. Treatment with a triptan usually only temporarily distorts the basic pattern of attacks. Hyperexcitability can respond before pain to treatment. These genuine findings of the classic symptoms of migraine attacks support the notion of a mutual underlying pathophysiological mechanism. SN - 0333-1024 UR - https://www.unboundmedicine.com/medline/citation/16686911/The_natural_course_of_migraine_attacks__A_prospective_analysis_of_untreated_attacks_compared_with_attacks_treated_with_a_triptan_ DB - PRIME DP - Unbound Medicine ER -