More than 80% of people who suffer from migraine have some pre-headache symptoms warning them of the impending headache, according to a study presented at the American Headache Society 64th Annual Scientific Meeting and also published in the journal Headache.¹

For the present study, researchers enrolled 12,810 participants with migraine from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study with the objective to describe the common pre-headache symptoms of migraine attacks. A pre-identified list was used to document feelings or warning of headache as reported by the participants. Pre-headache features that are not regarded as warning symptoms were also recorded.

A total of 10,800 (84.3%) had a minimum of one pre-headache and nearly 60% (n=6129; 56.7%) viewed them as a warning symptom for an oncoming headache. More than half (51.2%) of these reported neck pain or stiffness as a pre-headache warning symptom. The other pre-headache warning symptoms were vision problems (49.2%), feeling dizzy or light-headed (41.3%), difficulty thinking or concentrating (39.6%), feeling irritable or moody (36.4%)  and feeling tired or weary (32.5%). Forty-nine percent of those who reported visual problems also reported experiencing aura. The prevalence of moderate to severe anxiety or depression and interictal burden was also higher in them.

The symptoms of neck pain, vision problems, dizziness and difficulty in concentration or thinking were common between the two groups i.e., those who considered these as warning symptoms and those who did not. Participants who reported 15 or more monthly headache days were more likely to report a warning symptom than those who had monthly headache days ranging between 0 and 3; 57.5% vs 43.4%, respectively.

The first phase in a migraine attack is the prodrome; the phases of aura, headache and post-drome follow. The prodrome phase is also known as the pre-headache phase. People who suffer migraines often experience warning or pre-headache symptoms, but not all are aware of them as portending a headache. Recognition of these symptoms enables quick institution of treatment to either reduce the severity of headache or prevent it altogether.

Reference

1. Schwedt TJ, et al. P-10. Characterizing pre-headache (prodrome) features of migraine attacks: Results from the CaMEO study. Headache. 2022;62(Suppl. 1):11.