Autonomic Symptoms in Migraineurs: Are They of Clinical Importance

Abstract

Aim: The aim of this study was to evaluate the presence of autonomic symptoms in migraine patients with and without aura and to investigate whether there is an association between expression of autonomic symptoms and disease duration, headache side, attack duration and frequency. Methods: The study sample comprised 82 subjects in headachefree phase including 20 migraine with aura patients and 62 - without aura; 61 were females (74.39%) and 21 were males (25.61%). The mean headache frequency was 2.63 +/- 1.29 per month and the mean duration of headache occurrence was 10.04 +/- 7.26 years from the first episode. The subjects were asked whether or not they had autonomic symptoms like diaphoresis, diarrhea, eyelid oedema, pallor, flushing, syncope or syncope-like episode, constipation, palpitation, diuresis, blurred vision, sensation of chills and coldness during each migraine headache. Results: Of all 82 migraine patients, 50 (60.98%) experienced at least one of the autonomic symptoms during the attack periods. The most common symptom was flushing (39.2%). Among the autonomic symptoms, syncope or syncope-like episode was significantly more in patients without aura compared to those with aura (p< 0.05). In this study, patients who experienced autonomic symptoms during their headache attack had statistically significantly higher attack frequency (p= 0.019). Conclusion: This result indicate that migraine patients with autonomic nervous system involvement have more frequent headaches, therefore these patients should be particularly and cautiously investigated.