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Updated: Mar 19, 2026
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Published on: June 2, 2014
The migraine postdrome: An electronic diary study
Nicola J Giffin1, Richard B Lipton1, Stephen D Silberstein1
1From the Department of Neurology (N.J.G.), Royal United Hospital, Bath, UK; Albert Einstein College of Medicine (R.B.L.), New York, NY; Thomas Jefferson University (S.D.S.), Philadelphia, PA; Danish Headache Centre (J.O.), Glostrup Hospital, Denmark; NIHR-Wellcome Trust King's Clinical Research Facility (P.J.G.), King's College London, UK; and Department of Neurology (P.J.G.), University of California, San Francisco.
Objective:
To report migraine postdrome symptoms in patients who report nonheadache symptoms as part of their attacks.
Methods:
A prospective daily electronic diary study was conducted over 3 months in 120 patients with migraine. Nonheadache symptoms before, during, and after headache were collected on a daily basis. Visual analogue scales were used to capture the overall level of functioning and the severity of the headache. The postdrome was defined as the time from resolution of troublesome headache to return to normal.
Results:
Of 120 evaluable patients, 97 (81%) reported at least one nonheadache symptom in the postdrome. Postdrome symptoms, in order of frequency, included feeling tired/weary and having difficulty concentrating and stiff neck. Many patients also reported a mild residual head discomfort. In most attacks (93%), there was return to normal within 24 hours after spontaneous pain resolved. There was no relationship between medication taken for the headache and the duration of the postdrome. The severity of the migraine was not associated with the duration of the postdrome. Overall state of health scores remained low during the postdrome.
Conclusion:
Nonheadache symptoms in the postdrome were common and may contribute to the distress and disability in the patients studied. Postdrome symptoms merit larger observational studies and careful recording in clinical trials of acute and preventive migraine treatments.
