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Long-term outcome of migraine
F Granella1, A Cavallini, G Sandrini
1University Centre for Adaptive Disorders and Headache, Unit of Parma, Italy.
Cephalalgia : an International Journal of Headache
|April 9, 1998
Summary
Migraine prevalence declines with age, likely due to spontaneous remission, possibly linked to menopause. Head trauma and long-term contraceptive use are risk factors for poor migraine outcomes.
Area of Science:
- Neurology
- Epidemiology
Background:
- Migraine prevalence peaks in adulthood and declines in older individuals.
- The reasons for this age-related decline are not fully understood.
- Potential factors include treatment effects, mortality, cohort effects, and spontaneous remission.
Purpose of the Study:
- To explore hypotheses explaining the decrease in migraine prevalence with aging.
- To identify risk factors associated with a poor outcome in migraine patients.
- To investigate the potential protective effect of prophylactic treatments.
Main Methods:
- Literature review of hypotheses for age-related migraine decline.
- Case-control study to identify risk factors for poor migraine outcomes.
- Analysis of patient history including head trauma, contraceptive use, and treatment duration.
Main Results:
- Spontaneous remission, potentially linked to post-menopausal hormonal changes, is the most likely explanation for age-related migraine decline.
- Head trauma and prolonged oral contraceptive use were identified as risk factors for a poor migraine prognosis.
- Extended use of prophylactic migraine treatments demonstrated a protective effect.
Conclusions:
- Migraine remission is a significant factor in its age-related prevalence decrease.
- Identifying and mitigating risk factors like head trauma is crucial for managing migraine.
- Prophylactic treatments may play a role in improving long-term migraine outcomes.