Cranial autonomic symptoms in episodic and chronic migraine: a cross sectional study in Iran

• Published in: BMC neurology Vol. 21; no. 1; p. 493
• Main Authors: Togha, Mansoureh, Jafari, Elham, Moosavian, Atieh, Farbod, Abolfazl, Ariyanfar, Shadi, Farham, Fatemeh
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.12.2021; BioMed Central; BMC
• Subjects: Adult; Analysis; Blurred vision; Care and treatment; Cranial autonomic symptoms; Cross-Sectional Studies; Diagnosis; Disease Progression; Edema; Female; Headache; Headaches; Humans; Iran - epidemiology; Male; Migraine; Migraine Disorders - diagnosis; Migraine Disorders - epidemiology; Nerves, Cranial; Pain; Patients; Risk factors; Skull; Statistical analysis; Trigeminal autonomic cephalalgias; Vision; Iran; Cranial autonomic symptoms; Blurred vision; Migraine; Trigeminal autonomic cephalalgias
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-021-02513-0

Cranial autonomic symptoms are common in migraine, with eye redness and tearing being the most common ones. Their identification can help to avoid misdiagnosis, predict the disease course, and select the appropriate treatment. This was a cross-sectional study of 904 patients who presented with migraine to a headache referral clinic. The participants filled out a questionnaire about their headache characteristics, as well as the presence of cranial autonomic symptoms. A total of 904 patients, 698 women (77.2%) and 206 men (22.8%), were included in the study, with a mean (SD) age of 38.05 (11.76) years. About 70% of subjects with chronic migraine and 56.2% of those with episodic migraine reported one or more cranial autonomic symptoms. The two most commonly reported autonomic symptoms were eye redness (36.06%) and tearing (21.02%). Chronic migraine (43.4% vs. 29.5%), unilateral headache (56.8% vs. 48.7%), and blurred vision (20% vs. 14.7%) were significantly more frequent in migraineurs with cranial autonomic symptoms. Headache intensity and frequency in subjects with cranial autonomic symptoms were significantly higher than in those without cranial autonomic symptoms. We found higher percentages of cranial autonomic symptoms in patients with unilateral headaches, frequent and severe attacks and blurred vision. A diagnosis of cranial autonomic symptoms accompanying migraine may predict more severe disease and the possibility of evolution into chronic migraine.