Medscape Neurology reported on February 16th 2010 a study by Dr. Anne Calhoun looking at the percentage of migraine patients who reported neck pain and how that compares to those who have nausea.
See: http://www.medscape.com/viewarticle/717025?src=mpnews&spon=26&uac=88627FN
Is this surprising?
No.
Look to: Kaniecki et al. Poster presented at: 10th IHC; June 29-July 2, 2001; New York, NY.
Where they found that in a retrospective chart review of 144 patients with migraine, 75% reported neck pain with their migraines; 43% described bilateral neck pain and 57% unilateral (one-sided). 69% described the neck pain as "tightness" and 17% as "stiffness." The neck pain occurred 61% of the time in the prodrome (you just have a feeling that something isn't right and that a migraine is going to come on), 92% of the time during the headache and 41% during the postdrome (the yucky period you feel after the migraine).
Where they found that in a retrospective chart review of 144 patients with migraine, 75% reported neck pain with their migraines; 43% described bilateral neck pain and 57% unilateral (one-sided). 69% described the neck pain as "tightness" and 17% as "stiffness." The neck pain occurred 61% of the time in the prodrome (you just have a feeling that something isn't right and that a migraine is going to come on), 92% of the time during the headache and 41% during the postdrome (the yucky period you feel after the migraine).
In Cady et al. Poster presented at: 10th IHC; June 29-July 2, 2001; New York, NY, nausea is only present 63% of the time, while in Schreiber et al. Poster presented at: AHS June 21-23, 2002: Seattle, WA, nausea was present 70% of the time.
So, is anything new?
No.
We already knew this, as Dr. Calhoun pointed out: "...when we first presented these findings at the American Academy of Neurology meeting, the response from headache specialists was almost universal: vigorous nodding and assent,”
It is good, however to raise awareness to this and all the other common features of migraine, such as sinus stuffiness, pressure and drainage. Schreiber found prospectively in 2,524 patients without a prior migraine diagnosis that 82% of people reporting "sinus" headaches met the International Headache Society (IHS) criteria for migraines.
So, what does this mean?
1. Migraine is not just about the head pain and it is probably a lot more common than we think.
2. Not having a migraine diagnosis (yet) doesn't mean that your headaches aren't migraines.
3. Labels are important because they help with reassurance and they direct therapeutic options.
[see: http://neurologique.blogspot.com/2010/02/migraine-and-ms-lessons-for-ccsvi.html]
and ...
4. Take studies into their historical context. Maybe there really is nothing new under the sun.
- Dr. Daniel Kantor, MD BSE
Medical Director
Neurologique
info@neurologique.org
www.neurologique.org
Medical Director
Neurologique
info@neurologique.org
www.neurologique.org
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