Premonitory symptoms in migraine

Migraine commonly includes nonheadache symptoms before, during, and after attacks. However, premonitory symptoms before the headache have not been extensively studied. If these symptoms accurately forecast migraines, it could change migraine management significantly. In a three-month study, electronic diaries recorded nonheadache symptoms related to migraines. Patients who experienced nonheadache symptoms during at least two of three attacks participated. They entered symptoms in diaries at random times daily, ensuring data accuracy. One hundred twenty patients were recruited, with 97 providing usable data. Patients predicted migraines accurately from 72% of entries with premonitory symptoms. Various cognitive and physical symptoms appeared consistently across all migraine phases. Most prevalent premonitory symptoms included fatigue (72%), concentration difficulties (51%), and stiff neck (50%). Those struggling in the premonitory phase were most likely to predict migraines accurately. This study highlights the importance of recognizing premonitory symptoms for effective migraine management. Clinical relevance: This research indicates that identifying premonitory symptoms may enhance migraine management strategies.