Migraine Symptoms: Fatigue

Although it’s frequently overshadowed by more seemingly impactful symptoms like pain, nausea and sensitivity to light and sound, fatigue is a hallmark symptom of Migraine Disease.

According to a research study that asked patients to keep electronic diaries about their attacks, about 72% of Migraine patients who experience premonitory symptoms that alert them a Migraine attack is on the way experience fatigue. Fatigue is a state of extreme tiredness, weakness and exhaustion that can manifest itself either physically or mentally or both.

Fatigue among Migraine patients can be incredibly insidious because many of us experience it during most phases of the Migraine attack: Before the attack during the prodome phase, during the attack and after the attack during the postdome phase. And it’s even more burdensome for those living with Chronic Migraine, who often end up experiencing nearly constant fatigue. By one estimate 67% of people with Chronic Migraine meet the criteria for a diagnosis of Chronic Fatigue Syndrome.

Coping with high levels of fatigue, especially when you experience it frequently, is difficult. Here are a few strategies than can help:

  • Practice pacing.
  • Adjust your schedule to accommodate your needs and limits when possible.
  • Incorporate periods of rest into your day.
  • Strive to get some gentle exercise and movement into as many days as possible to prevent your fatigue from worsening.
  • Practice good sleep hygiene as often as possible / when a Migraine attack doesn’t interfere.

It may seem tempting to attribute Migraine-related fatigue to the burden of the pain and other symptoms associated with Migraine attacks, but it’s highly possible fatigue is related to the pathophysiology of Migraine (the disease process itself). It could be that fatigue is caused by the extreme neurological disruption involved in a migraine attack. Researchers don’t yet have confirmation of this, but as they learn more about the pathophysiology of Migraine, they come closer to being able to find out.

view references
1. Nicola J. Giffin, L. Ruggiero, Richard B. Lipton, Stephen D. Silberstein, J.F. Tvedskov, Jes Olesen, J. Altman, Peter J. Goadsby and A. Macrae. "Premonitory symptoms in migraine." Neurology March 25, 2003; 60(6): 935-940, doi: 10.1212/01.WNL.0000052998.58526.A9. 2. Mario Peres, Eliova Zukerman, William B. Young and Stephen D. Silberstein. "Fatigue in chronic migraine patients." Cephalalgia 2002 Nov;22(9):720-4, doi: 10.1046/j.1468-2982.2002.00426.x. 3. Roger K. Cady, Curtis P. Schreiber and Kathleen U. Farmer. "Understanding the Patient With Migraine: The Evolution From Episodic Headache to Chronic Neurologic Disease. A Proposed Classification of Patients With Headache." Headache 2004;44(5) doi: 10.1111/j.1526-4610.2004.04094.x.
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