Migraine Symptoms Vary From One Attack to the Next
With the long list of possible migrainesymptoms, it’s not surprising that attacks vary dramatically from one person to the next. The same is true for individuals, too. In a study published last fall—the first to investigate this idea—30 people recorded their symptoms for three consecutive migraine attacks. None of the participants had identical symptoms during all three recorded attacks.
For all three attacks, participants recorded whether or not they had any of these 11 symptoms:
- One-sided pain
- Pulsing pain
- Pain intensity
- Sensitivity to light (photophobia)
- Sensitivity to sounds (phonophobia)
- Sensitivity to odors (osmophobia)
- Cranial autonomic symptoms (like tearing eyes, nasal congestion, and constricted pupils)
- Premonitory symptoms (warning signs) in the 24-hours prior to the attack.
Not one single person in the study had consistent symptoms in all three of their recorded migraine attacks. For further analysis, researchers reduced the number of symptoms to seven of the eight core symptoms that are used for migraine diagnosis. Still no participant had consistent symptoms for all three attacks. Researchers then reduced the list to only six items (one-sided pain, pulsing pain, nausea, vomiting, photophobia, and phonophobia). Using the restricted list, only two participants had identical symptoms on three consecutive attacks.
Approximately 60% of participants had any one symptom consistently over three attacks. Depending on the symptom, the consistency varied from 23% to 93%. Pain severity was the least consistent symptom. Only 23% of the time was a participant's pain severity the same. Although vomiting was consistent 93% of the time, it was a symptom in only two attacks. Excluding these two extremes, researchers found that, on average, symptom consistency ranged from 43% to 77%.
Researchers also found variability in responsiveness to medication. Participants were given Frova (frovatriptan) to treat their migraine attacks. Only 39% had the same response to Frova (whether it worked or not) across all three attacks.
This was a preliminary study with a limited number of participants. More research is needed to further investigate the consistency of symptoms in larger populations. Still, these findings can help people with migraine more easily identify whether they're having an attack or not. It can also help patients who struggle to explain their varying symptoms to doctors.
What's your experience. Do your symptoms or medication responsiveness vary from one attack to the next?
How much has your migraine disease changed or evolved over time?