Abnormal sleep latency and impaired function related to concentration issues may occur more frequently in patients with chronic vs episodic migraine, according to a study published in Pain Medicine.
Guided by 2 neurologists, 897 patients (average age, 31.4 years) with episodic migraine and 183 patients (average age, 31.1 years) with chronic migraine completed questionnaires to assess the frequency and severity of cranial autonomic symptoms, vertigo/dizziness, cutaneous allodynia, concentration-related impairment, and abnormal sleep latency. Pain intensity and characteristics of migraine were also evaluated with the visual analog scale and the Migraine Disability Assessment, respectively.
Several cranial autonomic symptoms were found to be more frequent in patients with chronic vs episodic migraine, including rhinorrhea (18% vs 6.7%, respectively) and facial/forehead sweating (34.4% vs 24.1%, respectively), vertigo/dizziness (72.1% vs 59.2%, respectively), cutaneous allodynia (vs 80.9% vs 55.1%, respectively), concentration-related impairment in function (50.8% vs 21.7%, respectively), and abnormal sleep latency (39.3% vs 12%, respectively).
On average, patients with chronic vs episodic migraine also reported higher pain intensity and Migraine Disability Assessment scores (P <.001 for both). Patients with vs without cranial autonomic symptoms, vertigo/dizziness, and cutaneous allodynia were more likely to experience abnormal sleep latency and concentration-related impairment in function (P <.005).
Study limitations include a small sample size.
“The co-occurrence of cranial autonomic symptoms, vertigo/dizziness, and cutaneous allodynia in migraine suggests that these symptoms have a common pathophysiology that varies depending on the activation of trigeminal pathways,” noted the study authors.
Ceylan M, Yalcin A. Coexistence of symptoms associated with trigeminal pathways in chronic and episodic migraine and the effects on quality of life [published online September 14, 2018] Pain Med. doi: 10.1093/pm/pny118