Migraine attack symptoms vary dramatically from one person to the next. Given the vast list of migraine symptoms, that’s not surprising. Interestingly, the same can be true for individual people, as well. A study published last month was the first to explore this phenomenon. Thirty people recorded their migraine symptoms in three consecutive attacks. Not a single one had identical symptoms in all three attacks.

For each attack, participants recorded whether or not they experienced 11 symptoms: One-sided pain, pulsing pain, pain intensity, nausea, vomiting, photophobia, phonophobia, osmophobia, allodynia, cranial autonomic symptoms (like teary eyes, nasal congestion, and pupil constriction), and presence of premonitory symptoms (warning signs) in the 24-hours prior to the attack.

No participant had consistent symptoms in all three of their attacks. When researchers looked at only seven of the eight core symptoms that are used to diagnose migraine, still no participant had consistent symptoms. Researchers reduced the list to just six items: one-sided pain, pulsing pain, nausea, vomiting, photophobia, and phonophobia. Then, only two participants (6%) had the identical symptoms on three consecutive migraine attacks.

Researchers also evaluated each symptom for consistency over three attacks. This number varied from 23% to 93%. The intensity of pain, which participants could rank as mild, moderate, or severe, was the least consistent among the three attacks. It remained the same only 23% of the time. Vomiting was consistent 93% of the time, but it only occurred in two of the attacks (of two different patients). Researchers excluded these two extremes and found that the average consistency ranged from 43% to 77%. This indicates that about six of every 10 patients has any given symptom consistently over three migraine attacks.

Study participants were given Frova (frovatriptan) to treat their attacks. Less than half (39%) of participants had the same response to Frova (either it worked or didn’t) during all three attacks.

This study is the first of it’s kind, so more research will need to be done to solidify its findings. It’s an exciting start. Learning about the variability of symptoms and medication effectiveness could ultimately lead to better treatment for individual patients. 

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REFERENCE

Viana, M., Sances, G., Ghiotto, N., Guaschino, E., Allena, M., Nappi, G., ... & Tassorelli, C. (2015). Variability of the characteristics of a migraine attack within patients. Cephalalgia, 0333102415613612.