Long-term prognosis of migraine favorable

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New research indicates that a high percentage of patients with migraine or tension-type headaches experience remission on long-term follow-up.

The findings, which appear in the medical journal Neurology, are based on an analysis of 549 patients who participated in a Danish headache study in 1989 and were reevaluated in 2001. Patient interviews at both time points were conducted by physicians and standard criteria were used to diagnose headache.

Sixty-four of the subjects had migraines at the first evaluation, lead author Dr. Ann Christine Lyngberg, from Glostrup University Hospital in Denmark, and colleagues note.

At follow-up, 27 of the patients (42 percent) had experienced remission. The remaining migraine patients included 24 (38 percent) who had just 1 to 14 migraine days per year and 13 (20 percent) who had at least 15 migraine days per year, the report indicates.

Predictors of a poor outcome at follow-up included high migraine frequency at the first evaluation and the onset of headaches at younger than 20 years of age.

As for tension-type headache, 146 subjects had frequent episodic headaches and 15 had chronic headaches at the first evaluation. At follow-up, 72 subjects (45 percent) had 0 to 14 headache days per year, 64 (40 percent) had 15 to 179 headache days per year, and 25 (16 percent) had at least 180 headache days annually.

Predictors of a poor outcome included chronic tension-type headache at the first evaluation, coexisting migraine, not being married and sleep problems.

“Knowledge about the prognosis of migraine and tension-type headache and information of risk factors and protective factors is important from both a clinical and a public health perspective,” the authors emphasize. The present findings suggest that, in general, the long-term outcomes of these headaches are favorable, they add.

SOURCE: Neurology, August 23, 2005.

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