Neurol. praxi. 2010;11(3):191-194
Is migraine a progressive disease?
- 1 1. neurologická klinika LF MU a FN u sv. Anny, Brno
Introduction: The author aimed at evaluating the course of treatment in migraine patients and determining whether their migraine was
progressive.
Methods: A group of 72 patients with migraine without aura, migraine with aura, chronic migraine and analgesic- and ergotamine-overuse
headache was followed up retrospectively in the Regional Headache Centre in Brno for a mean period of 65 months. From October 1996
to July 2008, the following parameters were evaluated: the rate of attacks, severe pain intensity, degree of limitations in daily activities
and efficacy of treatment both at one year of treatment at the Centre and at present and these were compared to the baseline values.
Results: Improvement was achieved in 57.0 % of patients, 22.2 % deteriorated and 20.8 % were unchanged; the improvement was observed
as early as one year of treatment. There was a clear decrease in patients with a high intensity of migraine attacks and a severe degree
of limitations in daily activities. By contrast, the high frequency of pain remained unchanged and the number of patients with chronic
migraine decreased only slightly. There was a significant change in the profile of both acute and prophylactic antimigraine treatment.
Only 41.7 % of patients were familiar with triptans whereas now they are being used in almost 100 % and 88.7 % of patients are satisfied
with triptan treatment. Of concern was the finding that 26.4 % of our patients overused triptans. Initially, prophylaxis was used in only
55.6 % of the group; currently, it is used by 81.9 % of patients with topiramate being the most commonly used agent followed by valproates,
beta blockers and tricyclic antidepressants.
Conclusion: Our retrospective follow-up showed very decent results in migraine treatment with a balanced combination of acute and
prophylactic treatment and did not confirm the hypothesis that migraine must have a chronic-progressive course.
Keywords: migraine, acute treatment, triptans, overuse, prophylaxis
Published: June 1, 2010 Show citation
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