Good prognosis for migraine and tension-type headache sufferers

A population-based study of migraine and tension-type headaches published in Neurology has found the prognosis for the majority of sufferers to be favourable.Knowledge about the prognosis of migraine and tension-type headache, and identification of risk and protective factors is an important clinical and public health issue. However, few studies have adequately examined the prognosis of primary headaches, and those that have are based on clinical patient populations. Since the frequency of comorbidity and psychological abnormalities tends to be higher in clinical populations, prognosis and prognostic factors from clinical groups do not accurately reflect the general population.Lyngberg et al. conducted a 12-year follow-up of a population-based prevalence study of migraine and tension-type headache to determine prognosis and identify prognostic factors. The methods used in the baseline study were replicated in the follow-up study. A total of 549 subjects participated in the follow-up study. Of 64 migraine sufferers at baseline, 42% experienced remission, 38% had low migraine frequency, and 20% had poor outcome (14 migraine days per year) at follow up. Poor outcome was associated with high migraine frequency at baseline and age less than 20 years at onset. Of the 146 subjects with frequent episodic tension-type headache and 15 with chronic tension-type headache at baseline, 45% experienced remission, 39% had frequent episodic tension-type headache, and 16% had poor outcome (chronic tension-type headache) at follow-up.The results suggested that poor outcome of frequent episodic or chronic tension-type headache related significantly to previous chronic tension-type headache, coexisting migraine, not being married, and sleeping problems; however, no association was found with age, gender or educational level. For migraineurs, high frequency of migraine headache and young age at onset were found to be predictive of worse prognosis."The predictive factors for tension-type headache were different from those for migraine, which support a pathophysiologic distinction," the authors stated.The authors concluded that overall, the prognosis of migraine, frequent episodic tension-type headache, and chronic tension-type headache was good with the majority of sufferers experiencing favourable outcome.Reference...