Fast Five Quiz: Migraine Complications and Comorbidities
Migraine is associated with several complications and comorbidities that can significantly impact quality of life. Understanding risk profiles and monitoring for complications is paramount in managing patients living with migraine.
What do you know about the complications and comorbidities of migraine? Check your knowledge with this quiz.
Ischemic stroke is a complication among patients with migraine, especially among those who experience aura. Although the prevalence of stroke in migraine is relatively low, a recent review found that migraine with aura is consistently associated with higher risk for various cardiovascular complications than migraine without aura, with the evidence being the strongest for ischemic stroke. Lifestyle factors such as smoking and oral contraceptive use have also been found to increase the risk for stroke in patients with migraine.
Unilateral frontotemporal pain can be a typical symptom of migraine that is not as strongly associated with ischemic stroke, especially if it is not accompanied by aura; nausea and/or vomiting and mood changes are not strongly associated with ischemic stroke in patients with migraine as well.
Learn more about migraine symptoms.
Depression and migraine are found to have a bidirectional association, as well as shared genetic factors. Further, depression can be linked to any severity of migraine; patients who are treated for migraine can still experience depression as well. The dysregulation of the hypothalamic and thalamic pathways has been implicated as a possible cause in both diseases.
Learn more about depression in migraine.
Migrainous infarction is a rare complication that is defined as ischemic infarction in relevant areas occurring in a patient experiencing migraine with aura for over 60 minutes, which can be accounted for by no other International Classification of Headache Disorders (ICHD) diagnosis. Data indicate that migrainous infarction is implicated in up to 1.5% of all ischemic stroke cases and typically occurs in younger (29-39 years) patients. However, when compared with "strokes from traditional risk factors," researchers claim the prognosis for migrainous infarction is generally favorable.
Learn more about infarction in migraine.
Epilepsy is common in hemiplegic migraine, with one review citing occurrence in approximately 40% of patients with this migraine subtype. It also has a strong genetic component that it shares with epilepsy; several mutations, such as in the CACNA1A, ATP1A2, SCN1A, and PRRT2 genes, are seen in both diseases. As such, there is overlap in symptom presentation and even triggering mechanisms for both migraine and epilepsy, and the electrical signature of both diseases in the brain is similar.
Migraine without aura and retinal migraine can cause seizures in some patients, but they are not strongly associated with epilepsy. Migraine with aura is also a known seizure trigger, although not exclusively for epilepsy.
Learn more about migraine symptoms and presentation.
Sleep disorders such as insomnia, narcolepsy, restless leg syndrome, and obstructive sleep apnea are also associated with migraine, and sleep deprivation is known to be a migraine trigger as well. Data indicate that sleep complaints are more prevalent in patients with chronic migraine, which is consistent with a recent survey finding that headache frequency, but not severity, was associated with insomnia. As headache frequency increases and migraine proceeds to chronification, clinicians should be aware of the potential for further sleep-related quality of life deficits.
Learn more about migraine symptoms and presentation.
Editor's Note: This article was created using several editorial tools, including generative AI models, as part of the process. Human review and editing of this content were performed prior to publication.
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