CLINICAL PROFILE OF THE POSTDROME PHASE OF MIGRAINE AMONG THE PATIENTS AT NEUROLOGY DEPARTMENT OF A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.71000/by30yv26Keywords:
Adult, Headache Disorders, Migraine Disorders, Neurology Department, Postdrome Phase, Prevalence, Quality of LifeAbstract
Background: Migraine is a complex neurological disorder characterized by recurrent attacks involving multiple phases, including the premonitory, headache, and postdrome stages. The postdrome phase, often described as the “migraine hangover,” remains under-recognized despite its considerable impact on patients’ functionality and quality of life. Understanding its clinical profile is essential for comprehensive migraine management and improved patient care.
Objective: To determine the clinical profile and frequency of postdrome symptoms among migraine patients presenting to the Neurology Department of a tertiary care hospital.
Methods: A prospective descriptive cross-sectional study was conducted at the Pakistan Emirates Military Hospital from January 2022 to June 2023. A total of 385 patients aged ≥18 years, diagnosed with migraine according to the International Classification of Headache Disorders (ICHD) criteria, were included through simple random sampling. Patients with other neurological or psychiatric disorders were excluded. Data on demographics, migraine history, and postdrome symptoms—such as low mood, fatigue, concentration difficulty, light sensitivity, and sleep disturbance—were collected using a structured, pretested questionnaire. Statistical analysis was performed using SPSS version 26.0, applying descriptive and inferential statistics with a significance level set at p<0.05.
Results: Among the 385 patients, females constituted 72.5% (n=279), and the predominant age group was 31–50 years (51.2%). Family history of migraine was reported in 56.1% (n=216). Overall, 92.5% (n=356) experienced postdrome symptoms, with low mood (81.7%), concentration difficulty (74.2%), and light sensitivity (62.1%) being most frequent. No significant association was observed between medication use and postdrome symptoms (p=1.1) or between headache severity and postdrome occurrence (p=0.98).
Conclusion: The study revealed a high frequency of postdrome symptoms among migraine patients, emphasizing the need for better recognition and management of this phase to enhance patient outcomes and quality of life.
References
Cen J, Wang Q, Cheng L, Gao Q, Wang H, Sun F. Global, regional, and national burden and trends of migraine among women of childbearing age from 1990 to 2021: insights from the Global Burden of Disease Study 2021. The Journal of Headache and Pain. 2024 Jun 7;25(1):96.
Allais G, Chiarle G, Sinigaglia S, Airola G, Schiapparelli P, Benedetto C. Gender-related differences in migraine. Neurological Sciences. 2020 Dec;41:429-36.
Al Ghadeer HA, AlSalman SA, Albaqshi FM, Alsuliman SR, Alsowailem FA, Albusror HA, AlAbdi ZI, Alwabari EM, Alturaifi ZA, AlHajji AM. Quality of life and disability among Migraine patients: a single-center study in AlAhsa, Saudi Arabia. Cureus. 2021 Nov;13(11).
Gupta J, Gaurkar SS. Migraine: An underestimated neurological condition affecting billions. Cureus. 2022 Aug;14(8).
Yamanaka G, Go S, Morichi S, Takeshita M, Morishita N, Suzuki S, Tomoko T, Kasuga A, Daida A, Ishida Y, Oana S. Clinical features and burden scores in Japanese pediatric migraines with brainstem aura, hemiplegic migraine, and retinal migraine. Journal of Child Neurology. 2020 Sep;35(10):667-73.
Ruschel MA, De Jesus O. Migraine headache. InStatPearls [Internet] 2023 Feb 13. StatPearls Publishing.
Karsan N, Peréz-Rodríguez A, Nagaraj K, Bose PR, Goadsby PJ. The migraine postdrome: spontaneous and triggered phenotypes. Cephalalgia. 2021 May;41(6):721-30.
Qubty W, Patniyot I. Migraine pathophysiology. Pediatric neurology. 2020 Jun 1;107:1-6.
Thuraiaiyah J, Ashina H, Christensen RH, Al-Khazali HM, Ashina M. Postdromal symptoms in migraine: a REFORM study. The Journal of Headache and Pain. 2024 Feb 21;25(1):25.
Olesen J. The International Classification of Headache Disorders: History and future perspectives. Cephalalgia. 2024 Jan;44(1):03331024231214731.
Christensen RH, Eigenbrodt AK, Ashina H, Steiner TJ, Ashina M. What proportion of people with migraine report postdromal symptoms? A systematic review and meta-analysis of observational studies. Cephalalgia. 2023 Oct;43(10):03331024231206376.
Karsan N, Peréz-Rodríguez A, Nagaraj K, Bose PR, Goadsby PJ. The migraine postdrome: spontaneous and triggered phenotypes. Cephalalgia. 2021 May;41(6):721-30.
Witten A, Marotta D, Cohen‐Gadol A. Developmental innervation of cranial dura mater and migraine headache: A narrative literature review. Headache: The Journal of Head and Face Pain. 2021 Apr;61(4):569-75.
Bag A, Bhoi SK, Jha M, Palo GD. Sleep quality evaluation, correlation with headache frequency, and propensity to conversion from episodic to chronic daily headache in migraine patients: A cross-sectional study. Journal of Neurosciences in Rural Practice. 2023 Jan;14(1):70.
Thuraiaiyah J, Ashina H, Christensen RH, Al-Khazali HM, Ashina M. Postdromal symptoms in migraine: a REFORM study. The Journal of Headache and Pain. 2024 Feb 21;25(1):25.
Pleș H, Florian IA, Timis TL, Covache-Busuioc RA, Glavan LA, Dumitrascu DI, Popa AA, Bordeianu A, Ciurea AV. Migraine: advances in the Pathogenesis and treatment. Neurology International. 2023 Aug 31;15(3):1052-105.
Carvalho IV, Fernandes CS, Damas DP, Barros FM, Gomes IR, Gens HM, Luzeiro I. The migraine postdrome: Clinical characterization, influence of abortive treatment and impact in the quality of life. Clinical Neurology and Neurosurgery. 2022 Oct 1;221:107408.
Christensen RH, Eigenbrodt AK, Ashina H, Steiner TJ, Ashina M. What proportion of people with migraine report postdromal symptoms? A systematic review and meta-analysis of observational studies. Cephalalgia. 2023;43(10):3331024231206376.
Kitagawa S, Tang C, Unekawa M, Kayama Y, Nakahara J, Shibata M. Sustained Effects of CGRP Blockade on Cortical Spreading Depolarization-Induced Alterations in Facial Heat Pain Threshold, Light Aversiveness, and Locomotive Activity in the Light Environment. Int J Mol Sci. 2022;23(22).
Shibata M, Kitagawa S, Tang C, Unekawa M, Kayama Y, Shimizu T, et al. Protracted hypomobility in the absence of trigeminal sensitization after cortical spreading depolarization: Relevance to migraine postdrome. Neurosci Res. 2021;172:80-6.
Sampaio Rocha-Filho PA, Gherpelli JLD. Premonitory and Accompanying Symptoms in Childhood Migraine. Curr Pain Headache Rep. 2022;26(2):151-63.
Karsan N, Peréz-Rodríguez A, Nagaraj K, Bose PR, Goadsby PJ. The migraine postdrome: Spontaneous and triggered phenotypes. Cephalalgia. 2021;41(6):721-30.
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Copyright (c) 2025 Shaher Bano, Husnain Nawaz Malik , Tayba Zain, Asif Hashmat, Ayesha Zubair, Maham Syed (Author)
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