The course of frequent episodic migraine in a large headache clinic population: a 12-year retrospective follow-up study

Headache. 2009 Sep;49(8):1144-52. doi: 10.1111/j.1526-4610.2009.01502.x.


Background: Despite its high prevalence, little is known about the clinical course of migraine. Presented here are the findings of a 12-year follow-up study involving patients diagnosed at baseline with frequent episodic migraine.

Objective: The main objectives were to determine the long-term outcome of patients with frequent episodic migraine and to identify factors predictive of a favorable vs less favorable prognosis.

Methods: A total of 374 subjects (200 women, 174 men) were selected randomly from a total population of 2812 patients initially diagnosed before December 31, 1996, with episodic migraine and at baseline experiencing 1 to 6 attacks per month. Their subsequent migraine course was evaluated via telephone interviews conducted between 2005 and 2006.

Results: Migraine attacks had ceased in 110 (29%) of the 374 patients (57 women and 53 men). The remaining 264 subjects continued to experience migraine attacks at follow-up, and a change in attack frequency was reported by 80% (of whom 80% reported fewer attacks). Sixty-six percent reported a change in pain intensity over time, and of these 83% reported milder pain. Only 6 subjects (6/374 = 1.6%) had developed chronic migraine.

Conclusion: These data from a headache clinic population suggest that migraine has a favorable prognosis in most patients. Whether the findings reflect the natural history of the disorder or interval improvements in headache management remains conjectural.

MeSH terms

  • Adult
  • Age Distribution
  • Chronic Disease / epidemiology
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Migraine Disorders / epidemiology*
  • Migraine Disorders / physiopathology*
  • Migraine Disorders / therapy
  • Outcome Assessment, Health Care
  • Pain Clinics / statistics & numerical data
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Sex Distribution
  • Surveys and Questionnaires
  • Sweden / epidemiology
  • Treatment Outcome