From the School of Medicine at Ribeirão Preto, Neurology, Psychiatry and Medical Psychology, Ribeirão Preto, SP, Brazil (Martins, Bordini, Speciali); The Albert Einstein College of Medicine, Neurology, Bronx, NY (Dr. Bigal); The New England Center for Headache, Stamford, CT (Bigal).
Migraine in the Elderly: A Comparison With Migraine in Young Adults
Version of Record online: 21 FEB 2006
Headache: The Journal of Head and Face Pain
Volume 46, Issue 2, pages 312–316, February 2006
How to Cite
Martins, K. M., Bordini, C. A., Bigal, M. E. and Speciali, J. G. (2006), Migraine in the Elderly: A Comparison With Migraine in Young Adults. Headache: The Journal of Head and Face Pain, 46: 312–316. doi: 10.1111/j.1526-4610.2006.00343.x
- Issue online: 21 FEB 2006
- Version of Record online: 21 FEB 2006
- Accepted for publication September 30, 2005.
- clinical features
Objective.—In this study we compare the clinical features of migraine attacks occurring in the elderly (60 to 70 years) and in younger migraineurs (20 to 40 years).
Background.—Studies comparing the clinical features of migraine at different ages are still lacking. These studies are important for a better comprehension of the natural history of migraine, as well as to refine our recognition of the disease.
Methods.—We retrospectively assessed subjects seen from 1995 to 2000 in a university-based outpatient headache clinic in Brazil. We reviewed 144 charts from patients 60 to 70 years (mean = 66.4). We applied a questionnaire based on the first edition of the International Classification of Headache Disorders (criteria for episodic migraine remained unchanged in the second edition). Controls were migraineurs from 20 to 40 years (mean = 32.6).
Results.—Migraine occurred in 25% of the elderly and 29% of younger migraineurs (NS). A lower proportion of migraine attacks in the elderly were unilateral (38% vs. 57%, P < .01), or with associated symptoms (nausea = 75% vs. 86%, P= .05; vomiting = 30% vs. 54%, P < .05, photophobia and phonophobia = 83% vs. 94%, P < .05). Other symptoms such as paleness (P= .0441), dry mouth (P= .0093), and anorexia (P= .05) were more common in the elderly.
Conclusion.—Migraine is less typical in the elderly and more frequently associated with vegetative symptoms. Therefore, the diagnosis of migraine in elderly subjects may be more challenging, and many seniors with this primary headache can be misdiagnosed.