Neurology: Migraine incidence in Olmsted County, Minnesota, USA: features and predictors of recurrence

Migraine states are considered a complication of migraine, where pain and/or related symptoms persist for more than 72 hours and make a person debilitating
.
The epidemiology of migraine states in the general population is unknown
.
A study published in Neurology aimed to determine the incidence, recurrence rate, and clinical relevance
of migraine states in residents seeking care in Olmsted County, Minnesota.

The Rochester Epidemiology Project is used to identify event cases
of migraine states based on the criteria of the International Classification of Headache Disorders, 3rd edition of the criteria and the first physical case encountered in the record.
Extract the clinical features
of the event case from the medical record.
To assess and compare one-year relapse-free survival in clinically relevant groups, including baseline demographics, migraine characteristics, and treatment exposure
.

Between 1 January 2012 and 31 December 2017, 237 migraine status events
were confirmed.
The median age was 35 years (IQ 26,47 years), and there were 210 women (88.
6%)
.
There were 82/226 (36.
3%) patients with a history of chronic migraine and 76/213 (35.
7%)
with aura.
At the time of the incident, the drug blends included 127/233 (53.
6%) triptan or ergotamine and/or 43/233 (18.
5%) containing opioid analgesics
.

The overall age- and sex-adjusted incidence was 26.
60 per 100,000 population [95% confidence interval (CI), 23.
21 to 29.
97], with incidence peaking
between 40 and 49 years.
The median duration to episode (95% CI) was five days (4.
48 to 5.
42).

The most common triggers were stress (40/237, 16.
9%) and too little or too little sleep (27/237, 11.
4%)
.
Relapse occurred in 35/237 (14.
8%), with a median of 58 days (IQR 23,130).

In age- and sex-adjusted multivariate models, too much or too little sleep as a trigger was associated with a 12-month risk of recurrence [adjusted odds ratio 3.
59 (95% CI 1.
58 to 8.
14), p = 0.
0022].

The study provides the first population-based estimate of migraine incidence
.
Abnormal sleep patterns were found to be a potentially modifiable risk factor
for migraine recurrence at 1 year.

Sources:

VanderPluym JH, Mangipudi K, Mbonde AA, et al.
Incidence of Status Migrainosus in Olmsted County, Minnesota, United States: Characterization and Predictors of Recurrence [published online ahead of print, 2022 Sep 29].
Neurology.
2022; 10.
1212/WNL.
0000000000201382.
doi:10.
1212/WNL.
0000000000201382.