TREAT ATTACKS EARLY
Did you know your patients may be able
to predict migraine headache pain?
Understanding prodrome can help to identify
the optimal treatment window.
This presents an opportunity to consider
early treatment, effectively avoiding
headache progression.
Uncover
prodrome insights
Understanding prodrome can help determine how the migraine attack starts and evolves, and can help identify an optimal treatment window.
When does prodrome start?
How common is prodrome in migraine?
The neurological prelude
How can prodrome
be recognized?
Symptoms can be grouped into the following
broad categories:2
Are your patients telling you about
their prodrome symptoms?
Empower your diagnostic process with our prodrome symptoms checklist.
Download and print this comprehensive tool for informed and precise assessments.
Prodrome Symptoms Checklist
Explore all
migraine phases
Bar height represents the relative degree of impact on the daily life of a person with migraine. The depiction is an example only and each individual migraine cycle may look different.
Watch what experts say about prodrome
Are you asking patients with migraine about their premonitory symptoms?
Hi, I’m Dr. Stephanie Nahas. I’m a board-certified neurologist and headache specialist.
Migraine is a complex disease, and headache is just one of many important aspects. Migraine attacks have multiple phases, and not all of them include headache.
This video will highlight the prodrome (premonitory phase), the earliest of the phases. I personally conceptualize migraine symptoms as the result of alterations of brain states that can happen in anybody's brain. But people who have migraine, it tends to happen in their brains much more readily and often.
So, when we speak of the so-called migraine brain, we mean to say there's an increased propensity for these state changes. Let’s look at data from the CaMEO analysis.
The objective was to characterize common pre-headache (or prodromal) symptoms of migraine attacks.
Respondents were asked: Have you ever had a feeling or warning sign prior to a headache that let you know you may soon get a headache? The results might surprise you. Just over 84% of participants reported at least one pre-headache symptom.
The most common warning symptoms were:
- Neck pain or stiffness
- Vision problems
- Dizziness or lightheadedness
77% of these participants experienced more than one of these warning symptoms. Patients tell us all the time they can tell when a headache is coming, but I think few of them truly recognize this is prodrome.
Understanding this fully means a lot, because we know that treating early yields more consistent relief from migraine attacks. As healthcare providers, we can partner with patients to help them identify prodrome, by:
- ASKING: when asked, patients often recognize they have warning symptoms before their headache
- ACKNOWLEDGING: How these symptoms are part of migraine and contribute to disease burden
- EDUCATING: On how prodrome presents an opportunity to optimize managing a migraine attack
If you are the first to ask a patient about prodromal symptoms, they'll stop and think to themselves, "Wow, this person actually knows something, it’s like they're reading my mind." And when a patient knows that you know something, they're really going to listen to the next thing that you have to say. This strengthens the therapeutic alliance which is fundamental to achieving success.
Let’s recap why identifying prodrome is important. Prodrome represents a critical “state change” of the brain when an attack is just beginning. Increased awareness of prodromal symptoms may help patients predict the onset of their headache, and may help them identify the optimal treatment window, offering the potential to stop progression of a migraine attack.
Putting a focus on prodrome provides validation for patients and may empower them to manage their disease more effectively.
Dr. Stephanie Nahas
Dr. Stephanie Nahas is a paid consultant of AbbVie.References
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