A large study was recently presented at the 64th Annual Meeting of the American Academy of Neurology with findings indicating that headache-related nausea occurred in approximately 80% of people with migraines in the US population. According to Richard B.Lipton, MD, the Edwin S. Lowe Professor and Vice Chair in Neurology at Albert Einstein College of Medicine in New York City, nearly 5% of migraineurs with persistent frequent nausea saw a progression from episodic to chronic migraine, compared with 1% of migraineurs who did not have nausea.  Patients with the most recurring headache-related nausea also spent 2.2 times more on visits to neurologists or headache specialists, and 1.7 times more on visits to gynecologists or primary care doctors than patients who did not have headache-related nausea.  The approximate costs of emergency room visits were 5.4 times higher for patients who had persistent frequent nausea.

Close to 86% of the patients studied with persistent frequent nausea were female, compared to 71% of patients who had no headache-related nausea.  The study also found that a greater proportion of migraineurs with persistent frequent nausea used triptans, and had moderate or severe pain at least half the time.  Approximately 19% of the patients reported experiencing clinical depression compared to almost 14% of patients without nausea.  There was also a higher rate of anxiety for  patients with nausea, though the difference was not statistically significant.  The researchers were surprised to see a higher rate of progression to chronic migraine among the patients with persistent frequent nausea.  “This result suggests that persistent nausea, in addition to heightening disease impact, may also contribute to or be associated with disease progression” said Dr.Lipton.

In reviewing this study of 6,448 migraineurs, three important issues emerged.  Clinical depression, progression to chronic migraine, and visits to emergency rooms were more common among patients with episodic migraine and persistent frequent nausea.  “Greater attention among clinicians regarding secondary symptoms like nausea is important, given the outcomes associated with persistent and frequent nausea in persons with migraine,” said Dr.Lipton….. Neurology Reviews   July, 2012



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