Old patient migraine in comparrision with younger adult migrain

Abstract

Background: Migraine is a common chronic episodic disabling primary headache disorder. Migraine can affect all age groups elderly and young age with different presentation of symptoms between two age groups. The prevelance of migraine is highest between 20 and 55 years peaking at age around 40 years of age and the declines thereafter, however the primary headache disorder does also exist in older population.Objective: This study was undertaken in order to find out the differences in the characteristics of migraine headache between elderly and young for easy diagnosis and treatment.Patient and Method: We retrospectively assessed subjects seen from March 2010 to October 2010 in Baghdad Teaching Hospital neurology out-patient clinic. We applied a questionnaire based the criteria of episodic migraine headache (with and without aura) according to the international Classification of headache disorder; we elect 50 migrainous patients with age < 50 years old and compare them with other 50 migrainous patients > 50 years old.. Results: headache was more unilateral in the young group (84%) compared with ( 52%) in older patients (p=0.001). Throbbing headache and disability had been reported less in old group than in young .Pain aggravation with activity was significant more in the young group (p=0.004), the duration of pain was less in the elderly .The number of attacks also less in general when compared with the young. The presence of aura in the older group (12%) versus (24%) in young. Photophobia and phonophobia were less in elderly (P<0.0001), (P<0.0001) respectively. While nausea, diarrhea, rhinorrhoea, tearing eyes were more in older group than young. Vomiting (P=0.025) and sleeping late (as a triggering factor) (P=0.017) were more prominent features in young than older group. Conclusion: The study showed a decrease of most features in the above 50 years old group whether the differences are significant like (unilateral site of pain ,aggravation with activity, Sleeping late, Photophobia, Phonophobia, Vomiting ) and no statistical significant differences like (nausea , tiredness, hungry, uncomfortable sleep, food and need rest).Key words: Migraine, elderly patient, Younger patient