From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history

Migraines commonly occur in people with ME/CFS. In a 2011 study by Ravindran, et al, migraine headaches were found in 84%, and tension-type headaches in 81% of a cohort of chronic fatigue syndrome patients.[1] This compared to 5% and 45%, respectively, in a cohort of healthy controls.[1]

Symptoms[edit | edit source]


Phases[edit | edit source]

Migraine phases:

Prodromal (pre-headache) stage
changes in mood, energy levels, behaviour and appetite that can occur several hours or days before an attack
Aura phase (if present)
visual problems are very common, e.g. flashes of light (scintillations) or blind spots (scotoma), aura symptoms last for 5 to 60 minutes
Headache phase
usually a moderate or severe pulsating or throbbing pain on one side of the head, often accompanied by nausea, vomiting or extreme light sensitivity and extreme sensitivity to loud sounds, which last from 4 hours to 3 days
Postdromal or resolution stage
the severe headache and other symptoms gradually fade, but there may be tiredness for few days after[3][4][2]

Types[edit | edit source]

Migraine without aura[edit | edit source]

Migraine without aura is defined by the following diagnostic criteria outlined in The International Classification Of Headache Disorders, 3rd edition:

Migraine without aura diagnostic criteria[edit | edit source]

  1. At least five headache attacks that
  2. Last 4–72 hours without successful treatment
  3. Headaches have at least two of the following four characteristics:
    1. unilateral location;
    2. pulsating quality;
    3. moderate to severe pain intensity; and
    4. aggravation by or causing avoidance of routine physical activity.
  4. During the headaches at least one of the following:
    1. nausea and/or vomiting
    2. photophobia and phonophobia (avoidance of loud noises)
  5. Not better accounted for by another ICHD-3 diagnosis.
Migraines without aura may also be called common migraine or hemicrania simplex'.[5]

Migraine with aura[edit | edit source]

Migraine with aura diagnostic criteria[edit | edit source]

Visual, sensory and central nervous system symptom in beginning shortly before a migraine headache are known as an aura, although migraine with aura without migraine headaches are also recognized.
  1. At least two migraine attacks fulfilling criteria B and C
  2. One or more of the following fully reversible aura symptoms
    1. visual
    2. sensory
    3. speech and/or language
    4. motor
    5. brainstem
    6. retinal
  3. At least three of the following characteristics:
    1. at least one aura symptom spreads gradually over five minutes or longer
    2. two or more aura symptoms occur in succession
    3. each individual aura symptom lasts 5 to 60 minutes
    4. at least one aura symptom is unilateral (one sided)
    5. at least one aura symptom is positive
    6. the aura is accompanied, or followed within 60 minutes, by headache
  4. Not better accounted for by another ICHD-3 diagnosis.[5]

The recognized types of migraine with aura are:

  • Typical aura with headache
  • Typical aura without headache
  • Migraine with brainstem aura
  • Hemiplegic migraine, including familial hemiplegic migraine (FHM) type 1, type 2, type 3 and with other loci
  • Sporadic hemiplegic migraine (SHM)
  • Retinal migraine

Migraines without aura may also be called Classic or classical migraine, ophthalmic, hemiparaesthetic, hemiplegic or aphasic migraine, or complicated migraine.[5]

Chronic migraine[edit | edit source]


Silent migraine[edit | edit source]

Migraine symptoms that do not result in a headache are known as silent migraines, e.g. migraine aura symptoms without head pain.migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop.[2]

Abdominal migraine[edit | edit source]


Triggers[edit | edit source]

Migraine triggers. Source: Biomedicine & Pharmacotherapy, 139, 111557[4]

Common migraine triggers include:

  • Food and drinks, e.g., chocolate, alcohol, aged cheese, gluten
  • Lifestyle patterns, e.g. stress, weather changes, or fasting
  • Genetics
  • Physiological and biochemical factors, e.g. insulin or oestrogen hormone levels, increased oxidative stress[4][2]

Migraines in ME/CFS[edit | edit source]

Migraines is one of several illnesses or conditions common in people with ME/CFS.[6][7]

The Canadian Consensus Criteria recognizes migraines in the possible neurological symptoms of ME/CFS, and the International Consensus Criteria recognizes headache conditions including migraine and tension-type headache in the diagnostic criteria for myalgic encephalomyelitis.[7]

Possible causes[edit | edit source]

Potential treatments[edit | edit source]

Migraine treatment consists of:

  • Abortive treatments, that aim to stop a migraine attack or reduce the symptoms
  • Prevention, which aims to reduce how often migraines occur and their intensity

Migraine attack treatments[edit | edit source]

Migraine prevention[edit | edit source]

Notable studies[edit | edit source]

News and articles[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 Ravindran, Murugan K; Zheng, Yin; Timbol, Christian; Merck, Samantha J; Baraniuk, James N (March 5, 2011). "Migraine headaches in Chronic Fatigue Syndrome (CFS): Comparison of two prospective cross-sectional studies". BMC Neurology. 11 (1). doi:10.1186/1471-2377-11-30. ISSN 1471-2377. PMID 21375763.
  2. 2.0 2.1 2.2 2.3 "Migraine". National Health Service. Retrieved October 15, 2021.
  3. "Migraine - Symptoms". National Health Service. Retrieved October 15, 2021.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Khan, Johra; Asoom, Lubna Ibrahim Al; Sunni, Ahmad Al; Rafique, Nazish; Latif, Rabia; Saif, Seham Al; Almandil, Noor B.; Almohazey, Dana; AbdulAzeez, Sayed (July 1, 2021). "Genetics, pathophysiology, diagnosis, treatment, management, and prevention of migraine". Biomedicine & Pharmacotherapy. 139: 111557. doi:10.1016/j.biopha.2021.111557. ISSN 0753-3322.
  5. 5.0 5.1 5.2 5.3 5.4 Headache Classification Committee of the International Headache Society (2018). "The International Classification of Headache Disorders". Cephalalgia (3rd ed.). 38 (1): 1–211. doi:10.1177/0333102417738202. ISSN 0333-1024.
  6. "Overlapping Conditions – American ME and CFS Society". ammes.org. Retrieved August 12, 2018.
  7. 7.0 7.1 Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
  8. "Migraine Guide: Causes, Symptoms and Treatment Options". Drugs.com. Retrieved October 12, 2021.
  9. 9.0 9.1 9.2 Negro, Andrea; Martelletti, Paolo (June 2019). "Gepants for the treatment of migraine". Expert Opinion on Investigational Drugs. 28 (6): 555–567. doi:10.1080/13543784.2019.1618830. ISSN 1744-7658. PMID 31081399.
  10. 10.0 10.1 "Migraine - Treatment". National Health Service. Retrieved October 15, 2021.
  11. 11.0 11.1 11.2 "Migraine - Prevention". National Health Service. October 23, 2017. Retrieved October 12, 2021.
  12. Cascio Rizzo, Angelo; Paolucci, Matteo; Altavilla, Riccardo; Brunelli, Nicoletta; Assenza, Federica; Altamura, Claudia; Vernieri, Fabrizio (2017). "Daith Piercing in a Case of Chronic Migraine: A Possible Vagal Modulation". Frontiers in Neurology. 8. doi:10.3389/fneur.2017.00624. ISSN 1664-2295. PMC 5711775. PMID 29230190.
  13. Sun-Edelstein, Christina; Mauskop, Alexander (March 2011). "Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments: March 2011". Headache: The Journal of Head and Face Pain. 51 (3): 469–483. doi:10.1111/j.1526-4610.2011.01846.x.
  14. Barmherzig, Rebecca; Rajapakse, Thilinie (May 10, 2021). "Nutraceuticals and Behavioral Therapy for Headache". Current Neurology and Neuroscience Reports. 21 (7): 33. doi:10.1007/s11910-021-01120-3. ISSN 1534-6293.
  15. Sun-Edelstein, Christina; Mauskop, Alexander (June 2009). "Foods and Supplements in the Management of Migraine Headaches". The Clinical Journal of Pain. 25 (5): 446–452. doi:10.1097/AJP.0b013e31819a6f65. ISSN 0749-8047.
  16. "Dietary Supplements for Headaches: What the Science Says". National Center for Complementary and Integrative Health. Retrieved October 13, 2021.
  17. Rayhan, Rakib U.; Ravindran, Murugan K.; Baraniuk, James N. (2013). "Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation". Frontiers in Physiology. 4: 181. doi:10.3389/fphys.2013.00181. ISSN 1664-042X. PMID 23898301.
  18. Gonzalez, Antonio; Hyde, Embriette; Sangwan, Naseer; Gilbert, Jack A.; Virre, Erik; Knight, Rob (October 18, 2016). "Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort" (PDF). American Society for Microbiology. 1 (5).
  19. Devlin, Hannah (October 18, 2016). "Migraines could be caused by gut bacteria, study suggests". the Guardian. Retrieved August 11, 2018.
  20. Johnson, Cort (May 19, 2018). "The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit? - Health Rising". Health Rising. Retrieved August 11, 2018.