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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 12/2018

01-12-2018 | Episodic Migraine (S Nahas, Section Editor)

Triggers, Protectors, and Predictors in Episodic Migraine

Author: Michael J. Marmura

Published in: Current Pain and Headache Reports | Issue 12/2018

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Abstract

Purpose of Review

A wide variety of triggers prompt attacks in episodic migraine. Although experimental triggers such as glyceryl trinitrate reliably produce migraine, natural triggers are much less predictable and vary in importance between individuals. This review describes the most common triggers in episodic migraine and provides strategies for managing them in clinical practice.

Recent Findings

Multiple migraine attack triggers have been established based on patient surveys, diary studies, and clinical trials. Stress, menstrual cycle changes, weather changes, sleep disturbances, alcohol, and other foods are among the most common factors mentioned. Clinical studies have verified that fasting, premenstrual periods in women, “letdown” after stress, and most likely low barometric pressures are migraine triggers. Premonitory symptoms such as neck pain, fatigue, and sensitivity to lights, sounds, or odors may mimic triggers.

Summary

Multiple studies clearly demonstrate triggers in episodic migraine, often related to change in homeostasis or environment. Many common migraine triggers are not easily modifiable, and avoiding triggers may not be realistic. Healthy lifestyle choices such as exercise, adequate sleep, stress management, and eating regularly may prevent triggers and transformation to chronic migraine over time.
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Metadata
Title
Triggers, Protectors, and Predictors in Episodic Migraine
Author
Michael J. Marmura
Publication date
01-12-2018
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 12/2018
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-018-0734-0

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