title: Clinical Predictors for Migraine in Patients Presenting With Nausea and/or Vomiting.
abstract: OBJECTIVE
  Many migraine patients develop nausea and/or vomiting (N/V) and are referred to gastroenterologists. This can lead to an inappropriate treatment and a delay of the correct diagnosis. We therefore aimed to identify predictors for migraine in patients presenting with N/V as well as headache.
  
  
  METHODS
  A total of 407 patients who were first diagnosed with migraine at Samsung Medical Center, Seoul, Korea, in 2009 were analyzed. Among them, 261 patients had N/V (migraine with N/V group) and 146 did not (migraine without N/V group). Each patient was evaluated using a structured questionnaire.
  
  
  RESULTS
  Migraine with N/V group was younger, comprised of more females, had more abnormal body mass index, less alcohol intake, more family history of migraine, higher attack severity, more stress association, more aggravation by physical activity, more abdominal pain, and more photophobia/phonophobia than migraine without N/V group. Multivariate analysis revealed that young age (age < 40 years vs. ≥ 40 years, odds ratio (OR), 2.128; 95% confidence interval (CI), 1.206-3.756; P = 0.009), female (OR, 2.703; 95% CI, 1.492-4.896; P = 0.001), family history of migraine (OR, 2.080; 95% CI, 1.169-3.700; P = 0.013), abdominal pain (OR, 4.452; 95% CI, 1.263-15.693; P = 0.020), and photophobia/phonophobia (OR, 2.296; 95% CI, 1.308-4.030; P = 0.004) were independent predictive factors associated with migraine in patients with N/V.
  
  
  CONCLUSIONS
  Because young age, female, family history of migraine, abdominal pain, and photophobia/phonophobia are associated with migraine in patients presenting with N/V as well as headache, physicians should have a high index of suspicion for migraine in N/V patients who belong to these categories.
authors.affiliation: Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yang Won
authors.initials: YW
authors.lastname: Min
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Byung-Hoon
authors.initials: BH
authors.lastname: Min
authors.forename: Jun Haeng
authors.initials: JH
authors.lastname: Lee
authors.forename: Jae J
authors.initials: JJ
authors.lastname: Kim
authors.forename: Chin-Sang
authors.initials: CS
authors.lastname: Chung
authors.forename: Poong-Lyul
authors.initials: PL
authors.lastname: Rhee
keywords: Headache; Migraine disorders; Nausea; Vomiting