title: Phenotypic features of chronic migraine.
abstract: BACKGROUND
  Chronic migraine is a disabling, under-recognized, and undertreated disorder that increases health burdens. The aim of this study was to evaluate phenotypic features and the relevance of accompanying symptoms of migraine attacks in chronic migraine.
  
  
  METHODS
  This study was conducted as part of an ongoing Turkish Headache Database Study investigating the clinical characteristics and outcomes of headache syndromes in the Turkish population. The electronic database was examined retrospectively, and 835 patients with chronic migraine were included.
  
  
  RESULTS
  Patient group consisted of 710 women and 125 men (85 and 15 %, respectively). Mean patient age was 36.8 ± 13.5 years, median value of migraine onset was 60 months (18-120), median headache frequency was 25 days per month (16-30), median of attack duration was 12 h (4-24), and median of intensity was eight (7-9). Increasing headache days per month were inversely related with the presence of nausea, vomiting, phonophobia, and photophobia. Longer duration of headache (months) and higher visual analog scale (VAS) for headache intensity were associated with all accompanying symptoms. Phonophobia, nausea, photophobia, and vomiting were the most frequent accompanying symptoms (experienced by 80.2, 77.6, 71.2, and 40.9 % of patients, respectively). Osmophobia was also frequent in chronic migraine patients (53.4 %) and was closely associated with other accompanying symptoms. Vertigo and dizziness were observed less frequently, and they were not associated with accompanying symptoms.
  
  
  CONCLUSIONS
  Phenotype of chronic migraine may be associated with the course of chronification. Duration of illness and attack intensity were closely related with the presence of accompanying symptoms, although headache frequency was found to be inversely related to the presence of accompanying symptoms. Osmophobia was also a frequent symptom and was closely related with other accompanied symptoms, unlike vertigo and dizziness. Inclusion of osmophobia into the diagnostic criteria might improve accurate diagnosis of chronic migraine.
authors.affiliation: Neurology Department, Istanbul Education and Research Hospital, Kasap İlyas Mah. Org. Abdurrahman, Nafiz Gürman Cd, PK: 34098, Fatih, Istanbul, Turkey. osmanozguryalin@yahoo.com.
authors.forename: Osman Özgür
authors.initials: OÖ
authors.lastname: Yalın
authors.affiliation: Neurology Department, Istanbul University Cerrahpasa School of Medicine, İstanbul, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Uluduz
authors.affiliation: Neurology Department, Mersin University School of Medicine, Mersin, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Özge
authors.affiliation: Biostatistics Department, Düzce University School of Medicine, Düzce, Turkey.
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Sungur
authors.affiliation: Neurology Department, Kocaeli University School of Medicine, Kocaeli, Turkey.
authors.forename: Macit
authors.initials: M
authors.lastname: Selekler
authors.affiliation: Neurology Department, Istanbul University Cerrahpasa School of Medicine, İstanbul, Turkey.
authors.forename: Aksel
authors.initials: A
authors.lastname: Siva
mesh_terms: D000328:Adult; D016208:Databases, Factual; D005260:Female; D006801:Humans; D012001:Hyperacusis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000175:diagnosis*; D009325:Nausea / Q000150:complications*; D010641:Phenotype; D020795:Photophobia / Q000150:complications*; D012189:Retrospective Studies; D063189:Symptom Assessment; D013997:Time Factors; D014839:Vomiting / Q000150:complications*; D055815:Young Adult
keywords: Accompanying symptoms; Chronic migraine; Chronification; Phenotype