Clinical significance of nausea in migraine

AIM: To study the prevalence and intensity of nausea in pain, prodromal and postdromal phases of migraine paroxysm, and in between the paroxysms in migraine patients, depending on the type of migraine paroxysm and frequency of pain days, and to evaluate an effect of nausea on the course of migraine. MATERIAL AND METHODS: One hundred and four patients with migraine, aged from 18 to 60 years, were examined. The intensity of nausea was evaluated by a 5-point verbal analogue scale, and its intensity in between the paroxysms by the Gastrointestinal Symptom Rating Scale. All of the patients underwent a complex examination of the gastrointestinal tract. RESULTS AND CONCLUSION: Paroxysms with accompanying nausea were found in 90% patients. Acute nausea was associated with older age, earlier onset and longer experience of migraine. In a group of patients with acute nausea, the frequency and intensity of migraine paroxysms, probability of reoccuring pain in the first day and the severity of social disability were higher. Development of nausea in between the paroxysms and its intensity was significantly higher in patients with high intensity of nausea in migraine paroxysms. Nausea in the prodrome was significantly associated with migraine without aura and chronicity of the disorder. Patients with nausea in the prodrome also had a longer painful phase and more severe social disability. No relationship between organic diseases of the digestive tract and nausea was found. Nausea can have its own pathological mechanisms not related to concomitant diseases of the digestive tract that should be taken into account in therapeutic interventions aimed at improving quality of life of the patients.