"It does seem that in most people migraine is not a progressive disease," says Carl Dahlof, MD, PhD, a neurologist and medical director and founder of the Gothenburg Migraine Clinic in Gothenberg. He presented his findings this week at the American Headache Society annual meeting in Chicago.
But you may have to be patient. "The average duration is 25 years," Dahlof tells WebMD. "The average age of onset is about age 20."
An estimated 28 million Americans suffer from migraine headaches, according to the American Headache Society.
The 12-Year Study
Dahlof and his colleagues randomly selected 374 migraine patients, including 200 women and 174 men with an average age of 55, following them from 1994 to 2006. At the study's start, they reported having one to six migraines a month. Dahlof's team conducted telephone interviews in 2005 and 2006 to ask the men and women about their current migraine experience.
Over the 12-year period, the migraines of nearly 30% of the patients resolved, usually meaning they disappeared, Dahlof tells WebMD. "The majority, 91% [of these 110], had not had a migraine attack for at least two years," Dahlof says.
Among the remaining 264 who continued to experience the headaches at the 12-year follow-up mark, Dahlof found most had fewer, briefer, and milder attacks.
- 80% reported a change in attack frequency, with 80% of them having fewer migraines and 20% having more.
- 55% reported a change in duration of attack, with 66% of them saying their attacks lasted shorter periods of time and 34% saying they lasted longer.
- 66% said the pain intensity changed, with 83% of them experiencing milder pain and 17% experiencing more severe pain.
- Only 1.6%, or six participants, progressed to chronic migraine, defined as having migraines more than 15 days a month.
Despite the improvement in symptoms, Dahlof found that many of the patients still lost time from work or family or social events because of the migraines.
Whose Migraines Disappear?
"We don't know for sure," Dahlof says. Hereditary seemed to play a role, at least for the women in the study, with those having a family history more likely to continue to have attacks.
Early management of migraines by a specialist may be the driving force to making them disappear or improve over time, he says. "The risk of progression can be reduced by good management," he believes, although this study did not track the effect of good management. Dahlof credits in particular the improvements in migraine drug therapy in recent years, especially the use of the newer triptan drugs, which are taken at the start of the pain.
Another Expert Weighs In
The study reflects what one long-time headache specialist has observed in his patients. Migraine problems do tend to decrease with time, says Seymour Diamond, MD, founder of the Diamond Headache Clinic and executive chairman of the National Headache Foundation in Chicago.
"We find as people age they get fewer migraines," he says. "After age 50 or 55, they often decline. But in some people, they never do."
Migraine sufferers trying to reduce the chances their headaches will become more frequent can pay attention to other risk factors, other researchers suggested in a report published in 2006 in the journal Headache.
- Living with migraines? Get support and advice from Indie Cooper-Guzman, RN, and other members on our Migraines message board.