A large study on triggers of migraine with aura (MA) has provided new knowledge about factors, and can help in identifying what individual sufferers should avoid. This study, conducted by Drs. A Hauge, M Kirchmann and J Olesen of the University of Copenhagen, was unique in that it characterized factors in detail using a questionnaire developed specifically for the purpose of understanding perceived triggers and how patients can avoid them.

   If trigger factors were better known, it would be possible to change factors and thus reduce the frequency of migraine. Seven subtypes of trigger factors were mentioned by a very high proportion of patients: too much work (stress), reflected sunlight, too little sleep, red wine, menstruation, perfume and passive smoking.  In previous studies, factors were not broken down into subtypes. Based on the results in this study, it is possible to characterize some trigger factors: stress from too much work was reported by 84% and thus more prevalent than marital problems which were reported by 36%. In the category of “emotional influences” negative feelings and excitement were mentioned by 58%. Anxiety was the most prevalent of all triggers. In the alcohol subgroup, 91% specified red wine as the trigger.  Passive smoking was a trigger for 100%, whereas smoke from other sources was reported rarely. In the smells category, perfume was reported by 81% of all participants. As expected, menstruation was a trigger in the hormone group.

Based on these findings, it is possible to instruct patients to avoid certain specific triggers. There are certain lifestyle modifications which would greatly benefit migraine patients.  This detailed knowledge about triggers in migraine aura should be helpful in the management of patients with MA in daily routine practice. The study suggests further investigation would be helpful in researching combined trigger factors.

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