Clinical characteristics of migraine: A prospective cross-sectional study over nine years [version 1; peer review: 2 approved with reservations, 1 not approved]

Background: Migraine is the most common primary headache. This study aimed to describe clinical observations about migraine in outpatients in Iraq, including migraine types and subtypes, duration and frequency of acute attacks, severity, disability, effects on the quality of life, and complications. Methods: This is an outpatient-based prospective cross-sectional study, conducted in the Misan province, Iraq over nine years, and included 1412 patients aged 12 to 50 years. The data was collected from clinical records of patients who attended outpatient clinics. Results: The study included 1100 women (77.9%) and 312 men (22.1%); the women/men ratio being 3.5:1. The median age and standard deviation (SD) was 21 ± 5.42 years. The mean age at first attack of migraine was 17 ± 4.91 years. Migraine without aura was the most common type, accounting for 68% of the cases. The mean frequency of the attacks was (2 ± 4.63) days/month. In general, acute attacks were moderate to severe. Conclusions: In our study, we observed that migraine causes a headache resulting in episodes of temporary functional disability and women suffered more than men (ratio of 3.5:1). The mean age at first attack was a young age, and a family history of migraine highly altered distribution. Migraine without aura was the most common type, and symptoms including nausea and vomiting and photophobia were experienced by patients, which were used to diagnose migraines. Experienced aura was the most common migraine with aura, but also aura without a headache and aura with migraine were prevalent; therefore, it is important to differentiate between migraine subtypes. Visual aura was the most common aura, while motor symptoms were very rare. Chronic persistent headaches were a common complication recorded. These features provide evidence for the creation of screening tools in migraine prevention migraine.