• Christian Lampl, Mirjam Rudolph, Christina I Deligianni, and Dimos D Mitsikostas.
• Medical Headache Center, Hospital Sisters of Mercy, Seilerstaette Linz, Linz, 4020, Austria, christian.lampl@bhs.at.
• J Headache Pain. 2015 Jan 1;16:566.

BackgroundWhether neck pain (NP) is a prodromal migraine symptom or belongs to the migraine attack feature remains controversial.MethodsIn order to prospectively record neck pain (NP) and non-headache symptoms and to evaluate the percentage of patients having NP as clear premonitory, non-headache symptom of their migraine, a specific self fulfilled questionnaire was designed to record NP and premonitory symptoms in a migraine cohort. All patients who reported NP anytime during the migraine phase were allocated to 3 groups: A = NP starts with the onset of headache; B = NP starts < 2 h before the onset of headache; C = NP starts 2-48 h before the onset of headache.ResultsData were evaluated from 487 migraineurs with episodic migraine (73.1 % females; 77 % had migraine without aura). 338 patients (69.4 %) reported NP anytime during the migraine phase. 184 patients (group A; 54.4 %) noticed NP with the start of the headache phase; 118 patients (group B; 24.2 %) reported NP within 2 h before the headache phase; 36 patients (group C; 7.4 %) experienced NP 2-48 h before the headache phase. In group B we found a high proportion of typical migraine associated symptoms and NP progressed into the headache phase in 82.2 %.ConclusionsThese data indicate that NP is a very common feature of migraine attacks and is more likely to be part of the migraine attack than a prodromal migraine symptom.

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