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Case Reports
. 2023 Feb 22;17(1):62.
doi: 10.1186/s13256-023-03795-3.

Reduced frequency of migraine attacks following coronavirus disease 2019: a case report

Roland Houben  1
Affiliations
Case Reports

Reduced frequency of migraine attacks following coronavirus disease 2019: a case report

Roland Houben. J Med Case Rep. .

Abstract

Background: Severe acute respiratory syndrome coronavirus 2 is a virus affecting different organs and causing a wide variety and severity of symptoms. Headache as well as loss of smell and taste are the most frequently reported neurological manifestations of coronavirus disease 2019 induced by severe acute respiratory syndrome coronavirus 2. Here we report on a patient with chronic migraine and medication overuse headache, who experienced remarkable mitigation of migraine following coronavirus disease 2019.

Case presentation: For many years prior to the severe acute respiratory syndrome coronavirus 2 infection, a 57-year-old Caucasian male suffered from very frequent migraine attacks and for control of headaches he had been taking triptans almost daily. In the 16-month period before the outbreak of coronavirus disease 2019, triptan was taken 98% of the days with only a 21-day prednisolone-supported triptan holiday, which, however, had no longer-lasting consequences on migraine frequency. Upon severe acute respiratory syndrome coronavirus 2 infection, the patient developed only mild symptoms including fever, fatigue, and headache. Directly following recovery from coronavirus disease 2019, the patient surprisingly experienced a period with largely reduced frequency and severity of migraine attacks. Indeed, during 80 days following coronavirus disease 2019, migraine as well as triptan usage were restricted to only 25% of the days, no longer fulfilling criteria of a chronic migraine and medication overuse headache.

Conclusion: Severe acute respiratory syndrome coronavirus 2 infection might be capable of triggering mitigation of migraine.

Keywords: Case report; Coronavirus disease 2019; Migraine; Severe acute respiratory syndrome coronavirus 2; Triptan.

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Conflict of interest statement

The author declares no competing interests.

Figures

Fig. 1
Fig. 1
Remarkable increase in triptan-free days directly following COVID-19 disease. Displayed is the number of days per month without triptan consumption from September 2019 to May 2021, based on the recordings of the patient. The number of migraine-free days was identical to the depicted triptan-free days, with the exception of July 2020, when the 57-year-old patient experienced four migraine attacks, without triptan intervention, during a drug holiday associated with 12 days of prednisolone treatment (100 mg on the first 2 days and stepwise reduction to 10 mg on the last two days). The first SARS-CoV-2-positive PCR test was on 21 December 2020. The patient had COVID-19 symptoms until 4 January 2021, and a period of 80 days with only 20 migraine attacks started on 7 January 2021. Starting on 28 March, the patient returned to having almost daily migraine attacks
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