Migraine and Tumarkin Crisis
In our series, a smaller proportion of patients in the group of patients followed from the onset of the disease reported migraines relative to the total group of patients with UMD. Thus, early care and a close follow-up of the disease may be associated with a better management of this type of headaches. Taking into account that approximately 12% of the general population suffers from migraine (9), and 10 to 51% of patients with MD (10–12), this may be underestimated in our sample. The reason for this may be that we were not sufficiently cautious in assessing the presence of migraine in the initial years of data collection, as the migraine-MD relationship was not as relevant at that time as it is at present. However, these would be non-differential biases equally distributed throughout the sample and that would not lead to an incorrect estimate of the associations but rather, to a reduction in the existing estimates.
In our series 12,2% patients reported the presence of Tumarkin crises, that is consistent with the published, 5-15% of patients (13–16). Patients within model number 3 are those that experienced the highest proportion of Tumarkin crises between episodes (17.7%), which augmented the perceived severity of MD in these patients.