To evaluate the prevalence and impact of migraine as a comorbidity for patients with Postural Orthostatic Tachycardia Syndrome (POTS).

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition of dysautonomia resulting in orthostatic and neurological symptoms. POTS patients may frequently experience palpitations, syncope, headaches, GI irritability, and more. Headache has been shown to be a common cause of visits to the ED for POTS patients and a substantial obstacle to their quality of life. Migraine is an area of increasing interest in the POTS research field that warrants further investigation concerning its prevalence, possible link to shared pathophysiology with POTS, and impact on POTS patients.

In this study, 476 POTS patients who received care at our tertiary care center completed survey questions in 2020 about migraine. These questions were intended to gather information on migraines in POTS patients including whether they had a prior migraine diagnosis, if they experienced activity limitation, and if they had migraine-associated symptoms during a headache.

65.1% of patients surveyed had a previous diagnosis of migraine. Fewer than 40 of the 476 respondents to this survey reported having no headaches (~8%). 64.1% of patients indicated that they had headaches with concomitant nausea. Light sensitivity was also frequently experienced by our POTS patients who suffer from headaches (78.2%). When asked if in the last three months they had at least one day of activity limitation, 73.3% of patients participating in our study reported this level of disability.

A notable relationship of migraine with POTS is highlighted by this survey, suggesting that future studies are needed to clarify the nature of this association. Improved understanding of the potential connection between migraine and POTS may lead to new treatment advancements.