Abstract text (incl. figure legends and references)

Background: Migraine is one of the most common medical disorders, it affects almost 1 billion patients worldwide and it is a chronic disabling disease affects women more than men. Few neurological disorders have been reported to be a possible complication of COVID 19 infection.

AIM OF THE STUDY: to evaluate and assess the effect of covid 19 infection on the episodic migraine patients and if there were any differences either the patients are vaccinated or not.

STUDY DESIGN: our study was prospective and retrospective observational study and has been done at Neuroscience department, King Fahad Armed Forces Hospital (KFAFH) in Jeddah, Saudi Arabia. We have two group of episodic migraine patients each was 30 patients; the first group was the non-vaccinated while the second one was the vaccinated group, and we assessed all the patients and reviewed their daily headache at periods of 3 months and 6 months from COVID 19 infection which was confirmed with PCR. Also, we compared it with their last daily headache before the infection.

Results: total 11 patients (36.6%) from the non-vaccinated group developed chronic migraine after 3 months (7 females, 4 males), The vaccinated group only 5 patients (16.6 %) developed chronic migraine (3 females, 2 males) (p value 0.0014). while only 5 patients (16.6%) developed chronic migraine after 6 months (3 females, 2 males) in the non-vaccinated group while the vaccinated one only 3 patients (10 %) developed chronic migraine (2 females, 1 males) (p valuen0.0001).

Conclusion: COVID 19 infection has negative effects on the episodic migraine patients. However, the covid vaccination has a protective role against its conversion to chronic migraine.

Key Words: Episodic migraine, Chronic migraine, COVID 19 infection, COVID 19 Vaccination.