Currently Viewing:
Newsroom
Currently Reading
Study Finds Patients Misdiagnosed With MS Increases Morbidity, Healthcare Costs
April 19, 2019 – Samantha DiGrande
Analyzing the Scent of Parkinson Disease Could Lead to Diagnostic Tool
April 19, 2019 – Wallace Stephens
This Week in Managed Care: April 19, 2019
April 19, 2019
ctDNA Can Detect MRD and Early Cancer Recurrence in Colorectal Cancer
April 19, 2019 – Laura Joszt
5 Findings From the April 2019 Issue of AJMC®
April 19, 2019 – Christina Mattina
What We're Reading: Long-Term Care Benefits; Predicting Obesity; Montana Reauthorizes Medicaid Expansion
April 19, 2019 – AJMC Staff
AJMC® in the Press, April 19, 2019
April 19, 2019 – AJMC Staff
In Small Amount of Patients, CD4+ T Cells Continue to Decline Despite Being Virally Suppressed
April 18, 2019 – Jaime Rosenberg
Four States Picked for $350 Million Study to Prevent, Treat OUD
April 18, 2019 – Allison Inserro

Co-occurrence of Certain Migraine Symptoms Indicates a Common Pathophysiology

Laura Joszt
Patients who have migraine often suffer from coexisting issues, such as sleep difficulties, vertigo, and dizziness. A study evaluating the presence of certain symptoms in patients with migraine indicated that some may have a common pathophysiology.
Patients who have migraine often suffer from coexisting issues, such as sleep difficulties, vertigo, and dizziness. According to a new paper published in Pain Medicine, patients with chronic migraine (CM) were more likely to have co-occurring symptoms that affect quality of life than patients with episodic migraine (EM).

The researchers evaluated the presence of certain symptoms in patients with EM and CM and sought to determine the association between these symptoms and Migraine Disability Assessment (MIDAS) scores. Overall, 897 EM patients and 183 CM patients were included in the study.

The authors found that vertigo/dizziness, cutaneous allodynia, concentration-related impairment in function, and abnormal sleep latency were significantly more frequent in patients with CM. These patients also had higher MIDAS and visual analog scale for pain scores.

As for cranial autonomic symptoms (CAS), except for rhinorrhea and facial/forehead sweating, which were more prevalent in patients with CM, there were no significant differences between the 2 groups. Among the overall study population, 69.4% had at least 1 of the CAS and 61.4% had vertigo/dizziness.

The researchers found that abnormal sleep latency and concentration-related impairment in function were more likely to occur in patient groups with CAS, vertigo/dizziness, and cutaneous allodynia than patients without those symptoms.

In a majority (60%) of patients with migraine, it took longer than 30 minutes to fall asleep, and for 16.7% of patients, it took patients longer than 30 minutes more than 3 times a week. Among the CM population, 39.3% had sleep latency longer than 30 minutes more than 3 times a week.

In the overall study population, CAS, vertigo/dizziness, and cutaneous allodynia tended to co-occur.

“One of the most important findings in our study was the coexistence of CAS, vertigo/dizziness, and cutaneous allodynia in patients with migraine,” the authors wrote.

The trigeminovascular system is thought to have a role in CAS. Cortical spreading depression and migraine-related transmitters, such as calcitonin gene-related peptide, explain migraine with vertigo, but experimental studies have now also indicated a possible connection between vestibular and trigeminal nuclei. Finally, cutaneous allodynia is associated with trigeminal nucleus caudalis.

As a result of currently known mechanisms and the co-occurrence of CAS, vertigo/dizziness, and cutaneous allodynia, the authors believe sensitization of trigeminal nuclei may be responsible for generating the symptoms.

“The co-occurrence of CAS, vertigo/dizziness, and cutaneous allodynia in migraine suggests that these symptoms have a common pathophysiology that varies depending on the activation of trigeminal pathways,” the authors concluded.

Reference

Ceylan M, Yalcin A. Coexistence of symptoms associated with trigeminal pathways in chronic and episodic migraine and the effects on quality of life. [published online September 14, 2018.] Pain Med. doi: 10.1093/pm/pny118.

 
Copyright AJMC 2006-2018 Clinical Care Targeted Communications Group, LLC. All Rights Reserved.
x
Welcome the the new and improved AJMC.com, the premier managed market network. Tell us about yourself so that we can serve you better.
Sign Up