SYNOPSIS
In migraine, are there different metabolic responses to glucose ingestion, and if so, do the patients have different detectable characteristics which may be of use to determine their treatment?
Thirty two volunteer migraineurs, for whom fasting was a known precipitant, were challenged with a glucose meal after an overnight fast. Symptoms and glucose levels were recorded at intervals over three hours. Examination of the changes in symptoms, elicited two groups with opposite responses, which were also significantly different with respect to circulating glucose levels. Furthermore, sub‐groups defined by dietary precipitants as expressed by the migraineur, were also found to be significantly different in both of these parameters.
A treatment plan, for this type of migraine attack, based on the the dietary factors which may provoke its evolution and the response to glucose, is discussed.
The diagnosis of acephalgic migraine is complicated by the fact that other neurological conditions such as transient ischaemic attacks, demyelinating disease, simple partial epilepsy, and even glaucoma, can present with similar symptoms. Using both flash and pattern stimulation, visual evoked potentials (VEPs) were examined as a means of differentiating between acephalgic migraine, migraine with aura, migraine without aura, demyelinating disease and a control group. This study demonstrated that by analysing the amplitude of the background fast activity in the flash and pattern VEP, acephalgic migraine can be differentiated from demyelinating disease, migraine with aura, migraine without aura and absolute controls.
SYNOPSIS
Traditionally the diagnosis of migraine has been made by clinical history, examination and investigation to exclude other ophthalmological and neurological diseases. To date there has been no simple objective test for the diagnosis of migraine on an individual basis. Patients were subjected to both flash and pattern light stimuli, and measurements were made from the resultant visual evoked potential (VEP) charted as a waveform. Calculations based on the parameters of the waveforms produced a Coefficient which correlated well with the medical diagnosis. This study demonstrates that electro‐diagnostic methods can be utilised to provide a fast, reliable and accurate diagnosis for migraine on an individual basis, and which will also differentiate between the Common and Classical varieties.
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