Clinical recognition of allodynia in migraine

Mathew, Ninan T.; Kailasam, Jayasree; Seifert, Tad

doi:10.1212/01.wnl.0000137107.27585.f7

Cited by 149 publications

(195 citation statements)

References 22 publications

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“…These features, however, seem to be highly specific to migraine because they are absent in other types of headaches, but they are not sensitive for the diagnosis of migraine. These results are similar to those reported in the adult headache population for allodynia and osmophobia [2,5]. Yet, the prevalence of allodynia and osmophobia appears lower than that reported in adult migraine and possible explanations are the longer duration of illness in the adult population as well as the major difficulty in asking children about these clinical features.…”

Section: Discussionsupporting

confidence: 85%

The prevalence of allodynia, osmophobia and red ear syndrome in the juvenile headache: preliminary data

et al. 2005

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The aim of the study was to determine the frequency of clinical allodynia, osmophobia and red ear syndrome in a young population. Medical records of the children admitted for headache between 1 December 2004 and 31 March 2005 were consecutively studied. A questionnaire was used to find the prevalence of allodynia, osmophobia and red ear syndrome. We visited 96 children with headache. The range of age was 6–18 years. We classified migraine in 57%, other primary headaches in 25% and secondary headaches in about 18%. The presence of ipsilateral clinical allodynia was 14.5% in migraine, osmophobia in 20% of migraine and red ear syndrome in about 24% of migraine cases and they were absent in the other two headache groups. Our study shows that features like osmophobia, allodynia and red ear syndrome are not uncommon in migraine while they are absent in other types of headache.

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Section: Discussionsupporting

confidence: 85%

The prevalence of allodynia, osmophobia and red ear syndrome in the juvenile headache: preliminary data

et al. 2005

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“…Several groups have developed questionnaires to assess CA, 10,12,13 but only one instrument has been validated against QST. 13 Most questionnaires use dichotomous response options and score CA as present or absent.…”

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confidence: 99%

“…13 Most questionnaires use dichotomous response options and score CA as present or absent. However, CA is not an all-or-none phenomenon; it varies over time, emerging and remitting during the course of a migraine attack.…”

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confidence: 99%

Cutaneous allodynia in the migraine population

Lipton

Bigal

Ashina

et al. 2008

Annals of Neurology

502

567

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Objective-To develop and validate a questionnaire for assessing cutaneous allodynia (CA), and to estimate the prevalence and severity of CA in the migraine population. (n = 11,388) completed the Allodynia Symptom Checklist, assessing the frequency of allodynia symptoms during headache. Response options were never (0), rarely (0), less than 50% of the time (1), ≥50% of the time (2), and none (0). We used item response theory to explore how well each item discriminated CA. The relations of CA to headache features were examined. Methods-MigraineursResults-All 12 questions had excellent item properties. The greatest discrimination occurred with CA during "taking a shower" (discrimination = 2.54), wearing a necklace (2.39) or ring (2.31), and exposure to heat (2.1) or cold (2.0). The factor analysis demonstrated three factors: thermal, mechanical static, and mechanical dynamic. Based on the psychometrics, we developed a scale distinguishing no CA (scores 0-2), mild (3-5), moderate (6-8), and severe (≥9). The prevalence of allodynia among migraineurs was 63.2%. Severe CA occurred in 20.4% of migraineurs. CA was associated with migraine defining features (eg, unilateral pain: odds ratio, 2.3; 95% confidence interval, 2.0 -2.4; throbbing pain: odds ratio, 2.3; 95% confidence interval, 2.1-2.6; nausea: odds ratio, 2.3; 95% confidence interval, 2.1-2.6), as well as illness duration, attack frequency, and disability.Interpretation-The Allodynia Symptom Checklist measures overall allodynia and subtypes. CA affects 63% of migraineurs in the population and is associated with frequency, severity, disability, and associated symptoms of migraine. CA maps onto migraine biology. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptCutaneous allodynia (CA) is characterized by pain provoked by stimulation of the skin that would ordinarily not produce pain. 1 The underlying mechanism of facial CA is sensitization of the nociceptive neurons in the trigeminal nucleus caudalis, which receives convergent afferent input from the dura mater and periorbital skin. 2,3 Clinic-based studies suggest that about two thirds of migraine sufferers experience development of CA. [4][5][6] As a marker of central sensitization, allodynia has been proposed as a risk factor for progression to chronic migraine. 7-9 Therefore, CA has significant implications for our understanding of the pathophysiology of migraine attacks, for the implementation of treatment, and for assessing prognosis.CA is usually assessed by quantitative sensory testing (QST). QST requires specialized equipment, training, and testing; it is too cumbersome and costly for wide-spread use in clinical practice or epidemiological research and is subject to temporal sampling error. As a consequence, most studies on headache and CA come from a small number of headache centers and the highly selected patients treated there. 5,10,11 There is an urgent need to develop and validate simple methods for assessing CA to better characterize CA in representative samples and...

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confidence: 99%

Preventing chronicity of migraine

Fanciullacci

Cesaris

2005

J Headache Pain

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Progression during attacksAllodynia, pain resulting from application of a non-noxious stimulus to normal skin, is a recently described symptom of migraine [3]. In fact clinically detectable allodynia, a manifestation of central sensitisation, occurs with high frequency during migraine attacks. Migraine pain progresses along the neural pathway with throbbing head pain occurring early in the attack (sensitisation of first-order neurons), followed by central sensitisation and cutaneous allodynia within the J Headache Pain (2005) 6:331-333

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Clinical recognition of allodynia in migraine

Cited by 149 publications

References 22 publications

The prevalence of allodynia, osmophobia and red ear syndrome in the juvenile headache: preliminary data

The prevalence of allodynia, osmophobia and red ear syndrome in the juvenile headache: preliminary data

Cutaneous allodynia in the migraine population

Preventing chronicity of migraine

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