Coexistence of Symptoms Associated with Trigeminal Pathways in Chronic and Episodic Migraine and the Effects on Quality of Life

Ceylan, Mustafa; Yalçın, Ahmet

doi:10.1093/pm/pny118

Cited by 8 publications

(19 citation statements)

References 57 publications

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“…Our study suggests that migraineurs with vestibular symptoms exhibit similar postural control than migraineurs without self-report of vestibular symptoms. Additionally, we verified a high prevalence of the vestibular symptoms among the patients, which agrees with previous findings [1][2][3][4][5][6][7][8][9][10][11]. Based on the present and previous findings, we suggest that the vestibular symptoms and balance changes are a common condition among migraineurs and may be present on different severity levels according to the classic clinical presentation of migraine; and not due to a different classification considering only the presence of vestibular symptoms.…”

Section: Discussionsupporting

confidence: 91%

“…In the same way, some migraineurs without self-reported vestibular symptoms also present vestibular dysfunction [23], suggesting that these vestibular problems and symptoms can be related to the presence of migraine and probably not related to a different condition. Furthermore, the vestibular symptoms are more prevalent in migraine with aura and chronic migraine [1][2][3][4][5], even in the interictal period [4,6,9]. This implies that an overlap between these subdiagnosis and the presence of the vestibular symptoms may occur.…”

Section: Discussionmentioning

confidence: 99%

“…Migraineurs present a high prevalence of vestibular symptoms, such as dizziness and vertigo [1][2][3][4][5][6][7][8][9][10]. The cooccurrence of these symptoms with migraine is more frequent than expected by chance [10,11] during both the ictal and interictal period [6,9], and it can augment the impact on migraineurs' quality of life [1,4]. In that way, these symptoms can be considered as either part of the migraine presentation [11] or a different classificationas described in the Appendix of the International Classification of Headache Disorders (ICHD-III) as vestibular migraine [12], which was jointly formulated with the Committee for Classification of Vestibular Disorders of the Bárány Society [13].…”

Section: Introductionmentioning

confidence: 99%

“…In that way, these symptoms can be considered as either part of the migraine presentation [11] or a different classificationas described in the Appendix of the International Classification of Headache Disorders (ICHD-III) as vestibular migraine [12], which was jointly formulated with the Committee for Classification of Vestibular Disorders of the Bárány Society [13]. Patients with chronic migraine and migraine with aura present more prevalence of vestibular symptoms compared to migraineurs without aura [1][2][3][4][5][6]9]. Furthermore, it has been suggested that the presence of aura and headache frequency can predict dizziness handicap [4].…”

Section: Introductionmentioning

confidence: 99%

“…Taking all together, it is not clear if the statements of worse balance in patients with vestibular migraine or migraine-associated dizziness are influenced by the migraine subdiagnosis, since patients with aura and chronic migraine present a high prevalence of structural brain alterations [26][27][28], balance impairments [5][6][7], vestibular symptoms [1][2][3][4][5] and dysfunctions [20]. To improve our understanding regarding the migraine spectrum and to ensure adequate classification and subsequent treatment, it is important to determine whether the balance instability of these patients is determined by the presence of vestibular symptoms or by the migraine features itself [15,20].…”

Section: Introductionmentioning

confidence: 99%

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Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

et al. 2020

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Background: Vestibular symptoms and balance changes are common in patients with migraine, especially in the ones with aura and chronic migraine. However, it is not known if the balance changes are determined by the presence of vestibular symptoms or migraine subdiagnosis. Therefore, the aim of this study was to verify if the migraine subdiagnosis and/or the presence of vestibular symptoms can predict balance dysfunction in migraineurs. Methods: The study included 49 women diagnosed with migraine with aura, 53 without aura, 51 with chronic migraine, and 54 headache-free women. All participants answered a structured questionnaire regarding migraine features and presence of vestibular symptoms, such as dizziness/vertigo. The participants performed the Modified Sensory Organization Test on an AMTI© force plate. The data were analysed using a linear mixed-effect regression model. Results: The presence of vestibular symptoms did not predict postural sway, but the subdiagnosis was a significant predictor of postural sway. Migraine with aura patients exhibited more sway than migraine patients without aura when the surface was unstable. Additionally, we found high effect sizes (ES > 0.79) for postural sway differences between patients with chronic migraine or with aura compared to controls or migraine without aura, suggesting that these results are clinically relevant. Conclusions: The subdiagnosis of migraine, instead of the presence of vestibular symptoms, can predict postural control impairments observed in migraineurs. This lends support to the notion that balance instability is related to the presence of aura and migraine chronicity, and that it should be considered even in patients without vestibular symptoms.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

et al. 2020

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Craniofacial Autonomic Dysfunction in Migraine: Implications for Treatment and Prognosis

Cortez

Millsap²,

Brennan³

et al. 2020

Journal of Neuro-Ophthalmology

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Background: Craniofacial autonomic signs and symptoms (CASS) are relatively underrecognized in the evaluation of migraine headache. Yet, these features provide insight into diagnostic criterion, therapeutic approaches, and overarching disease burden. Evidence Acquisition: This review aims to summarize relevant literature evaluating autonomic dysfunction, with focus on CASS, in migraine through targeted literature searches in PubMed. Full articles of original data published between 1974 and 2019 were identified using MeSH terms with no search limits. Results: Although CASS are typically clinically evaluated by subjective patient report, investigational measures of cranial autonomic function have identified marked distinctions between headache attack and attack-free intervals. The presence of CASS during an attack does not differ based on age, sex, or presence of aura. Unilateral CASS may be predictive of longer, more frequent, and/or severe attacks and often co-occur with sensory dysfunction such as allodynia and photophobia. Although limited research has been performed to evaluate targeted therapeutics for migraine with CASS, triptans and onabotulinumtoxinA may demonstrate greater effects in this group. Conclusions: Migraine remains a debilitating disorder with significant community-wide impacts, necessitating continued evaluation of contributing features. Consideration of CASS provides important insight into potential treatment approaches and the effectiveness of novel therapeutic interventions aimed at improving overall disease burden. However, further investigation is needed to fully understand primary craniofacial features in migraine, and how these might inform individualized treatment decisions.

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Population-based prevalence of cranial autonomic symptoms in migraine and proposed diagnostic appendix criteria

et al. 2022

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Background Migraine with cranial autonomic symptoms is well described in the literature, but its prevalence in previous studies varies enormously. A precise estimate of the prevalence in a population-based material is important because migraine with cranial autonomic symptoms might represent an endophenotype, in which genetic and pathophysiological features differ from those without cranial autonomic features. The aim of the present study, therefore, was to estimate the prevalence in a big population-based sample using both questionnaire-based diagnosis (N = 12,620) and interview-based diagnosis (N = 302). We validate questionnaire-based diagnosis of migraine with cranial autonomic symptoms and develop the first diagnostic criteria for future research of this possible endophenotype. Methods The Danish Blood Donor Study included 127,802 persons who all received a migraine diagnostic questionnaire. Participants who had answered the diagnostic questionnaire constituted the Danish Migraine Population Cohort (N = 62,677) of whom 12,620 had migraine. The diagnostic migraine questionnaire included questions about the following cranial autonomic symptoms: Facial/forehead sweating, lacrimation, ptosis, conjunctival injection, rhinorrhea, nasal congestion, and miosis. Validation was performed by a follow-up semi-structured, purpose-built interview of 302 participants with migraine, where detailed questions were asked to ascertain the validity of the symptoms. Results The questionnaire-based prevalences of one, respectively two cranial autonomic symptoms were 57% and 31%. The semi-structured interview-based prevalences of one, respectively two symptoms were 44% and 22%. The most common symptoms were facial/forehead sweating (39%) and lacrimation (24%). The specificity of the questionnaire was 80% and the sensitivity was 68%. Correlation analysis showed a weak correlation between symptoms ranging from 0.07 – 0.41, and no clear clustering of symptoms was detected. We suggest the first diagnostic appendix criteria for genetic and epidemiological studies and tighter criteria for clinical and pathophysiological studies. We encourage further studies of severity and consistency of symptoms. Conclusion Migraine with cranial autonomic symptoms is prevalent in the general population. Suggested diagnostic appendix criteria are important for future studies of this possible migraine endophenotype.

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Coexistence of Symptoms Associated with Trigeminal Pathways in Chronic and Episodic Migraine and the Effects on Quality of Life

Abstract: Abnormal sleep latency and concentration-related impairment in function were more frequent in patients with chronic migraine than those with the episodic form. Cranial autonomic symptoms, vertigo/dizziness, and cutaneous allodynia were significantly coexisting in migraine patients.

Cited by 8 publications

References 57 publications

Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

Subdiagnosis, but not presence of vestibular symptoms, predicts balance impairment in migraine patients – a cross sectional study

Craniofacial Autonomic Dysfunction in Migraine: Implications for Treatment and Prognosis

Population-based prevalence of cranial autonomic symptoms in migraine and proposed diagnostic appendix criteria

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