Episodic Migraine With and Without Aura: Key Differences and Implications for Pathophysiology, Management, and Assessing Risks

Vgontzas, Angeliki; Burch, Rebecca

doi:10.1007/s11916-018-0735-z

Cited by 51 publications

(40 citation statements)

References 69 publications

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“…The International Classification of Headache Disorders (ICHD) has classified migraine into two types: with and without aura [9]. Based on the classification of ICHD-3, an aura must present with at least three of the following six symptoms: spreading gradually for more than 5 min, two or more symptoms occurring in succession, each individual aura symptom lasts 5-60 min, at least one aura symptom is unilateral, at least one aura symptom is positive, and the aura is accompanied or followed within 60 min by headache [9,10]. An aura is known as a warning sign prior to migraine for some patients.…”

Section: Introductionmentioning

confidence: 99%

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Increased Risk of Migraine in Patients with Temporomandibular Disorder: A Longitudinal Follow-Up Study Using a National Health Screening Cohort

et al. 2020

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Background: The aim of this study was to investigate the association between temporomandibular disorder (TMD) and migraine through a longitudinal follow-up study using population data from a national health screening cohort. Methods: This cohort study used data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015. Of the 514,866 participants, 3884 TMD patients were matched at a 1:4 ratio with 15,536 control participants. Crude models and models adjusted for obesity, smoking, alcohol consumption, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, and Charlson Comorbidity Index (CCI) scores were calculated. Chi-squared test, Kaplan–Meier analysis, and two-tailed log-rank test were used for statistical analysis. Stratified Cox proportional hazard models were used to assess hazard ratios (HR) and 95% confidence intervals (CIs) for migraine in both control groups. Results: The adjusted HR for migraine was 2.10 (95% CI: 1.81–2.44) in the TMD group compared to the control group, which was consistent in subgroup analyses according to age, sex, and Kaplan–Meier analysis. Conclusions: This study demonstrated that TMD patients have a higher risk of migraine. These results suggest that dentists can decrease the risk of migraine in TMD patients by managing TMD properly.

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Section: Introductionmentioning

confidence: 99%

“…A migraine without aura is the most common type of migraine, comprising approximately 75% of all migraines [9]. This type of migraine develops without aura, but it can present with various symptoms at its initial stages.…”

Section: Introductionmentioning

confidence: 99%

Increased Risk of Migraine in Patients with Temporomandibular Disorder: A Longitudinal Follow-Up Study Using a National Health Screening Cohort

et al. 2020

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“…No sub-group distinction between migraine with and without aura was made. Although both migraine types are usually treated similarly, it has been suggested that response to treatment may be different for migraine sub-types due their distinct pathophysiology [19]. Stricter inclusion criteria that will ensure homogeneity will thus benefit future studies to determine if sub-analysis of pure migraineurs with and without aura will have an effect.…”

Section: Discussionmentioning

confidence: 99%

Memantine for prophylaxis of episodic migraine: a systematic review and meta-analysis

Mondia¹,

Espiritu²,

Bolaños³

et al. 2020

Preprint

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Background Migraine is a common debilitating primary headache. Memantine is a non-competitive N-methyl D-aspartate (NMDA) antagonist that lowers neuronal excitability that could prevent migraine attacks.Objectives This study aimed to determine the efficacy and safety of memantine in patients experiencing episodic migraine attacks using a systematic review and meta-analysis.Methods We searched CENTRAL, MEDLINE, Scopus, Cochrane, LILACS, ClinicalTrials.gov, HERDIN and Google Scholar for relevant studies. Prespecified screening and eligibility criteria for inclusion were applied. Included studies underwent methodological quality assessment. Study design, patient characteristics, interventions given, and relevant outcomes were extracted and synthesized.Results This review included five relevant articles – 2 randomized controlled trials (RCT) and 3 observational studies (1 retrospective case-series, 2 prospective non-randomized open-label single arm trials). There were 109 patients included in the RCTs and 197 patients reported in the observational studies. Pooled data from the 2 RCTs showed that Memantine at 10mg/day decreased the monthly migraine days at 12 weeks compared to placebo with a mean difference of -1.58 [95% confidence interval (CI) -1.84, -1.32]. Observational studies also showed a decrease in migraine days per month with Memantine (5-20mg/day) after 12 weeks [95% CI]: -9.1 [-11, -7.23], -7.2 [-8.85, -5.55], and -4.9 [-6.29, -3.51]. There were no statistically significant adverse drug events (ADE) noted in patients treated with Memantine compared to placebo.Conclusion Memantine may be effective and well-tolerated as prophylaxis for episodic migraine.

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“…Medications used for migraine prophylaxis aim to reduce the frequency and severity of migraines by suppressing the susceptibility of neurons to CSD. 56 There are multiple options including antidepressants (amitriptyline), anticonvulsants (topiramate and sodium divalproex/valproate), and antihypertensive medications (propranolol and candesartan). In clinical practice, the choice of these preventative medications is often determined by potential side effects, interactions, or comorbidities.…”

Section: Preventative Treatmentmentioning

confidence: 99%

Migraine Aura: Pathophysiology, Mimics, and Treatment Options

et al. 2019

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Recent insights into the clinical presentation and pathophysiology of migraine aura have paved the way for new treatments for this common but frequently debilitating condition. Marked efflux of cellular potassium and glutamate contributes to the cortical spreading depression that forms the electrophysiological basis of migraine aura phenomena. Secondary vascular perturbations also contribute to the various symptoms of a migraine attack. Calcitonin gene-related peptide (CGRP) plays a key role in many of these steps, and a growing class of CGRP-antagonists have emerged as a novel, efficacious preventative therapy. It is still not fully understood why a preponderance of migraine aura symptoms is visual, and this issue is an active area of research. In addition, the pathophysiological changes responsible for visual snow syndrome are under investigation. Before diagnosing a patient with migraine aura, it is important to consider the differential diagnosis of transient visual phenomena, with attention to clinical features that may suggest conditions such as retinal disorders, transient ischemic attack, or occipital epilepsy.

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Episodic Migraine With and Without Aura: Key Differences and Implications for Pathophysiology, Management, and Assessing Risks

Cited by 51 publications

References 69 publications

Increased Risk of Migraine in Patients with Temporomandibular Disorder: A Longitudinal Follow-Up Study Using a National Health Screening Cohort

Increased Risk of Migraine in Patients with Temporomandibular Disorder: A Longitudinal Follow-Up Study Using a National Health Screening Cohort

Memantine for prophylaxis of episodic migraine: a systematic review and meta-analysis

Migraine Aura: Pathophysiology, Mimics, and Treatment Options

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