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Migraine Equivalent

Migraine Headache Equivalent


Presentation

  • We report a 14-year-old girl who presented with yearly attacks of bilateral internal ophthalmoplegia, nausea and headache, since the age of nine. The episodic isolated bilateral mydriasis in this child is believed to be a migraine equivalent.[ncbi.nlm.nih.gov]
  • Vestibular responses were normal in all except 2 cases which presented signs of central vestibular impairment at the level of the vestibulocerebellar pathways.[karger.com]
  • An aura presents as a progressive neurologic deficit or disturbance with subsequent complete recovery.[hmsphysiology.pbworks.com]
Asymptomatic
  • Abnormal delta activity seen during both episodes resolved at follow-up, when the patient asymptomatic.[ncbi.nlm.nih.gov]
Abdominal Pain
  • Although not common, the most prevalent migraine equivalent is “abdominal migraine”, which is characterized by recurrent episodes of vomiting and abdominal pain without headache.[headaches.org]
  • In addition, several children had a positive family history for migraine, headache was frequently associated with the crisis and other signs of a ‘periodic syndrome’ (motion sickness, cyclic vomiting, abdominal pain) were present, unrelated to vertiginous[karger.com]
  • Abdominal migraine: an under-diagnosed cause of recurrent abdominal pain in children. Headache. 2011 ;51: 707 – 712. Google Scholar Crossref Medline ISI 11. Mortimer, MJ, Kay, J, Jaron, A.[journals.sagepub.com]
Recurrent Abdominal Pain
  • Abdominal migraine: an under-diagnosed cause of recurrent abdominal pain in children. Headache. 2011 ;51: 707 – 712. Google Scholar Crossref Medline ISI 11. Mortimer, MJ, Kay, J, Jaron, A.[journals.sagepub.com]
  • abdominal pain; that is, abdominal migraine is only 1 type of recurrent abdominal pain, which has a strong relationship with migraine.[medlink.com]
  • Abu Arafeh I (1998) Long term follow up of children with recurrent abdominal pain: Definition of recurrent abdominal pain was not applied. BMJ 317: 682-683.[headache.imedpub.com]
  • pain [ 26 ], motion sickness [ 25 ], and anxiety [ 27 ].[thejournalofheadacheandpain.biomedcentral.com]
Episodic Vomiting
  • There may be a history in childhood of motion sickness or cyclic vomiting (episodic vomiting without other accompanying symptoms or signs).[dartmouth.edu]
Hypersalivation
  • The diagnosis of motion sickness was made in children experiencing discomfort when perceived motion disturbs the organs of balance; they could show nausea, vomiting, pallor, cold sweats, hypersalivation, hyperventilation and headaches [ 19 ].[thejournalofheadacheandpain.biomedcentral.com]
Torticollis
  • Coexisting more typical migraines were observed in from 10% (benign paroxysmal torticollis) to 70% (abdominal migraines/cyclical vomiting) of the cases.[scite.ai]
  • Fifteen had abdominal migraine, 12 benign paroxysmal vertigo, 5 confusional migraine, 3 aura without migraine, 2 paroxysmal torticollis, and 1 cyclic vomiting.[journals.sagepub.com]
  • BPV, like paroxysmal torticollis in infancy and the signs of the periodic syndrome, can be considered a migraine equivalent or a migraine precursor and could be due to the same vascular and/or biochemical mechanisms responsible for the migraine.[karger.com]
  • Rosman NP, Douglass LM, Sharif UM,Paolini J (2009) The neurology of benign paroxysmal torticollis of infancy. J child neurology24: 155-160 Drigo P, Carli G, Lavendra AM (2000) Benign paroxysmal torticollis of infancy. Brain Dev 22: 169-172.[headache.imedpub.com]
Musculoskeletal Pain
  • Egger HL, Costello EJ, Erkanli A, Angold A (1999) Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches. J Am Acad Child Adolesc Psychiatry 38(7):852–860 23.[thejournalofheadacheandpain.biomedcentral.com]
  • J Headache Pain 14(1):39 PubMed Central PubMed View Article Google Scholar Egger HL, Costello EJ, Erkanli A, Angold A (1999) Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches.[thejournalofheadacheandpain.springeropen.com]
Scotoma
  • The following observations were made regarding auras: The typical visual aura started with a flickering uncolored zig-zag line in the center of the visual field and gradually progressed toward the periphery of one hemifield, often leaving a scotoma.[hmsphysiology.pbworks.com]
  • The classic scintillating scotoma with fortification spectrum is suggestive of migraine. Residual visual field defects may indicate another underlying process, such as cerebrovascular disease or a vascular malformation.[aao.org]
  • In his first series, Fisher reported 120 patients with neurologic accompaniments of migraine classified according to the following symptoms: visual accompaniments (excluding patients who had only ordinary scintillating scotoma) (25); visual symptoms and[medlink.com]
  • […] typical migraines. [8] [9] Individuals who experience acephalgic migraines in childhood are highly likely to develop typical migraines as they grow older. [10] Among women, incidents of acephalgic migraine increase during perimenopause. [7] Scintillating scotoma[en.wikipedia.org]
  • The Varying Frequency of Migraines, and Health Risks I have had migraine equivalents (aura without headache) once or twice a year for the last 20 years: I get a scintillating scotoma that fades within half an hour.[consults.blogs.nytimes.com]
Scintillating Scotoma
  • The classic scintillating scotoma with fortification spectrum is suggestive of migraine. Residual visual field defects may indicate another underlying process, such as cerebrovascular disease or a vascular malformation.[aao.org]
  • In his first series, Fisher reported 120 patients with neurologic accompaniments of migraine classified according to the following symptoms: visual accompaniments (excluding patients who had only ordinary scintillating scotoma) (25); visual symptoms and[medlink.com]
  • scotoma is the most common symptom [11] which usually happens concurrently with Expanding Fortification Spectra. [12] Also frequently reported is monocular blindness. [13] Acephalgic migraines typically do not persist more than a few hours and may last[en.wikipedia.org]
  • The Varying Frequency of Migraines, and Health Risks I have had migraine equivalents (aura without headache) once or twice a year for the last 20 years: I get a scintillating scotoma that fades within half an hour.[consults.blogs.nytimes.com]
  • There are many other migraine equivalents [ 19, 20 ] (old terminology for episodic syndromes) described in the literature like hemianopia, scintillating scotomas, ophthalmoplegias, blurring of vision, amaurosis fugax, diplopia, oculosympathetic palsy,[headache.imedpub.com]
Psychiatric Symptoms
Withdrawn
  • The issue with Midrin being withdrawn from the market is a bit complicated. It stems from Midrin having been developed and first marketed prior to the current FDA drug approval process.[healthcentral.com]
Headache
  • Migrainous headache is determined by pathogenetic mechanisms that are also able to affect the peripheral and/or central vestibular system, so that vestibular symptoms may substitute and/or present with headache.[ncbi.nlm.nih.gov]
  • Headache followed the aura in 93 percent. Less commonly, headache and aura occurred simultaneously or aura followed the headache (4 and 3 percent, respectively).[hmsphysiology.pbworks.com]
  • […] they are equal to a migraine attack, just without the headaches.[migravent.com]
  • Headaches are the most common and most incapacitating symptom of the disorder, he said. Generally, migraine headaches can be treated by medication and by a restricted diet.[articles.baltimoresun.com]
Dizziness
  • Among the brain stem symptoms, vestibular manifestations are quite common and include nonspecific dizziness, disequilibrium, vertigo, and motion intolerance. Auditory symptoms are less common.[ncbi.nlm.nih.gov]
  • About 10 to 20 percent of those who suffer from migraine headaches also experience other symptoms, such as blurry vision, dizziness or numbness just before they get a headache, Bergey said.[articles.baltimoresun.com]
  • This edition includes a new chapter on the dizzy patient.[books.google.de]
  • Migraine headaches are one of the most common causes of dizziness. Dizziness in migraine may occur with the HA, prior to or after the HA or completely independent of the HA. It is common to have dizziness as the only symptom of a migraine HA.[earassociates.com]
  • Dizziness, drowsiness, or nausea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.[rxlist.com]
Stroke
  • Even if you think you are having a severe migraine equivalent attack involving stroke-like symptoms, you should have somebody contact emergency services.[migravent.com]
  • Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. ‎ 115 ページ - North American Symptomatic Carotid Endarterectomy Trial Collaborators; Beneficial Effect of Carotid Endarterectomy[books.google.com]
  • Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. ‎[books.google.de]
  • Stroke-like symptoms presenting for the first time require rapid stroke evaluation, preferably in the emergency department or stroke unit.[neurologyadvisor.com]
  • Needless to say, he was concerned that he was having a stroke. How common are these symptoms, and is there a connection between migraine and stroke? Can a migraine cause a stroke? Shari, Kiel, Wis.[consults.blogs.nytimes.com]
Vertigo
  • Based on such considerations, we proposed a classification of vertigo and other vestibular disorders related to migraine, and believe that a particular variant of migraine-related vertigo should be introduced, namely "epigone migraine vertigo" (EMV):[ncbi.nlm.nih.gov]
  • Fifteen had abdominal migraine, 12 benign paroxysmal vertigo, 5 confusional migraine, 3 aura without migraine, 2 paroxysmal torticollis, and 1 cyclic vomiting.[journals.sagepub.com]
  • These are episodic symptoms such as vertigo, tingling, weakness, visual changes or aura, slurred speech or even confusion that are often not accompanied by headache but are nonetheless due to the physiologic changes that are occurring in migraine, typically[sharecare.com]
  • The following distribution among migraine equivalents was observed: benign paroxysmal torticollis 11 (10.2% of patients with migraine equivalents), benign paroxysmal vertigo 41 (38%), abdominal migraine/cyclical vomiting 20 (18.5%), acephalgic migraine[scite.ai]
Sinus Headache
  • Some symptoms are the same , but sinus headaches don’t keep coming back. Robert G.[migraineagain.com]
  • Sufferers notice increased medication use with a decreased results. back to top Sinus Headache True sinus headache will show up on an x-ray and the sufferer will experience a yellow-green discharge from their nasal area.[headache-help.org]
  • How can I tell if I have a migraine or a sinus headache? Many people confuse a sinus headache with a migraine because pain and pressure in the sinuses, nasal congestion, and watery eyes often occur with migraine.[womenshealth.gov]
  • “They’re told they have migraines or they’re told they have sinus headaches or some other thing.” Mike Scott, 42, thought for years that he was suffering from sinus headaches.[theatlantic.com]
  • Some days patients may mistake the pain for a “tension-headache” or “sinus headache” if the pain is less severe.[americanmigrainefoundation.org]

Workup

  • The chapters present detailed, methodical guidelines f or the workup of the patient with chronic pelvic pain and for the diag nosis and treatment of the many disorders that cause pelvic discomfort.[books.google.com]
  • “The first one may prompt a workup, while subsequent ones do not.” Stroke evaluation in these cases includes neuroimaging using noncontrast computed tomography in the emergency department.[neurologyadvisor.com]
  • Gastroenterologic evaluation and workup typically yield unremarkable results. [48] Abdominal migraine symptoms are usually relieved with sleep. Antiemetics may help in aborting an acute attack.[emedicine.medscape.com]
  • These patient’s often undergo extensive abdominal and intestinal workups for infection or other intrinsic diseases of the bowel which are negative.[entad.org]

Treatment

  • Beware, however, that tension headaches, as opposed to migraines, are not necessarily neurological in origin, and cannot merit this treatment.[donpilzer.com]
  • The chapters present detailed, methodical guidelines f or the workup of the patient with chronic pelvic pain and for the diag nosis and treatment of the many disorders that cause pelvic discomfort.[books.google.com]
  • Prophylactic treatment was introduced in 23 patients; 4 lost follow-up and 19 had significant improvement. We conclude that the correct diagnosis of migraine equivalents enables an effective treatment with an excellent outcome. 1. Barlow, CF.[journals.sagepub.com]
  • These symptoms can sometimes be mistaken for stress or anxiety, when they really indicate a need for migraine treatment.[migravent.com]
  • After that period, we suggested that they use prophylactic treatment with flunarizine (5 mg per day) and/or acetylsalicylic acid (100 mg per day), or propranolol (40 mg twice a day).[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis Responsive prevention and treatment of migraine is incredibly important.[ninds.nih.gov]
  • First, genetics undoubtedly plays a very prominent role in determining the frequency, severity and long-term prognosis of migraine for an individual sufferer.[consults.blogs.nytimes.com]
  • Dignan F, Abu Arafeh, Russel G (2001) The prognosis of childhood abdominal migraine. Arch Dis Child 84: 415-418. Mcgrath PJ, Goodman JT, Firestone P (1983) Recurrent abdominal pain: a psychogenic disorder. Arch Dis Child 58: 888-890.[headache.imedpub.com]
  • What is the prognosis for a person with migraines? Is there a cure? Most people who have migraines find that their headaches may be controlled with the preventive medications and lifestyle changes.[medicinenet.com]

Etiology

  • Abstract: Migraine equivalents of infancy, childhood, and adolescence are recognized periodic, paroxysmal syndromes without associated headache that are thought to be migrainous in etiology. Five such equivalents are presently recognized.[scite.ai]
  • These recognized migraine equivalents of infancy, childhood, and adolescence are recognized periodic paroxysmal syndromes without associated headache that are thought to be migrainous in etiology.[medlink.com]
  • This strongly suggests dopaminergic hypersensitivity as a possible etiology of migraine.[ahcmedia.com]
  • Guidetti V, Galli F (2002) Psychiatric comorbidity in chronic daily headache: pathophysiology, etiology, and diagnosis. Curr Pain Headache Rep 6(6):492–497 24.[thejournalofheadacheandpain.biomedcentral.com]
  • J Am Acad Child Adolesc Psychiatry 38(7):852–860 PubMed View Article Google Scholar Guidetti V, Galli F (2002) Psychiatric comorbidity in chronic daily headache: pathophysiology, etiology, and diagnosis.[thejournalofheadacheandpain.springeropen.com]

Epidemiology

  • Clinical epidemiology of childhood abdominal migraine in an urban general practice. Dev Med Child Neurol. 1993 ;35: 243 – 248. Google Scholar Crossref Medline ISI 12. Symon, DN, Russell, G.[journals.sagepub.com]
  • Medication-overuse headache: epidemiology, diagnosis and treatment. Ther Adv Drug Saf. 2014;5(2):87-99. [ PubMed ] 28. Leniger T, Pageler L, Stude P, Diener H, Limmroth V.[aliem.com]
  • Migraine: epidemiology, impact, and risk factors for progression. Headache. 2005 Apr. 45 Suppl 1:S3-S13. [Medline]. [Guideline] Headache Classification Subcommittee of the International Headache Society.[emedicine.medscape.com]
  • Epidemiology and economic impact of migraine. Curr Med Res Opin. 2001;17(suppl 1):s4-s12. 3. Minen MT, Tanev K, Friedman BW. Evaluation and treatment of migraine in the emergency department: a review. Headache. 2014;54(7):1131-1145. 4. Goldberg LD.[uspharmacist.com]
Sex distribution
Age distribution

Pathophysiology

  • Migraine: pathophysiology, pharmacology, treatment and future trends. Curr Vasc Pharmacol. 2003;1(1):71-84. 9. Reddy DS. The pathophysiological and pharmacological basis of current drug treatment of migraine headache.[uspharmacist.com]
  • Treatment There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks.[ninds.nih.gov]
  • After the ongoing evidence on the multifaceted pathophysiology of CSX, it became even more clear that there is a need for a pragmatic approach to education and training of medical practitioners in the management of patients, especially in refractory patients[onlinejacc.org]
  • Guidetti V, Galli F (2002) Psychiatric comorbidity in chronic daily headache: pathophysiology, etiology, and diagnosis. Curr Pain Headache Rep 6(6):492–497 24.[thejournalofheadacheandpain.biomedcentral.com]
  • Functional neuroimaging: enhanced understanding of migraine pathophysiology. Neurology. 2000. 55(9 Suppl 2):S36-45. [Medline]. Goadsby PJ. Migraine pathophysiology. Headache. 2005 Apr. 45 Suppl 1:S14-24. [Medline]. Lagman-Bartolome AM, Lay C.[emedicine.medscape.com]

Prevention

  • Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. ‎ 115 ページ - North American Symptomatic Carotid Endarterectomy Trial Collaborators; Beneficial Effect of Carotid Endarterectomy[books.google.com]
  • Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. ‎[books.google.de]
  • Prognosis Responsive prevention and treatment of migraine is incredibly important.[ninds.nih.gov]
  • Preventive (prophylactic) medications are taken on a regular basis to prevent headaches before they start and may lower the frequency and severity of migraines, or prevent them all together.[migrelief.com]
  • Antidepressants, anti-seizure drugs and antihistamines have also been used to prevent migraines. A doctor can help you choose the best medicinal route if you need preventive medication.[livestrong.com]

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