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]
Headache was present in 40% of cases in this series. In both of Fisher's studies, many patients had headache; thus, all were not totally acephalgic (only aura). [medlink.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]
Entire Body System
- Pain
Prevalence of pain combinations and overall pain: a study of headache, stomach pain and back pain among school-children. [pedneur.com]
pain society in the United States. [books.google.com]
Posted at 21:11h in Headache Fact Sheets This term applies to migraine that exhibits itself in a form other than head pain. [headaches.org]
- Inflammation
Together they cause inflammation within the brain. Over time, repeated inflammation causes damage and changes to the neural circuitry. [migrainedisorders.org]
An increase of serotonin can reduce inflammation and constrict blood vessels, helping alleviate migraines. [healthline.com]
Inflammation Inflammation in the subarachnoid space, whether caused by infection, hemorrhage, or chemical irritation, results in headache. Some inflammation may be intrinsic to the blood vessel walls. [dartmouth.edu]
Ginger also has a long history of use as a natural treatment for pain and inflammation. Some clinical studies have supported this use with positive results in people with arthritis, chronic low back pain, painful menstruation, and muscle pain. [doctormurray.com]
- Swelling
Although the details of this interaction are not yet known, it is understood that the chemicals that are released from nerve ending cause both blood vessels to swell, contract and become leaky and the immune system to become active. [migrainedisorders.org]
However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. [rxlist.com]
Migraine pain is thought to be caused by contraction followed by dilation of blood vessels in the brain and thought that swelling activates pain in the nervous system. [migrainerelief.co]
- Limb Pain
Other clinical entities, such as motion sickness and limb pain have been associated with migraine. [pedneur.com]
Ital J Neurol Sci 18(5):283–288 PubMed View Article Google Scholar Abu-Arafeh I, Russell G (1996) Recurrent limb pain in schoolchildren. [thejournalofheadacheandpain.springeropen.com]
Ital J Neurol Sci 18(5):283–288 Article CAS PubMed Google Scholar Abu-Arafeh I, Russell G (1996) Recurrent limb pain in schoolchildren. [thejournalofheadacheandpain.biomedcentral.com]
Gastrointestinal
- Nausea
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]
There can be side effects of nausea, dizziness and muscle cramps, however. Anti-nausea Drugs Migraine headaches are often accompanied by nausea, so medications have been developed to be used with migraine drugs. [livestrong.com]
Treating nausea and preventing vomiting If you have nausea without vomiting, your doctor may suggest medication to ease nausea called anti-nausea or antiemetic drugs. In this case, the antiemetic can help prevent vomiting and improve the nausea. [healthline.com]
At this stage there are less women suffering from migraine, but those who are may experience them more frequently, though accompanying symptoms such as nausea and photophobia are usually less pronounced. [headacheaustralia.org.au]
Instead, migraine equivalent symptoms include strong stomach cramps, nausea, vomiting, fatigue and excessive yawning. These symptoms can sometimes be mistaken for stress or anxiety, when they really indicate a need for migraine treatment. [migravent.com]
- Vomiting
The brain wave changes counter the hypothesis that vomiting in these patients is psychosomatic, and support the interpretation of cyclic vomiting as a migraine equivalent. [ncbi.nlm.nih.gov]
Efficacy of flunarizine in the prophylaxis of cyclical vomiting syndrome and abdominal migraine. Eur J Paediatr Neurol. 2005; 9: 23-26 Giffin N.J. Benton S. Goadsby P.J. [pedneur.com]
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]
- Abdominal Pain
[…] migraine, migraine with abdominal pain, and recurrent abdominal pain of childhood. [medlink.com]
Abdominal migraine Out of 98 children with Abdominal migraine, 69 had central or peri umbilical pain, 29 with generalized pain. [headache.imedpub.com]
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]
- Diarrhea
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Tell your doctor if any of these symptoms are severe or do not go away: flushing tingling feeling feeling warm or cold drowsiness tiredness weakness dizziness upset stomach diarrhea nausea muscle cramps Some side effects can be serious. [medlineplus.gov]
Sensitivity to light, noise and odors Nausea and vomiting, stomach upset, abdominal pain Loss of appetite Feeling very warm (sweating) or cold (chills) Pale color (pallor) Feeling tired Dizziness Blurred vision Tender scalp Diarrhea (rare) Fever (rare [my.clevelandclinic.org]
Aura symptoms may include: blurry vision light sensitivity vision loss seeing zigzags or squiggly lines numbness tingling weakness confusion difficulty speaking dizziness diarrhea vomiting abdominal pain Silent migraines occur when you have aura symptoms [healthline.com]
- Recurrent Abdominal Pain
[…] migraine, migraine with abdominal pain, and recurrent abdominal pain of childhood. [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]
Abdominal migraine: an under-diagnosed cause of recurrent abdominal pain in children. Headache. 2011; 51: 707-712 Symon D.N. Is cyclical vomiting an abdominal form of migraine in children?. Dig Dis Sci. 1999; 44: 23S-25S Arruda M.A. Guidetti V. [pedneur.com]
Abdominal migraine: evidence for existence and treatment options. Paediatr Drugs. 2002 ;4: 1. Google Scholar | Crossref | Medline 10. Carson, L, Lewis, D, Tsou, M. Abdominal migraine: an under-diagnosed cause of recurrent abdominal pain in children. [journals.sagepub.com]
Ital J Neurol Sci 18(5):283–288 PubMed View Article Google Scholar Abu-Arafeh I, Russell G (1996) Recurrent limb pain in schoolchildren. [thejournalofheadacheandpain.springeropen.com]
Ears
- Benign Paroxysmal Positional Vertigo
They include abdominal migraine, cyclical vomiting, benign paroxysmal vertigo, and benign paroxysmal torticollis. Other clinical entities, such as motion sickness and limb pain have been associated with migraine. [pedneur.com]
Migraine related ear symptoms may vary from patient to patient and may take the form of episodic vertigo, benign paroxysmal positional vertigo(BPPV), recurrent benign positional vertigo, Menieres disease, ear pain, aural pressure, tinnitus, fluctuating [entad.org]
Musculoskeletal
- 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]
Benign paroxysmal torticollis of infancy: four new cases and linkage to CACNA1A mutation. Dev Med Child Neurol. 2002; 44: 490-493 Cuenca-León E. Corominas R. Fernàndez-Castillo N. et al. [pedneur.com]
Eyes
- 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]
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]
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]
Face, Head & Neck
- Facial Pain
Jay CRC Press, ١٩/٠٤/٢٠١٦ - 336 من الصفحات 0 مراجعات As headache and facial pain are two of the most common medical complaints, it is essential that clinicians are well equipped to handle these issues. [books.google.com]
“It’s variable from person to person, but I can say the vast majority of people we see at the San Francisco Headache Clinic are very active, working and enjoying life,” says Goldstein who recently was named president of the Headache and Facial Pain Section [mercurynews.com]
B. chest pain. C. visual changes. D. intense headache pain. E. Both A and B are correct. 77. Cluster headaches are characterized by: A. unilateral, excruciating facial pain often lasting for days. B. lacrimation. C. ipsilateral nasal congestion. D. [ahcmedia.com]
Headache Classification Committee of the International Headache Society (1988) Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 8: 1–96. View Article Google Scholar 32. [journals.plos.org]
Neurologic
- 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]
Primary headaches: a convergence hypothesis. Headache. 2002; 42: 204-216 Silberstein S.D. Twenty questions about headaches in children and adolescents. Headache. 1990; 30: 716-724 Valeriani M. Galli F. Tarantino S. et al. [pedneur.com]
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]
Posted at 21:11h in Headache Fact Sheets This term applies to migraine that exhibits itself in a form other than head pain. [headaches.org]
- Dizziness
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]
Among the brain stem symptoms, vestibular manifestations are quite common and include nonspecific dizziness, disequilibrium, vertigo, and motion intolerance. Auditory symptoms are less common. [pubmed.ncbi.nlm.nih.gov]
Dizziness, drowsiness, or nausea may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly. [rxlist.com]
Some include: dimenhydrinate (Gravol) metoclopramide (Reglan) prochlorperazine (Compazine) promethazine (Phenergan) trimethobenzamide (Tigan) These drugs may make you drowsy, less alert, or dizzy, and have other possible side effects. [healthline.com]
- Stroke
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]
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]
Ruling out stroke and other more serious disorders is crucial since the typical migraine head pain is not present. [migraine.com]
Twenty-seven percent of all strokes suffered by persons under the age of 45 are caused by Migraine. Stroke is the third leading cause of death in this country. [migrelief.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]
Five patients with migraine equivalent symptoms that include vertigo are presented. The vertigo was the dominant symptom in some cases and was accompanied by nausea and vomiting. [pubmed.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]
Benign Paroxysmal Vertigo is considered as an early manifestation of migraine related vertigo. [headache.imedpub.com]
- Seizure
Our firm recently successfully argued that a claimant with migraine headaches was the medical equivalent of meeting the listing for seizure disorders. [donpilzer.com]
During an attack he became irritated, agitated and amnesic, but did not have headaches or seizures. Associated findings were transient elevation of serum creatine kinase (CK) (331-3381 IU/l), and of plasma ACTH and cortisol. [ncbi.nlm.nih.gov]
Migraines with aura rarely may be complicated by a seizure. According to the International Headache Society, for a diagnosis of migraine seizure, the seizure must occur within one hour of the onset of the aura. [icd10monitor.com]
Medicines used to prevent migraines include the anti-seizure medicine topiramate and a medicine called propranolol that's usually used to treat high blood pressure. It may take several weeks before your migraine symptoms begin to improve. [nhs.uk]
Acephalalgic migraine should be differentiated from transient ischemic attacks, occipital lobe seizures, and temporal lobe seizures. [emedicine.medscape.com]
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]
The sooner these treatments are administered, the more effective they are. × Treatment There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. [ninds.nih.gov]
Sumatriptan-naproxen for acute treatment of migraine: a randomized trial. JAMA. April 4, 2007;297(13):1443-1454. 8. Cady R, Elkind A, Goldstein J, Keywood C. [consumerreports.org]
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]
The prognosis of childhood abdominal migraine. Arch Dis Child. 2001; 84: 415-418 Lanzi G. Balottin U. Fazzi E. Rosano F.B. The periodic syndrome in pediatric migraine sufferers. Cephalalgia. 1983; 3: 91-93 Lanzi G. Zambrino C.A. Balottin U. [pedneur.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]
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]
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]
Medscape: "Migraine Headache," "Migraine in Children," "What is the vascular theory of migraine etiology?" "Understanding migraine." National Headache Foundation: "Low Tyramine Diet for Migraine." NIH: "Migraine information page." [onhealth.com]
Despite such progress, in view of the complexity of the etiology of migraine, it still remains undiagnosed and available therapies are underused. [raysahelian.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]
Epidemiology of vertigo, migraine and vestibular migraine. Lempert T, Neuhauser H. Lempert T, et al. J Neurol. 2009 Mar;256(3):333-8. doi: 10.1007/s00415-009-0149-2. Epub 2009 Feb 17. J Neurol. 2009. PMID: 19225823 Review. [pubmed.ncbi.nlm.nih.gov]
Epidemiology of migraine and tension type headache. Current Opinion in Neurology 1994; 7: 264-271. More than two-thirds of medication overuse headache occurs in people with migraine as the primary headache. [migraine.ie]
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]
The epidemiology, burden, and comorbidities of migraine. Bigal ME, Lipton RB. Neurol Clin. 2009 May;27(2):321-34. Review. 40. Neurologie, editions Masson, 2008, J. Cambier, H. Dehen, M. Masson. 41. [passeportsante.net]
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]
The sooner these treatments are administered, the more effective they are. × Treatment There is no absolute cure for migraine since its pathophysiology has yet to be fully understood. [ninds.nih.gov]
Primary headache pathophysiology in children: the contribution of clinical neurophysiology. Clin Neurophysiol. 2014; 125: 6-12 Hashkes P.J. Gorenberg M. Oren V. Friedland O. Uziel Y. [pedneur.com]
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]
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
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]
If your migraines are severe or you have tried avoiding possible triggers and are still experiencing symptoms, a GP may prescribe medicines to help prevent further attacks. [nhs.uk]
Effect of Fremanezumab compared with placebo for prevention of episodic migraine a randomized clinical trial. JAMA. 2018 May 15;319(19):1999-2008. [revistafarmaciahospitalaria.sefh.es]