The role of migraine-associated symptoms in the clinical picture of migraine pain.
DOI:
https://doi.org/10.52692/1857-0011.2022.3-74.41Keywords:
migraine, associated symptoms, migraine attack intensity, migraine attack durationAbstract
Migraine is a disorder of multisensory integration of somatosensory, visual, auditory, olfactory stimuli, which subsequently can lead to various combinations of symptoms: headache, photophobia, phonophobia, nausea/vomiting, osmophobia.The purpose of the study: To isolate the characteristics of pain phenomenon (frequency, duration, and severity of migraine symptoms) in relation to associated symptoms in migraine patients. Materials and Methods: 94 patients with frequent episodic and chronic migraine were included in a cross-sectional study. Research methods used: clinical, descriptive, statistical. Migraine patient questionnaires were used as a research instrument. Primary data were entered into Excel programs and processed in MedCalc. Results and discussion: A statistically significant positive correlation between phonophobia and throbbing headache was observed in the conducted study. Statistically significant positive correlations were found between the duration of a migraine attack (in hours) and some migraine-related symptoms, such as: anxiety, shortness of breath. Conclusions: Thus, intensity rather than duration of headache may be the trigger for most, but not all, of the associated symptoms. This study demonstrated the clinical significance of the pain phenomenon and symptoms associated with migraine. In order to isolate the specificity of migraine attacks and elucidate their features, the study of autonomic symptoms accompanying the pain phenomenon is a particularly important part of establishing a correct diagnosis.
References
Bigal ME, Ashina S, Burstein R, et al. Prevalence and characteristics of allodynia in headache sufferers: a population study. In: Neurology. 2008; nr. 70, pp.: 1525–33.
Burstein R, Collins B, Jakubowski M. Defeating migraine pain with triptans: a race against
Calhoun AH, Ford S, Millen C, Finkel AG, Truong Y, Nie Y. The prevalence of neck pain in migraine. In: Headache. 2010 Sep; nr. 50, pp. : 1273-1277.
Choi J.Y. et al. Usefulness of a photophobia questionnaire in patients with migraine. In: Cephalalgia. 2009, vol. 29, p. 953-959.
De Queiroz LP, Rapoport AM, Sheftell FD. Clinical characteristics of migraine without aura. In: Arq Neuropsiquiatr, 1988, nr. 56 (1), pp.: 78–82.
Dolgonos S, Ayyala H, Evinger C. Light-induced trigeminal sensitization without central visual pathways: another mechanism for photophobia. In: Invest Ophthalmol Vis Sci. 2011; nr. 52, pp.: 7852–7858.
Drummond PD, Woodhouse A. Painful stimulation of the forehead increases photophobia in migraine sufferers. In. Cephalalgia. 1993; nr.13, pp.: 321–324.
Eckardt LB, McLean JM, Goodell H. Experimental studies on headache: the genesis of pain from the eye. In: Res Publ-Assoc Res Nerv Ment Dis. 1943; nr. 23, pp.: 209–227.
Fernandez-de-Las-Penas C, Cuadrado ML, ArendtNielsen L, Pareja JA. Side-to-side differences in pressure pain thresholds and pericranial muscle tenderness in strictly unilateral migraine. In: Eur J Neurol. 2008; nr. 15, pp.: 162-168.
Goadsby, P. J., Holland, P. R., Martins-Oliveira, M., Hoffmann, J., Schankin, C., &Akerman, S. Pathophysiology of Migraine: A Disorder of Sensory Processing. In: Physiological Reviews. 2017, nr. 97(2), pp.: 553– 622. doi:10.1152/physrev.00034.2015.
Hood JD, Kayan A. Neuro-otology and migraine. In: Blau JN, editor. Migraine. London: Chapman and Hall, 1987, pp.: 597-611.
Horiuchi J., McDowall L.M., Dampney R.A. Vasomotor and respiratory responses evoked from the dorsolateral periaqueductal grey are mediated by the dorsomedial hypothalamus. In: J. Physiol Lond. 2009; nr. 587: pp.: 5149–5162. doi: 10.1113/jphysiol.
Hyland N.P., Abrahams T.P., Fuchs K., Burmeister M.A., Hornby P.J. Organization and neurochemistry of vagal preganglionic neurons innervating the lower esophageal sphincter in ferrets. In: Comp Neurol. 2001; nr.430, pp.:222–234. doi: 10.1002/1096-9861(20010205).
Kannan H., Yamashita H. Connections of neurons in the region of the nucleus tractus solitarius with the hypothalamic paraventricular nucleus: their possible involvement in neural control of the cardiovascular system in rats. In: Brain Res. 1985; nr. 329, pp.: 205–212. doi: 10.1016/0006-8993(85)90526-8.
Kaube H, Keay KA, Hoskin KL, Bandler R, Goadsby PJ. Expression of c-Fos-like immunoreactivity in the caudal medulla and upper cervical cord following stimulation of the superior sagittal sinus in the cat. In: Brain Res. 1993; nr. 629, pp.: 95–102. doi: 10.1016/00
Kelman L, Tanis D. The relationship between migraine pain and other associated symptoms. In: Cephalalgia. 2006; nr. 26, pp.: 548–553.
Kelman L. Migraine pain location: a tertiary care study of 1283 migraineurs. In: Headache. 2005, nr. 45, pp.: 1038–1047.
Kelman L. The place of osmophobia and taste abnormalities in migraine classification: a tertiary care study of 1237 patients. In: Cephalalgia. 2004 ; nr. 24, p.940.
Lance JW, Lambert GA, Goadsby PJ, Duckworth JW. Brain-stem influences on the cephalic circulation: experimental data from cat and monkey of relevance to the mechanism of migraine. In: Headache. 1983; nr. 23, p.258.
Lebensohn JE. The nature of photophobia. In: Arch Ophthalmol. 2017, nr.12, pp.: 380–383. doi: 10.1001/archopht.1934.00830160084010.
Lipton R.B., Bigal ME, Ashina S., Burstein R., Silberstein S., Reed M.L. Cutaneous allodynia in the migraine population. In: Ann Neurol. 2008; nr. 63, pp.: 148–158.
MODOVANU, Ion, ODOBESCU, Stela, CONCESCU, Diana. Alodinia cefalică şi extracefalică la pacienţii cu migrenă cronică: studiu multimodal al sensibilităţii. In: Anale Științifice ale USMF “Nicolae Testemiţanu”. Ed. a 10-a. Chișinău: CEP Medicina, 2009, vol. 3: Probleme actuale în medicina internă, pp. 312-318.
Nakazawa K., Umezaki T., Zheng Y, Miller A.D. Behaviors of bulbar respiratory interneurons during fictive swallowing and vomiting. In: Otolaryngol Head Neck Surg. 1999; nr. 120: pp.: 412–418. doi: 10.1016/S01945998(99)70285-8.
Noseda R, Constandil L, Bourgeais L, et al. Changes of meningeal excitability mediated by corticotrigeminal networks: a link for the endogenous modulation of migraine pain. In: J Neurosci. 2010; nr. 30(43), pp.: 14420–14429.
Noseda R, Jakubowski M, Kainz V, Borsook D, Burstein R. Cortical projections of functionally identified thalamic trigeminovascular neurons: implications for migraine headache and its associated symptoms. In: J Neurosci. 2011; nr. 31(40), pp.: 14204–14217.
Noseda R., Burstein R. Advances in understanding the mechanisms of migraine-type photophobia. In: Curr. Opin. Neurol. 2011, vol. 4, p. 197-202.
Okamoto K, Tashiro A, Chang Z, Bereiter DA. Bright light activates a trigeminal nociceptive pathway. In: Pain. 2010; nr. 149, pp.: 235–242.
Olsson JE. Neurotologic findings in basilar migraine.In: Laryngoscope 1991; nr. 101, pp.: 1-41.
Rojahn J, Gerhards F. Subjective stress sensitivity and psychological responses to an aversive auditory stimulus in migraine and control subjects. In: J Behav Med. 1986; nr. 9, pp.: 203-12.
Schmidt T.M., Chen S.K., Hattar S. Intrinsically photosensitive retinal ganglion cells: many subtypes, diverse functions. In: Trends Neurosciens, 2011, vol. 34, p. 572-580.
Schwedt, T. J. (2013). Multisensory integration in migraine. Current Opinion. In: Neurology, nr. 26(3), pp.: 248–253. doi:10.1097/wco.0b013e328360ed
Stewart, W. F., Linet, M. S., & Celentano, D. D. Migraine headaches and panic attacks. In: Psychosomatic Medicine, 1989, nr. 51(5), pp.: 559– 569. doi:10.1097/00006842-198909000-00007.
Trobe J.D. Photophobia in anterior visual pathway disease. In: J. Neuroophthalmol. 2002, vol. 22, p. 1-2.
Tschiassny K. Stapedioparalytic phonophobia („hyperacusis”) in a deaf ear. Laryngoscope (St Louis) 1949, nr. 59, pp.: 886-903.
Vanagaite Vingen J, Pareja JA, Wren. Oslo. ISSN 0333-1024. 0, white LR, stovner LJ. Phonophobia in migraine. 1998; nr. 18, p. 243.
Vingen J.V., Pareja J.A., Storen O., White L.R,. Stovner L.J. Phonophobia in migraine. In: Cephalalgia. 1998; nr. 18, pp.: 243–249.
VonKorff MR, Eaton WW, Keyl PM: The epidemiology of panic attacks and panic disorders. In: Am J Epidemiol.1985, nr. 122(6), pp.: 970-981.
Wober-Bingol C, Wober C, Karwautz A, Auterith A, Srim M, Zebenholzer K, Aydinkoc K, Kienbacher C, Wanner C, Wessely P. Clinical features of migraine: a cross-sectional study in patients aged three to sixty-nine. In: Cephalalgia. 2004; nr. 24, pp.: 12–17.
Woodhouse, A., & Drummond, P. D. Mechanisms of Increased Sensitivity to Noise and Light in Migraine Headache. In: Cephalalgia, 1993, nr. 13(6), pp.: 417–421. doi:10.1046/j.1468-2982.1993.1306417.x.
Wu, Y., & Hallett, M. Photophobia in neurologic disorders. In: Translational Neurodegeneration, 2017, nr. 6(1). doi:10.1186/s40035-017-0095-3.
Yuan CS, Barber WD. Area postrema: gastric vagal input from proximal stomach and interactions with nucleus tractus solitarius in cat. In: Brain Res Bull. 1993; nr. 30(1–2), pp. : 119–125.
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