Rizatriptan Efficacy in ICHD-II Pure Menstrual Migraine and Menstrually Related Migraine

Migraine is a common disorder that affects women of menstruating age, and it is frequently the chief complaint of women presenting in the neurology clinic. The prevalence of menstrually related migraine can range from 20–60%, while pure menstrual migraine occurs in less than 10% of women. In addition to utilizing non–gender-specific abortive and preventative strategies, understanding migraine and its relationship to hormones, particularly estrogen, can have clinical implications for optimal treatment. This chapter seeks to provide insight into diagnosing menstrually related migraine, the role of decreased estrogen just prior to menstrual cycle onset and migraine, as well as the therapeutic options that are available to treat and possibly prevent menstrual migraine attacks.

Download Full-text

Brain structural and functional differences between pure menstrual migraine and menstrually-related migraine

Scientific Reports ◽

10.1038/s41598-020-73399-0 ◽

2020 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Tao Xu ◽

Yutong Zhang ◽

Chen Wang ◽

Huaqiang Liao ◽

Siyuan Zhou ◽

...

Keyword(s):

Prefrontal Cortex ◽

Low Frequency ◽

Menstrual Migraine ◽

Grey Matter Volume ◽

Menstrually Related Migraine ◽

Spontaneous Neural Activity ◽

Dorsolateral Prefrontal ◽

Brain Structure And Function ◽

And Function ◽

Pure Menstrual Migraine

Abstract The pathophysiological differences between menstrually-related migraine (MRM) and pure menstrual migraine (PMM) are largely unclear. The aim of this study was to investigate the potential differences in brain structure and function between PMM and MRM. Forty-eight menstrual migraine patients (32 MRM; 16 PMM) were recruited for this study. Voxel-based morphometry (VBM) was applied on structural magnetic resonance imaging (sMRI), and the amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) in resting state functional MRI (rsfMRI) were calculated. No significant between-group difference was observed in the grey matter volume (GMV). MRM patients exhibited lower ALFF values at the dorsolateral prefrontal cortex (DLPFC) and medial prefrontal cortex (mPFC) than PMM patients. Moreover, the MRM group showed significantly higher ReHo values in the DLPFC. Higher values in the mPFC were related to higher expression of calcitonin gene-associated peptide (CGRP) in the PMM group (r = 0.5, P = 0.048). Combined ALFF and ReHo analyses revealed significantly different spontaneous neural activity in the DLPFC and mPFC, between MRM and PMM patients, and ALFF values in the mPFC were positively correlated with CGRP expression, in the PMM group. This study enhances our understanding of the relationship between neural abnormalities and CGRP expression in individuals with PMM.

Download Full-text

Perimenstrual headache: Migraine without aura or premenstrual syndrome symptom?

Vojnosanitetski pregled ◽

10.2298/vsp1012969s ◽

2010 ◽

Vol 67 (12) ◽

pp. 969-976 ◽

Cited By ~ 2

Author(s):

Ana Sundic ◽

Jasna Zidverc-Trajkovic ◽

Svetlana Vujovic ◽

Nadezda Sternic

Keyword(s):

Premenstrual Syndrome ◽

Migraine Headache ◽

Migraine Without Aura ◽

Tension Type Headache ◽

Menstrual Migraine ◽

Menstrually Related Migraine ◽

Headache Onset ◽

Perimenstrual Headache ◽

Type Headache ◽

Pure Menstrual Migraine

Background/Aim. Definition of menstrual migraine as a specific clinical entity or, maybe, migraine headache with menstrually related occurring, still remains unresolved question. The aim of this study was to investigate if perimenstrual headache in our patients fulfills diagnostic the International Classification of Headache Disorders (ICHD) criteria for migraine without aura or represents a different type of headache which is the symptom of premenstrual syndrome (PMS). Methods. The study included 50 women with headache in perimenstrual period in at least two out of three menstrual cycles, during the last year or longer. Two questionnaires, a questionnaire for headache and a questionnaire for PMS, were used. Results. The majority of all the examined women, 29 of them, had migraine and PMS and 9 women had migraine without PMS. Headache in 38 (76.0%) patients fulfilled diagnostic criteria for menstrual migraine, (26 and 12 women had pure menstrual migraine and menstrually related migraine respectively). Intensity of PMS was not different in a groups of women with different types of headache (p = 0.184): a total number of PMS symptoms was 8.2 ? 4.6 in the group with pure menstrual migraine, 10.8 ? 3.9 in the group with menstrually related migraine and 10.8 ? 6.3 in the group with non-migraine headache. Conclusion. This study shows that headache, occuring in perimenstrual period, is not always migraine, but could fulfill criteria for tension-type headache, as well. Specific characteristics of perimenstrual headache, which could distinguish it as a symptom of PMS, were not found. Expected relation in time of headache onset and menarche was not confirmed.

Download Full-text

Lack of Seasonal Variation in Menstrually-Related Migraine

Cephalalgia ◽

10.1111/j.1468-2982.2008.01676.x ◽

2008 ◽

Vol 28 (12) ◽

pp. 1277-1281 ◽

Cited By ~ 5

Author(s):

SI Bekkelund ◽

KB Alstadhaug ◽

R Salvesen

Keyword(s):

Seasonal Variation ◽

Migraine Headache ◽

Migraine Without Aura ◽

Telephone Interview ◽

Menstrual Migraine ◽

Menstrually Related Migraine ◽

Headache Diary ◽

June July ◽

Arctic Area ◽

North Norway

The aim of the study was to study seasonal variation in migraine headache in a group of women with menstrually-related migraine (MRM) compared with non-menstrual migraine. Via newspaper advertisement, women with migraine living in North Norway were invited. The patients were included by questionnaire and telephone interview. We prospectively recorded migraine attacks from a 12-month headache diary performed by a group of 62 women with a mean age of 36.0 years (range 16-46 years), who fulfilled the criteria of migraine without aura. Of these, 29 had MRM and 33 non-menstrual migraine. Mean ratio between number of attacks in the light arctic season (May-June-July) divided with total number of migraine attacks during 12 months was 0.24 (9.4/38.4) in the group of MRM compared with 0.25 (5.6/22.1) in others (confidence interval -4.2, 6.3, P = 0.84). Nor were there more migraine attacks in the dark season in an arctic area (November-December-January) in any group. We found a higher migraine attack rate in those with MRM, but no indication of more or less frequency of attacks during the bright arctic season. These findings support the assumption that MRM and seasonal variation of migraine are due to different mechanisms.

Download Full-text

Menstrual Migraine : How Hormones Impact Migraine

JOURNAL OBGIN EMAS ◽

10.25077/aoj.5.1.9-17.2021 ◽

2021 ◽

Vol 5 (1) ◽

pp. 9-17

Author(s):

Restu Susanti ◽

Syamel Muhammad

Keyword(s):

Menstrual Cycle ◽

Trigeminal Nerve ◽

Menstrual Migraine ◽

Menstrually Related Migraine ◽

Female Hormones

Menstrual Migraine is divided into 2 subtypes: Menstrually Related Migraine (MRM) and Pure Menstrual Migraines (PMM). In PMM symptoms do not occur outside the menstrual cycle while MRM, symptoms can occur at other times apart from the menstrual cycle. The occurrence of menstrual migraines is related to the female hormones cycle in the form of the decrease in estrogen levels which usually occurs a week before the onset of menstruation. The mechanism is unclear, but it is thought that a decrease in estrogen levels can trigger decrease in serotonin levels, causing cranial vasodilation and sensitization of the trigeminal nerve. Keywords: menstrual migraine, hormones

Download Full-text

The effect of melatonin on gene expression of calcitonin gene-related peptide and some proinflammatory mediators in patients with pure menstrual migraine

Acta Neurologica Belgica ◽

10.1007/s13760-017-0803-x ◽

2017 ◽

Vol 117 (3) ◽

pp. 677-685 ◽

Cited By ~ 9

Author(s):

Mohammad Ansari ◽

Azam Karkhaneh ◽

Asma Kheirollahi ◽

Solaleh Emamgholipour ◽

Mohammad Hessam Rafiee

Keyword(s):

Gene Expression ◽

Calcitonin Gene Related Peptide ◽

Menstrual Migraine ◽

Related Peptide ◽

Proinflammatory Mediators ◽

Calcitonin Gene ◽

Pure Menstrual Migraine

Download Full-text

Treatment Strategies for Menstrually Related Migraine

Women s Health ◽

10.2217/whe.12.37 ◽

2012 ◽

Vol 8 (5) ◽

pp. 529-541 ◽

Cited By ~ 4

Author(s):

Gianni Allais ◽

Ilaria Castagnoli Gabellari ◽

Ornella Mana ◽

Chiara Benedetto

Keyword(s):

Sex Hormones ◽

Gold Standard ◽

Prophylactic Treatment ◽

Treatment Strategies ◽

Menstrual Migraine ◽

Preventive Strategies ◽

Menstrually Related Migraine ◽

Menstrual Flow ◽

Female Sex Hormones ◽

Analgesic Agents

Approximately 50% of migrainous women suffer from menstrually related migraine (MRM), a type of migraine in which the attacks occur at the same time as or near the menstrual flow. Attacks of MRM tend to be longer, more intense and disabling and sometimes less responsive to treatment than non-menstrual migraines. Similar to the management of non-menstrual migraine, the use of triptans and NSAIDs is the gold standard for MRM treatment. In this paper, the most important studies in the literature that report the effectiveness of triptans, of certain associated drugs and other analgesic agents are summarized. Preventive strategies that can be used if a prophylactic treatment is needed is also analyzed, with particular attention paid to the use of perimenstrual prophylaxis with triptans and/or NSAIDs. Moreover, considering the peculiar interaction between menstrual migraine and female sex hormones, brief mention is made to possible hormonal manipulations.

Download Full-text