Trigger factors for familial hemiplegic migraine

Objective: The aim was to identify and describe migraine trigger factors in patients with familial hemiplegic migraine (FHM) from a population-based sample. Methods: 127 FHM patients were sent a questionnaire listing 16 trigger factors. Distinction was made between attacks of hemiplegic migraine (HM) and migraine with aura (MA) or without aura (MO) within each patient. Results: The response rate was 59% (75/127) of whom 57 (76%) had current HM attacks. Sixty-three per cent (47/75) reported at least one factor triggering HM, and 36% (27/75) reported at least one factor that often or always caused HM. Twenty per cent (15/75) reported only HM, whereas FHM in combinations with MA and MO were reported by 80% (60/75). Stress (with attacks either following or during the stress), bright light, intense emotional influences and sleeping too much or too little were the trigger factors mentioned by most. Conclusion: Many FHM patients report trigger factors and one-third reported at least one trigger factor often or always triggering FHM. The typical triggers are the same as for MA. Patients should be educated to avoid these factors. The role of trigger factors in the onset of new or first attacks of FHM remains unknown.

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Trigger factors in migraine with aura

Cephalalgia ◽

10.1111/j.1468-2982.2009.01930.x ◽

2009 ◽

Vol 30 (3) ◽

pp. 346-353 ◽

Cited By ~ 37

Author(s):

AW Hauge ◽

M Kirchmann ◽

J Olesen

Keyword(s):

Migraine With Aura ◽

Migraine Without Aura ◽

Bright Light ◽

Trigger Factor ◽

Free Text ◽

Danish Population ◽

Attack Frequency ◽

Trigger Factors

The aim of the present study was to identify trigger factors in migraine with aura (MA). A total of 629 MA patients representative of the Danish population were sent a questionnaire listing 16 trigger factors thought to be relevant as well as space for free text. Distinction was made between attacks with or without aura within each patient. The questionnaire was returned by 522 patients of whom 347 had current MA attacks. In total 80% with current attacks (278/347) indicated that at least one factor triggered their migraine, and 67% (187/278) in this group indicated that they were aware of at least one factor often or always giving rise to an attack of MA. Forty-one per cent (113/278) had co-occurring attacks of migraine without aura (MO). Stress (following stress), bright light, intense emotional influences, stress (during stress) and sleeping too much or too little were the trigger factors mentioned by most. Attack frequency had little impact on the number of trigger factors. Women reported more trigger factors than men. Patients having attacks of both MA and MO reported more trigger factors for MO attacks than for MA attacks. In conclusion, 80% of patients with MA reported trigger factors and two-thirds of these reported at least one trigger factor often or always triggering an attack of MA. Patients should be educated to avoid these factors.

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Evidence for a separate type of migraine with aura

Neurology ◽

10.1212/01.wnl.0000046524.25369.7d ◽

2003 ◽

Vol 60 (4) ◽

pp. 595-601 ◽

Cited By ~ 87

Author(s):

Lise L. Thomsen ◽

Elsebet Ostergaard ◽

Jes Olesen ◽

Michael B. Russell

Keyword(s):

Migraine With Aura ◽

Telephone Interview ◽

Clinical Symptoms ◽

Familial Hemiplegic Migraine ◽

Computer Search ◽

Hemiplegic Migraine ◽

Motor Weakness ◽

National Patient Register ◽

National Patient ◽

Sequential Appearance

Objective: To compare clinical characteristics of patients with sporadic hemiplegic migraine (SHM) with those of patients with migraine with typical aura (MA) and patients with familial hemiplegic migraine (FHM).Methods: The authors used a computer search of Denmark’s National Patient Register to screen the population for patients with migraine with aura with motor weakness, and also examined case records from headache clinics and private practicing neurologists and placed advertisements. The authors screened patients and their relatives with a semi-structured validated telephone interview. All recruited patients were then interviewed by a physician and given a neurologic examination.Results: A total of 105 patients with SHM were identified. Seventy-two percent had four typical aura symptoms: visual, sensory, aphasic, and motor. All had at least two symptoms present during SHM attacks. A gradual progression and sequential appearance of aura symptoms was typical; compared with MA, the duration of each aura symptom was usually prolonged and bilateral motor symptoms were more frequent. Of the patients with SHM, 72% fulfilled the criteria for basilar migraine during SHM attacks. The aura was usually followed by headache, as is common in FHM but not MA.Conclusions: Patients with sporadic hemiplegic migraine had clinical symptoms identical to familial hemiplegic migraine and significantly different from migraine with typical aura. Sporadic hemiplegic migraine is a separate entity, and should be classified with familial hemiplegic migraine.

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A population‐based study of familial hemiplegic migraine suggests revised diagnostic criteria

Brain ◽

10.1093/brain/awf132 ◽

2002 ◽

Vol 125 (6) ◽

pp. 1379-1391 ◽

Cited By ~ 148

Author(s):

L. L. Thomsen ◽

M. K. Eriksen ◽

S. F. Roemer ◽

I. Andersen ◽

J. Olesen ◽

...

Keyword(s):

Diagnostic Criteria ◽

Familial Hemiplegic Migraine ◽

Population Based ◽

Hemiplegic Migraine ◽

Population Based Study

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Genetic Analysis of 27 Spanish Patients with Hemiplegic Migraine, Basilar-Type Migraine and Childhood Periodic Syndromes

Cephalalgia ◽

10.1111/j.1468-2982.2008.01645.x ◽

2008 ◽

Vol 28 (10) ◽

pp. 1039-1047 ◽

Cited By ~ 40

Author(s):

E Cuenca-León ◽

R Corominas ◽

N Fernàndez-Castillo ◽

V Volpini ◽

M del Toro ◽

...

Keyword(s):

Genetic Analysis ◽

Migraine With Aura ◽

Genetic Heterogeneity ◽

Familial Hemiplegic Migraine ◽

Base Change ◽

Hemiplegic Migraine ◽

Rare Type

Familial hemiplegic migraine (FHM) is a rare type of migraine with aura. Mutations in three genes have been described in FHM patients: CACNA1A (FHM1), ATP1A2 (FHM2) and SCN1A (FHM3). We screened 27 Spanish patients with hemiplegic migraine (HM), basilar-type migraine or childhood periodic syndromes (CPS) for mutations in these three genes. Two novel CACNA1A variants, p.Val581Met and p.Tyr1245Cys, and a previously annotated change, p.Cys1534Ser, were identified in individuals with HM, although they have not yet been proven to be pathogenic. Interestingly, p.Tyr1245Cys was detected in a patient displaying a changing, age-specific phenotype that began as benign paroxysmal torticollis of infancy, evolving into benign paroxysmal vertigo of childhood and later becoming HM. This is the first instance of a specific non-synonymous base change being described in a subject affected with CPS. The fact that the molecular screen identified non-synonymous changes in< 15± of our HM patients further stresses the genetic heterogeneity underlying the presumably monogenic forms of migraine.

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Motor Cortex Excitability in Patients with Migraine with Aura and Hemiplegic Migraine

Cephalalgia ◽

10.1046/j.1468-2982.2000.00011.x ◽

2000 ◽

Vol 20 (1) ◽

pp. 45-50 ◽

Cited By ~ 55

Author(s):

KJ Werhahn ◽

K Wiseman ◽

J Herzog ◽

S Foörderreuther ◽

M Dichgans ◽

...

Keyword(s):

Motor Cortex ◽

Migraine With Aura ◽

Silent Period ◽

Intracortical Inhibition ◽

Familial Hemiplegic Migraine ◽

Hemiplegic Migraine ◽

Cortical Hyperexcitability ◽

Motor Cortex Excitability ◽

Patient Groups ◽

Intracortical Inhibition And Facilitation

We studied the excitability of the motor cortex using transcranial magnetic stimulation (TMS) in 12 patients with migraine with aura (MA) and nine patients with familial hemiplegic migraine (FHM). Motor thresholds at rest, the duration of the cortical and peripheral silent period and intracortical inhibition and facilitation using paired-pulse TMS at intervals of 2 to 15 ms were measured with patients free of attacks for at least 48 h. In contrast to previous reports we could not find any significant differences between patient groups and compared to controls ( n = 17) in the parameters tested. The results suggest that there are no interictal changes of excitability of the motor cortex in migraine. This study does not support the concept of general cortical hyperexcitability in migraine secondary to a genetic predisposition or a structural alteration of inhibitory interneurones in the cortex due to repeated parenchymal insults during attacks.

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Development and Representativeness of a Large Population-Based Cohort of Native Californian Twins

Twin Research ◽

10.1375/twin.4.4.242 ◽

2001 ◽

Vol 4 (4) ◽

pp. 242-250 ◽

Cited By ~ 15

Author(s):

Myles G. Cockburn ◽

Ann S. Hamilton ◽

John Zadnick ◽

Wendy Cozen ◽

Thomas M. Mack

Keyword(s):

Response Rate ◽

Large Population ◽

Population Based ◽

Multiple Births ◽

Motor Vehicles ◽

California Department ◽

Birth Records ◽

Residential Distribution ◽

Near Future

AbstractWe have established a large cohort of twins to facilitate studies of the role of genetics and environment in the development of disease. The cohort has been derived from all multiple births occurring in California between 1908–82 (256,616 in total). We report here on our efforts to contact these twins and their completion of a detailed 16 page risk factor questionnaire. Addresses of the individuals were obtained by linking the birth records with the California Department of Motor Vehicles (DMV) roster of licensees. To date this has been completed for twins born between 1908 and 1972 (200,589 individuals). The linkage has revealed 112,468 matches and, because of less complete DMV records in some years, was less successful in older females than in younger females and all males. Over 41,000 twins have participated by completing the questionnaire. Based on estimates of numbers of individuals receiving a questionnaire, we estimate our crude response rate to be between 42.2% and 49.6%, highest among females in their 40s (62.8%). We describe the representativeness of the twins in the original birth cohort, those identified by the linkage, and those completing the questionnaire. Compared to the 1990 resident population of California-born resident singletons, the respondents were of similar age, sex, race and residential distribution (for although we were able to locate fewer older females, they had a higher response rate), but were less likely to have been educated for more than 12 years. We provide a brief synopsis of studies nested within this cohort. We also elucidate our plans for expanding the cohort in the near future.

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Remission of chronic headache: Rates, potential predictors and the role of medication, follow-up results of the German Headache Consortium (GHC) Study

Cephalalgia ◽

10.1177/0333102417699180 ◽

2017 ◽

Vol 38 (3) ◽

pp. 551-560 ◽

Cited By ~ 6

Author(s):

Verena Henning ◽

Zaza Katsarava ◽

Mark Obermann ◽

Susanne Moebus ◽

Sara Schramm

Keyword(s):

Partial Remission ◽

Chronic Headache ◽

Response Rate ◽

Medication Overuse ◽

Population Based ◽

Headache Frequency ◽

Female Sex ◽

Headache Type

Objectives To estimate remission rates of chronic headache (CH), focusing on potential predictors of headache remission and medication. Methods We used data from the longitudinal population-based German Headache Consortium (GHC) Study (n = 9,944, 18–65 years). Validated questionnaires were used at baseline (t0, 2003–2007, response rate: 55.2%), first follow-up after 1.87 ± 0.39 years (t1, 37.2%) and second follow-up after 3.26 ± 0.60 years (t2, 38.8%) to assess headache type and frequency, use of analgesics and anti-migraine drugs, medication overuse, education, BMI, smoking and alcohol consumption. CH was defined as ≥ 15 headache days/month at t0 over three months. Outcomes were: CH remission (<15 headache days/month at both follow-ups), CH persistence (≥ 15 headache days/month at both follow-ups); all others were considered as partially remitted. To estimate predictors of remission, univariate and multiple logistic regression were calculated. Results At baseline, 255 (2.6%) participants were identified with CH. Of these, 158 (62.0%) participants responded at both follow-ups. Remission was observed in 58.2% of participants, partial remission in 17.7% and persistence in 24.1%. Remission was associated with female sex (adjusted odds ratio: 3.10, 95% confidence interval: 1.06–9.08) and no medication overuse (4.16, 1.45–11.94) compared to participants with persistent CH; participants with higher headache frequency at t0 were less likely to remit (0.90, 0.84–0.97). Medication, age, education, BMI, smoking and drinking showed no effects on remission. Similar results were observed for partial remission. Conclusion The majority of CH participants remitted from CH. Female sex, no overuse of pain medication and lower headache frequency were associated with remission.

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The Genetics of Migraine Without Aura and Migraine With Aura

Cephalalgia ◽

10.1046/j.1468-2982.1993.1304245.x ◽

1993 ◽

Vol 13 (4) ◽

pp. 245-248 ◽

Cited By ~ 52

Author(s):

Michael Bjørn Russell ◽

Jes Olesen

Keyword(s):

Migraine With Aura ◽

Migraine Without Aura ◽

Familial Aggregation ◽

Familial Hemiplegic Migraine ◽

Hemiplegic Migraine ◽

Future Studies ◽

Progressive Ataxia ◽

Reduced Penetrance ◽

Genetically Determined ◽

Selection Of

Studies of twins, spouses and familial aggregation strongly suggest that migraine without aura (MO) and migraine with aura (MA) are genetically determined. The mode of inheritance is most likely multifactorial in both MO and MA. However, autosomal dominant inheritance with reduced penetrance cannot be excluded in either MO or MA. At present the only evidence for genetic heterogeneity of MA is familial hemiplegic migraine with slowly progressive ataxia. This phenomenon can also be explained by linkage of different genes. All existing studies have been characterized by one or more of the following methodologic shortcomings: selection of probands from clinic populations, information obtained by questionnaire, family history obtained through probands, insufficient description of the attacks, lack of distinction between MO and MA. Useful strategies for future studies of migraine genetics are discussed.

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Screen for CACNA1A and ATP1A2 Mutations in Sporadic Hemiplegic Migraine Patients

Cephalalgia ◽

10.1111/j.1468-2982.2008.01599.x ◽

2008 ◽

Vol 28 (9) ◽

pp. 914-921 ◽

Cited By ~ 36

Author(s):

LL Thomsen ◽

E Oestergaard ◽

A Bjornsson ◽

H Stefansson ◽

AC Fasquel ◽

...

Keyword(s):

Population Based ◽

Causal Role ◽

Danish Population ◽

Promoter Regions ◽

Hemiplegic Migraine ◽

Functional Studies ◽

Dna Variants ◽

Atp1a2 Gene ◽

Cacna1a Gene

The aim of this study was to investigate the involvement of the CACNA1A and ATP1A2 gene in a population-based sample of sporadic hemiplegic migraine (SHM). Patients with SHM ( n = 105) were identified in a nationwide search in the Danish population. We sequenced all exons and promoter regions of the CACNA1A and ATP1A2 genes in 100 patients with SHM to search for possible SHM mutations. Novel DNA variants were discovered in eight SHM patients, four in exons of the CACNA1A gene and four in exons of the ATP1A2 gene. Six of the variants were considered non-pathogenic. The causal role of the two remaining DNA variants is unknown until functional studies have been made or independent genetic evidence is discovered. Only very few DNA variants were identified in 100 SHM patients, and regardless of whether the identified variants are causal the CACNA1A and ATP1A2 genes are not major genes in SHM.

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