Migraine Co-morbidities Patients with migraine are more likely than non-migraineurs to have coexisting disorders. Migraines may occur more frequently in persons with the following conditions or illnesses: Epilepsy A relationship between epilepsy and migraine has long been postulated, but the nature of this interaction is still debated. It appears that epilepsy and migraines share a similar pathophysiology. The median prevalence of epilepsy in migraineurs is 6%, compared with 0.5% in the general population. Among people with epilepsy, 8%-23% have migraine headaches, compared with 12% of the general population. Patients with partial and generalised forms of epilepsy are more likely to have migraines, with the biggest increase in those with posttraumatic epilepsy. Ischaemic stroke Recent German research has found that migraine was present in 23% of stroke patients compared to in 12.5% of a non-stroke control group. Although strokes caused solely by a migraine (Migrainous infarction) are extremely rare, it is accepted that migraine with aura is an independent risk factor for stroke, especially in young women. • The stroke risk for young women with migraine is approximately 3 times that of young women without migraine. • Young women with Migraine with aura are 6 times more likely to suffer stroke than young women that don't have migraine. • Young Women with migraine who smoke are 10 times more likely to have a stroke than young women without migraine who don't smoke. • Young women with Migraine with Aura who smoke and who are on the contraceptive pill are 34 times more likely to suffer stroke Psychiatric disorders People with migraine are more likely to develop psychiatric disorders, just as people with psychiatric disorders are more likely to develop migraine. These disorders include: • major depression • manic episodes • anxiety disorder • panic disorder Patterns suggests an interplay of the conditions, rather than a cause-and-effect situation. Patent Foramen Ovale Patent Formaent Ovale (PFO) is a small flap-like opening between the right atrium and the left atrium that persists after age 1 year. It is present in up to 25% of the population. In utero, the foramen ovale serves as a conduit for right-to-left shunting. Usually, once the pulmonary circulation is established after birth, left atrial pressure increases, allowing functional closure of the foramen ovale. PFO has already been linked to stroke and recently, some research has shown that patients who have a PFO are more likely to suffer from migraine. Research is currently taking place in the USA and UK to establish whether or not the link exists and if it does to investigate whether or not closing the PFO leads to an improvement in migraine. Coeliac Disease An Italian study published in the American Journal of Gastroenterology (2003;98:625-629) found that about 4% of migraine sufferers may have been found to have coeliac disease compared to less than 0.4% of the general population.
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