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Migraine Co-morbidities Patients with migraine are more likely

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Migraine Co-morbidities Patients with migraine are more likely ...

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									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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