Faculty Collaboration Database

Syncopal migraine. Clin Auton Res 2012 Feb;22(1):17-23

Date

08/19/2011

Pubmed ID

21847710

DOI

10.1007/s10286-011-0141-7

Scopus ID

2-s2.0-84858700457 (requires institutional sign-in at Scopus site)   24 Citations

Abstract

OBJECTIVE: A subgroup of syncope patients report migraine headaches immediately preceding or following syncope, and some respond to anti-migrainous prophylactic agents. This study aimed to describe the frequency of migrainous features concurrent with episodes of syncope and to propose clinical criteria for assessing whether a migrainous mechanism might underlie syncope.

METHODS: This retrospective, questionnaire-based study developed criteria for syncopal migraine based on the International Classification of Headache Disorders II (ICHD-II) migraine criteria. Two hundred and forty-eight recurrent syncope subjects (>3 episodes) were stratified based on the presence (N = 127) or absence (N = 121) of a headache concurrent with syncopal episodes. Syncopal headaches were classified as either syncopal migraine (meeting ICHD-II criteria for migraine or probable migraine, without aura) or nonspecific (not meeting the criteria for syncopal migraine). The syncope groups were then compared to 199 subjects with migraine headaches using chi-square and Cochran-Armitage test for trend.

RESULTS: Nearly one-third of recurrent syncope subjects met criteria for syncopal migraine. This group resembled the migraine headache population more than the syncope population in age, gender, autonomic testing, and comorbid conditions. The syncopal migraine group also reported a longer duration of syncope and a longer recovery time to normal. Finally, anti-migrainous medications reduced syncope in half of the syncopal migraine subjects.

INTERPRETATION: Syncope may have a migrainous basis more commonly than previously suspected, and we suggested criteria to identify these patients. Syncopal migraine appears epidemiologically more closely related to migraine than to reflex syncope.

Author List

Curfman D, Chilungu M, Daroff RB, Alshekhlee A, Chelimsky G, Chelimsky TC

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Autonomic Nervous System
Comorbidity
Databases, Factual
Female
Hemodynamics
Humans
Male
Middle Aged
Migraine Disorders
Reproducibility of Results
Retrospective Studies
Syncope
Tilt-Table Test
Unconsciousness
Valsalva Maneuver