Abstract

AUTONOMIC FUNCTION TEST IN MIGRAINEUR WITH PATENT FORAMEN OVALE

Dr. Kifah K. Al- Ubaidy*, Dr. Aqeel R. Hassan and Dr. RadhiF. Shlash

Abstract

Background: Several studies have reported a significantly higher incidence of patent foramen ovale (PFO) in patients with migraine with aura. Furthermore; several publications reported a consistent improvement of migraine symptoms following PFO closure. Some authors have emphasized a high concentration of vasoactive agents shunted to left circulation by PFO will trigger migraine attacks. The shunting of vasoactive agents to the left circulation eventually has its influence on autonomic function. Aim: Study the autonomic changes in migraineur during ictal phase to verify whether PFO triggering migraine attacks. Methods: The study included 112 patients, satisfying the International Headache Society criteria-2 for primary episodic migraine, within age group of 20 to 40 years of either sex. All patients underwent transthoracic Echocardiography. The autonomic function test (Expiratory-inspiratory (E: I ratio), Standing to Lying Ratio (S/L Ratio), 30: 15 ratio, Valsalva ratio and hand Grip Test) was performed in the neurology department under standardized laboratory conditions. Results: From 112 migraine patients, 34 (30.4%) patients having PFO (MPFO) and 78 (69.6%) not having PFO (MN). Megrainers with aura were 28/112 (25%), MPFO having aura 18/34 (52.9%) Vs. 10/78 (12.8%) MN patients, aura is significantly higher in MPFO P value

Keywords: PFO, migraine, aura, autonomic changes.