Migraine and Its Equivalents: What Do They Share? A Narrative Review on Common Pathophysiological Patterns.

Ilaria Frattale,Luigi Mazzone,Laura Papetti,Giorgia Sforza,Federico Vigevano,Samuela Tarantino,Massimiliano Valeriani,Fabiana Ursitti,Martina Balestri,Claudia Ruscitto,Romina Moavero,Michela Ada Noris Ferilli

doi:10.3390/life11121392

Abstract

Migraine is the first in order of frequency of the neurological disorders, affecting both adult and paediatric populations. It is also the first cause of primary headaches in children. Migraine equivalents are periodic disorders that can be associated with migraine or considered as prognostic features of a future migraine manifestation. Despite the mechanisms underlying migraine and its equivalents are not entirely clear, several elements support the hypothesis of common pathophysiological patterns shared by these conditions. The aim of this review is thus to analyze the literature in order to highlight which currently known mechanisms may be common between migraine and its equivalents.

Highlights

Headache is an extremely common disorder that might affect people at any age.Regarding pediatric age, as established by the World Health Organization (WHO), migraine is the third most disabling condition [1] with a prevalence in childhood and adolescence that ranges from 7.7% to 17.8% and a gender difference of 3.7% (9.7% in females vs 6.0% in males) [2,3,4]
Episodic syndromes that can be associated with migraine, known as migraine equivalents, are a set of periodic or paroxysmal manifestations that can be associated with migraine or be considered as prognostic factors of a future migraine manifestation [6]
In spite of a largely incomplete knowledge of the shared pathophysiology, evidence that episodic syndromes are associated with migraines is considered high enough that some authors, including ourselves, have proposed the use the term “migraine syndrome of childhood” to include both migraine equivalents and migrainous headache [24,116]

Summary

Introduction

Headache is an extremely common disorder that might affect people at any age.Regarding pediatric age, as established by the World Health Organization (WHO), migraine is the third most disabling condition [1] with a prevalence in childhood and adolescence that ranges from 7.7% to 17.8% and a gender difference of 3.7% (9.7% in females vs 6.0% in males) [2,3,4]. Migraine attacks are characterized by a variety of symptoms involving the sensory system with symptoms such as phonophobia, osmophobia, photophobia, allodynia and muscle pain; autonomic systems with nausea, vomiting, ptosis, lacrimation, yawning, nasal congestion or changes in urination and defecation; cognitive impairment with transient amnesia, attention deficit and word-finding difficulties; affective areas with irritability and depression [5]. Several elements support the hypothesis that migraine and episodic syndromes associated with migraine share common pathophysiological patterns. Both conditions have periodic and paroxysmal presentation [9,10]. Associated symptoms such as phonophobia, photophobia, vomiting, nausea and pallor could subsist in both episodic syndromes and migraine attacks [9,11,12,13,14]. Other conditions probably associated with migraine are motion sickness, periodic sleep disorders (such as sleep walking, sleep talking, night terrors and bruxism) and leg pain [11]

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Findings

Discussion

Conclusion