Title: Co-occurrence of Epistaxis in Migraine Sufferers - A Hospital Based Prospective Observational Study from Kerala
Authors: Dr Kabeer Kaithadiyil Abdul Khayar Kutty, Dr Sunil Das, Dr S.R .Chandra, Dr Jyothish Sivananda Panicker, Dr Sreedevi Parameswara Panicker
DOI: https://dx.doi.org/10.18535/jmscr/v8i1.167
Abstract
Background: Migraine is a common type of primary head ache syndrome .Various co morbid conditions have been associated with migraine. This include stroke, epilepsy, psychiatric illness, fibromyalgia, restless leg syndrome etc.
We have observed that there is an increased incidence of epistaxis in patients admitted with acute migraine.
Objectives: Present study aims is to determine the incidence of epistaxis in patients with migraine.
Materials and Methods: All patients who satisfied the criteria of migraine based on ICHD 2 were included in this study. Patients with features of secondary headache syndromes and other causes of epistaxis were excluded from the cohort using appropriate investigations. This is a hospital based prospective observational study conducted in two tertiary institutions of Kerala over a period of seven years.
Observations: Total number of patients enrolled for study was 486, of which 331 (68.1%) were females and 155(31.9%) were males. 433 patients (89.09%) were between the age of 11and 45yrs, 418 (86%) had one or more co morbid diseases and 117(24.07 %) had one or more recurrent episodes of epistaxis during acute phase of migraine. 452 patients (93%) with epistaxis also had other associated illnesses.
Conclusions: Epistaxis is more frequently seen in migrainers than in general population. Awareness of co-occurrence of migraine and epistaxis is important to avoid unnecessary investigations and the use of NSAID during acute phase of illness.
Keyword: Migraine, Epistaxis, Co morbid illness.
References
- Pharmacologic Prevention of Migraine: A Narrative Review of the State of the Art in 2018- Elizabeth Loder etal: Headache. 2018
- Migrainomics identifying brain and genetic markers of migraine Dale R. Nyholt etal :Nature Reviews Neurology vol 13, pages725–741 :2017
- Acute treatment of Migraine –Bert .B .Vergas: Continuum. August 2018 ,vol 24,No 24:1032-1051
- Migraine and its psychiatric comorbidities- Minen MT, et al. J Neurol Neurosurg Psychiatry 2016; 87:741–749.
- Biological insights from the premonitory symptoms of migraine-Nazia Karsan& Peter J. Goadsby : Nature Reviews Neurology volume 14, pages699–710 (2018)
- Migraine and epistaxis: An interesting combination- Sweta Adatia et al. Neurology Asia 2012; 17(2): 153 – 154.
- Relationships between Epistaxis, Migraines, and Triggers in Hereditary Hemorrhagic Telangiectasia. Amy Elphick etal -Laryngoscope 124: July 2014.
- Migraine-Induced Epistaxis - Ami D. Sperber et al - Headache 26:517-518, 1986.
- Migraine and Recurrent Epistaxis in Children. Imad T. Jarjour etal. Pediatr Neurol 2005; 33:94-97.
- Epistaxis accompanying migraine attacks. Letter to the editor. E Durán-Ferreras etal. Cephalalgia, 2007, 27, 958–959.
- Neurobiology of migraine -P. J. Goadsby etal. Neuroscience 161 (2009) 327–341.
- Epistaxis management - our point of view and literature review-Romanian Journal of Rhinology, Vol. 7, No. 28, October - December 2017.