Migraine with Brainstem Aura Accompanied by Disorders of Consciousness
Sui-yi Xu,* Hui-juan Li,* Jing Huang, Xiu-ping Li, Chang-xin Li Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chang-xin LiDepartment of Neu...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-04-01
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| Series: | Journal of Pain Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/migraine-with-brainstem-aura-accompanied-by-disorders-of-consciousness-peer-reviewed-fulltext-article-JPR |
| _version_ | 1818445207103864832 |
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| author | Xu SY Li HJ Huang J Li XP Li CX |
| author_facet | Xu SY Li HJ Huang J Li XP Li CX |
| author_sort | Xu SY |
| collection | DOAJ |
| description | Sui-yi Xu,* Hui-juan Li,* Jing Huang, Xiu-ping Li, Chang-xin Li Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chang-xin LiDepartment of Neurology, The First Hospital of Shanxi Medical University, Jiefangnan Road 85, Taiyuan, 030001, Shanxi Province, People’s Republic of ChinaTel +86-15103513579Email lichangxin0351@sina.comAbstract: Migraine with brainstem aura (MBA) accompanied by disorders of consciousness (DOC) is a rare subtype of migraine. The pathophysiology of MBA with DOC has not been elucidated yet. Some patients have a family history of migraine, and women are more affected than men. The aura symptoms are diverse; however, when MBA is combined with DOC, the clinical manifestations are more complicated. Coma is the most common clinical manifestation. The overall duration of the patient’s DOC is short and can often return to normal within half an hour. Headache often occurs after regaining consciousness and can also occur at the same time as DOC. The most common headache is located at the occipital region. Although DOC is reversible, considering the current small number of cases, we still need to improve our understanding of the disease to avoid misdiagnosis. The MBA patient’s electroencephalogram and cerebral blood flow perfusion may have transient changes and may return to normal in the interictal period or after the DOC. Although triptans have traditionally been contraindicated in MBA under drug instructions, the evidence of basilar artery constriction, as postulated in MBA, is lacking. Lasmiditan is currently the first and only 5-HT 1F receptor agonist approved by the Food and Drug Administration. The calcitonin gene-related peptide receptor antagonists and monoclonal antibody therapies may be the most promising for future consideration. Here, the pathophysiology, clinical manifestations, diagnostic tools, and treatment progress for MBA with DOC are reviewed.Keywords: migraine, brainstem aura, coma, calcitonin gene-related peptide |
| first_indexed | 2024-12-14T19:28:09Z |
| format | Article |
| id | doaj.art-7145166b95a64a099687783a2b4e8d59 |
| institution | Directory Open Access Journal |
| issn | 1178-7090 |
| language | English |
| last_indexed | 2024-12-14T19:28:09Z |
| publishDate | 2021-04-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Journal of Pain Research |
| spelling | doaj.art-7145166b95a64a099687783a2b4e8d592022-12-21T22:50:08ZengDove Medical PressJournal of Pain Research1178-70902021-04-01Volume 141119112764110Migraine with Brainstem Aura Accompanied by Disorders of ConsciousnessXu SYLi HJHuang JLi XPLi CXSui-yi Xu,* Hui-juan Li,* Jing Huang, Xiu-ping Li, Chang-xin Li Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chang-xin LiDepartment of Neurology, The First Hospital of Shanxi Medical University, Jiefangnan Road 85, Taiyuan, 030001, Shanxi Province, People’s Republic of ChinaTel +86-15103513579Email lichangxin0351@sina.comAbstract: Migraine with brainstem aura (MBA) accompanied by disorders of consciousness (DOC) is a rare subtype of migraine. The pathophysiology of MBA with DOC has not been elucidated yet. Some patients have a family history of migraine, and women are more affected than men. The aura symptoms are diverse; however, when MBA is combined with DOC, the clinical manifestations are more complicated. Coma is the most common clinical manifestation. The overall duration of the patient’s DOC is short and can often return to normal within half an hour. Headache often occurs after regaining consciousness and can also occur at the same time as DOC. The most common headache is located at the occipital region. Although DOC is reversible, considering the current small number of cases, we still need to improve our understanding of the disease to avoid misdiagnosis. The MBA patient’s electroencephalogram and cerebral blood flow perfusion may have transient changes and may return to normal in the interictal period or after the DOC. Although triptans have traditionally been contraindicated in MBA under drug instructions, the evidence of basilar artery constriction, as postulated in MBA, is lacking. Lasmiditan is currently the first and only 5-HT 1F receptor agonist approved by the Food and Drug Administration. The calcitonin gene-related peptide receptor antagonists and monoclonal antibody therapies may be the most promising for future consideration. Here, the pathophysiology, clinical manifestations, diagnostic tools, and treatment progress for MBA with DOC are reviewed.Keywords: migraine, brainstem aura, coma, calcitonin gene-related peptidehttps://www.dovepress.com/migraine-with-brainstem-aura-accompanied-by-disorders-of-consciousness-peer-reviewed-fulltext-article-JPRmigrainebrainstem auracomacalcitonin gene-related peptide |
| spellingShingle | Xu SY Li HJ Huang J Li XP Li CX Migraine with Brainstem Aura Accompanied by Disorders of Consciousness Journal of Pain Research migraine brainstem aura coma calcitonin gene-related peptide |
| title | Migraine with Brainstem Aura Accompanied by Disorders of Consciousness |
| title_full | Migraine with Brainstem Aura Accompanied by Disorders of Consciousness |
| title_fullStr | Migraine with Brainstem Aura Accompanied by Disorders of Consciousness |
| title_full_unstemmed | Migraine with Brainstem Aura Accompanied by Disorders of Consciousness |
| title_short | Migraine with Brainstem Aura Accompanied by Disorders of Consciousness |
| title_sort | migraine with brainstem aura accompanied by disorders of consciousness |
| topic | migraine brainstem aura coma calcitonin gene-related peptide |
| url | https://www.dovepress.com/migraine-with-brainstem-aura-accompanied-by-disorders-of-consciousness-peer-reviewed-fulltext-article-JPR |
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