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Syncope in migraine

The population-based CAMERA study

From the Departments of Neurology and Clinical Neurophysiology (R.D.T., M.D.F., J.G.V.D.) and Radiology (M.C.K., M.A.V.B.), Leiden University Medical Center, and Center for Prevention and Health Services Research (L.J.L.), National Institute of Public Health and the Environment, Bilthoven, the Netherlands; and Laboratory of Epidemiology, Demography, and Biometry (L.J.L.), Intramural Research Program, National Institute on Aging, Bethesda, MD.

Address correspondence and reprint requests to Dr Thijs, Department of Neurology and Clinical Neurophysiology, Leiden University Medical Center, Postal Zone J3-R, PO Box 9600, 2300 RC Leiden, the Netherlands; e-mail: r.d.thijs{at}lumc.nl

Objective: To examine the association between migraine and syncope-related autonomic nervous system (ANS) symptoms.

Methods: A population-based study among migraineurs with and without aura (n = 323) and control subjects (n = 153) was conducted. A systematic questionnaire and cardiovascular measurements during rest, while standing, and after venipuncture addressed the prevalence of syncope, orthostatic intolerance, orthostatic hypotension (OH), and the postural tachycardia syndrome (POTS) in migraineurs and control subjects.

Results: The lifetime prevalence of syncope in all participants was 41%, more often in women (45 vs 32%; p = 0.02). Compared with control subjects, migraineurs had a higher lifetime prevalence of syncope (46 vs 31%; p = 0.001), frequent syncope (five or more attacks) (13 vs 5%; p = 0.02), and orthostatic intolerance (32 vs 12%; p < 0.001). There was no association between ANS symptoms and the severity of migraine or migraine subtype. Cardiovascular measurements and the prevalence of POTS and OH did not differ significantly between migraineurs and control subjects.

Conclusion: This population-based study demonstrated an elevated prevalence of syncope and orthostatic intolerance in migraineurs without clear interictal signs of autonomic nervous system dysfunction.

*Both authors contributed equally.

Supported by a grant from the Netherlands Heart Foundation (grant 97.108) and in part by the Intramural Research Program, NIA. The Genetic Epidemiology of Migraine study was conducted by the National Institute of Public Health and the Environment, Department of Chronic Disease and Environmental Epidemiology, Bilthoven, the Netherlands.

Disclosure: The authors report no conflicts of interest.

Received July 19, 2005. Accepted in final form December 19. 2005.

This article has been cited by other articles:

				L. R.A. Olde Nordkamp, W. Wieling, A. H. Zwinderman, A. A.M. Wilde, and N. van Dijk Genetic aspects of vasovagal syncope: a systematic review of current evidence Europace, April 1, 2009; 11(4): 414 - 420. [Abstract] [Full Text] [PDF]

				S. Blitshteyn, W. P. Cheshire Jr, I. T. Jarjour, E. O. Smith, R .D. Thijs, M .C. Kruit, M .A. van Buchem, M .D. Ferrari, L .J. Launer, and J .G. van Dijk Syncope in migraine: the population-based CAMERA study. Neurology, March 13, 2007; 68(11): 878 - 878. [Full Text] [PDF]

				Syncope in Migraine Journal Watch Neurology, June 8, 2006; 2006(608): 2 - 2. [Full Text]

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