Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine

被引:3
作者
Vicente, Beatriz Nunes [1 ]
Oliveira, Renato [2 ]
Martins, Isabel Pavao [1 ,3 ]
Gil-Gouveia, Raquel [2 ,4 ]
机构
[1] Ctr Hosp Univ Lisboa Norte, Hosp Santa Maria, Headache Outaptient Clin, Neurol Dept, P-1649028 Lisbon, Portugal
[2] Hosp Luz, Headache Ctr, Neurol Dept, P-1500650 Lisbon, Portugal
[3] Univ Lisbon, Ctr Estudos Egas Moniz, P-1649028 Lisbon, Portugal
[4] Univ Catolica Portuguesa, Ctr Interdisciplinary Res Hlth, P-1649023 Lisbon, Portugal
关键词
migraine; cranial autonomic symptoms; cluster headache; neck pain; TENSION-TYPE HEADACHE; CERVICOGENIC HEADACHE; MUSCULOSKELETAL; PREVALENCE; DISORDERS; LOCATION; CARE;
D O I
10.3390/diagnostics13040590
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Cranial autonomic symptoms and neck pain have been reported to be highly prevalent in migraine, although they are rarely considered in clinical evaluation. The aim of this review is to focus on the prevalence, pathophysiology, and clinical characteristics of these two symptoms, and their importance in the differential diagnosis between migraines and other headaches. The most common cranial autonomic symptoms are aural fullness, lacrimation, facial/forehead sweating, and conjunctival injection. Migraineurs experiencing cranial autonomic symptoms are more likely to have more severe, frequent, and longer attacks, as well as higher rates of photophobia, phonophobia, osmophobia, and allodynia. Cranial autonomic symptoms occur due to the activation of the trigeminal autonomic reflex, and the differential diagnosis with cluster headaches can be challenging. Neck pain can be part of the migraine prodromal symptoms or act as a trigger for a migraine attack. The prevalence of neck pain correlates with headache frequency and is associated with treatment resistance and greater disability. The convergence between upper cervical and trigeminal nociception via the trigeminal nucleus caudalis is the likely mechanism for neck pain in migraine. The recognition of cranial autonomic symptoms and neck pain as potential migraine features is important because they often contribute to the misdiagnosis of cervicogenic problems, tension-type headache, cluster headache, and rhinosinusitis in migraine patients, delaying appropriate attack and disease management.
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页数:12
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