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Abstract Details

Cranial Autonomic Symptoms in Migraine
Headache
Headache Posters (7:00 AM-5:00 PM)
144

CAS are usually associated with the trigeminal autonomic cephalalgias (TACs), although it is clear that they can also occur in migraine and are compatible with the diagnosis.

To study the phenotype and laterality of cranial autonomic symptoms (CAS) in a cohort of migraineurs, and to understand any associations with headache laterality and frequency.

Migraineurs seen within our tertiary headache service between 2014 and 2018 were selected (n=340). Clinical information regarding age, disease duration, sex, headache frequency, headache diagnosis, headache laterality, CAS phenotype and laterality was acquired from the first consultation, during which a standardised detailed headache history is taken by a trained headache physician. Statistical analyses were performed to assess for an association between headache frequency and number of CAS and the relationship between headache laterality and CAS laterality.

The mean age at evaluation was 43 (range 14-94, SD 15), with a mean disease duration of 26 years (range 2-77, SD 14). The majority (84%) were female. The most common diagnosis was chronic migraine (78%) and aura was present in 54%. The median number of headache days a month was 26 (IQR 15-75). At least one CAS was reported in 74%. A median of two CAS were reported (IQR 0-3), with the most common being nasal congestion (32%), lacrimation (31%) and aural fullness (25%).  Most patients reported unilateral headache (80%) and strictly unilateral CAS (64%). There was a positive association between headache laterality and strict CAS laterality in the same individual (χ2120.7, P<0.001). There was a weak positive correlation between headache frequency at baseline and the total number of CAS reported in any individual (r=0.11, P=0.047).

CAS are common in migraine and may be associated with increasing headache frequency. CAS tend to lateralise with the headache. The presence of lateralised CAS should not deter from a migraine diagnosis.
Authors/Disclosures
Nazia Karsan, PhD, MBBS (Headache Group, Basic and Clinical Neuroscience)
PRESENTER
Dr. Karsan has nothing to disclose.
Karthik Nagaraj Dr. Nagaraj has nothing to disclose.
Peter Goadsby, MD, PhD, FRS (University of California, Los Angeles) Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amgen. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie. Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Eli-Lilly. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aurene. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Teva Pharmaceuticals. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Lundbeck. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Satsuma. Dr. Goadsby has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Pfizer. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shiratronics. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CoolTech LLC. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Linpharma. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tremeau. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PureTech Health LLC. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vial. Dr. Goadsby has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aeon Biopharma. Dr. Goadsby has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Massachusetts Medical Society. The institution of Dr. Goadsby has received research support from Celgene. The institution of Dr. Goadsby has received research support from NIHR. The institution of Dr. Goadsby has received research support from Kallyope. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has received publishing royalties from a publication relating to health care. Dr. Goadsby has a non-compensated relationship as a Trustee with Migraine Trust that is relevant to AAN interests or activities. Dr. Goadsby has a non-compensated relationship as a Trustee with Organisation for Understanding Cluster Headache (UK) that is relevant to AAN interests or activities. Dr. Goadsby has a non-compensated relationship as a Executive roles with American Headache Society that is relevant to AAN interests or activities. Dr. Goadsby has a non-compensated relationship as a Director with American Migraine Foundation that is relevant to AAN interests or activities.