Are There Objective Criteria to Follow Up Migrainous Patients? A Prospective Study with Thermography and Evoked Potentials

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Abstract

SYNOPSIS

Eight patients with common migraine (CM), 9 with classic migraine (CLM), 5 with cluster headache (CH), and 10 with muscle contraction headache (MCH) were evaluated, before and after treatment, using electronic thermography of face (T.T.) and visual evoked potentials (V.E.R).

In the 10 MCH's the T.T. and V.E.P. findings were comparable to those obtained from ten control subjects.

In the three remaining groups we obtained the following results: Before therapy eighteen out of the 22 vascular headache patients showed a positive “cold patch” in the external carotid territory, ipsilateral to the prevailing side of pain. After six months on therapy the “cold patch” had disappeared or was attenuated in all the patients, who concomitantly had clinical improvement.

Ten out of the 22 patients (all CH's, 5 out of 9 CLM, no CM) presented in the baseline condition an asymmetry in V.E.P.s (hemifield stimulation). After six months the asymmetry persisted in only 4 patients.

The evidence supports a valid temporal relationship between the clinical improvement and the modification in T.T. and V.E.P.s findings in CLM and CH. In CM there is a relationship between clinical course and T.T. but not V.E.P.s.

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