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- W1719339966 abstract "OBJECTIVE: Evaluating efficacy and tolerability of triptans in basilar and hemiplegic migraines. BACKGROUND: Basilar migraine (BM) is a migraine sub-type with symptoms thought to originate from the brainstem and/or from simultaneous bihemispheric activation. Hemiplegic migraine (HM) is another migraine sub-type involving episodes of unilateral weakness in the setting of headache. Although triptans have been a mainstay in abortive treatment of migraine headaches, the FDA mandates that package labeling state that triptans are contraindicated in BM and HM. Triptans are 5-HT1B/D agonists which inhibit vasoactive peptide release by trigeminal nerves, and cause vasoconstriction of dilated cerebral arteries.A proposed mechanism for BM is basilar artery vasoconstriction, which has not been demonstrated in angiographic studies. HM carries a theoretically elevated risk of stroke compared to migraine with aura, which has not been well elucidated. Despite this lack of data, patients with BM and HM have been excluded from triptan clinical trials. In clinical practice, physicians at times prescribe triptans in patients meeting criteria for or have features consistent with BM and HM. DESIGN/METHODS: A retrospective chart review was conducted at two tertiary care institutions via electronic searchable databases from 2007-2013. Searchable terms included basilar migraine, vertigo, dysarthria, diplopia, hemiplegia/hemiparesis, facial droop, weakness, confusion, altered consciousness, confusion, ataxia, and aphasia, as well as all triptans. RESULTS: The study included thirty-nine patients. Thirty-six were included in the BM subtype, three in HM. No side effects of stroke or myocardial infarction were reported. Five patients reported adverse effects, including GI upset, rash, neck dystonia, nightmares, and flushing. CONCLUSIONS: In this retrospective study, triptans were used effectively with no subsequent vascular events for the abortive treatment of migraines with basilar and hemiplegic features. This data also suggests that beta blockers, tricyclic anti-depressants, anti-convulsants, and Botox injections have some efficacy in the treatment of migraines with basilar type and hemiplegic features. Disclosure: Dr. Krel has nothing to disclose. Dr. Mathew has nothing to disclose. Dr. Spinner has received personal compensation for activities with Merz Pharma and Allergan Inc. as speaker bureau member. Dr. Joshi has nothing to disclose." @default.
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- W1719339966 date "2014-04-08" @default.
- W1719339966 modified "2023-10-01" @default.
- W1719339966 title "Spinning Out of Control: The Black Box of Basilar and Hemiplegic Migraine (P7.176)" @default.
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