A touchy subject: an assessment of cutaneous allodynia in a chronic migraine population

Abstract

Paul G Mathew,1–4 Fred Michael Cutrer,5 Ivan Garza5 1Department of Neurology, John R Graham Headache Center, Brigham and Women’s Hospital, Boston, MA, 2Department of Neurology, Harvard Vanguard Medical Associates, Braintree, MA, 3Division of Neurology, Cambridge Health Alliance, Cambridge, MA, 4Harvard Medical School, Boston, MA, 5Department of Neurology, Mayo Clinic, Rochester, MN, USA Background: Cutaneous allodynia (CA) is a common feature of migraine, which has a complex underlying pathophysiology that is not well understood. In addition to pain, photophobia, phonophobia, osmophobia, nausea, and vomiting, CA can contribute to the overall disability caused by migraine. The presence of CA can be established via a validated questionnaire. Validated questionnaires and other tests are rarely performed in clinical practice. As such, current prevalence estimates for CA may be an underestimation. Methods: Utilizing a validated questionnaire, we assessed the presence of CA in consecutive patients (n=44) presenting with chronic migraine at a tertiary headache center. Results: CA appears to be quite prevalent, at ~90%, among female patients with chronic migraine. Conclusion: CA prevalence in chronic migraine may be underestimated in the literature, and larger studies may better demonstrate a more accurate estimate of its prevalence. Keywords: headache, validated questionnaire, migraine chronification, central sensitization

Keywords

• headache
• chronic migraine
• cutaneous allodynia
• questionnaire