Spinal Fluid Tests May Help in the Diagnosis of Migraines


Spinal Fluid Tests May Help in the Diagnosis of Mirgraines

New data indicate that people who experience migraines have significantly higher levels of sodium in their cerebrospinal fluid compared with people who do not experience migraines. A study led by Melissa Meyer, MD, used a sodium MRI to measure sodium levels in different parts of people’s brains. The study is one of the first to use this technique to study migraines. Migraines are typically defined by severe head pain often described as “an intense pulsing or throbbing” in part of a person’s head. Migraines are quantified by length and severity of the attack as well as other symptoms, including nausea, vomiting, or enhanced sensitivity to light or sound. Because of this wide spectrum of symptoms, migraines are often misdiagnosed and wrongly treated. For this reason, scientists are increasing the usage of the sodium MRI to assess biomedical properties of living tissues in a noninvasive way to better classify migraines. Dr. Meyer’s study assessed 12 women who were clinically diagnosed with migraines and 12 women who were in good health. They found that there was no statistically significant difference between sodium levels of gray and white matter, cerebellum, or brainstem between the groups. However, there was a statistically significant difference in levels of sodium in the cerebrospinal fluid between the groups. Cerebrospinal fluid envelops the brain and spinal cord, acting as a cushion and stabilizer to the brain. Dr. Meyer’s study was an exploratory study; however, these findings challenge the current diagnosis of migraines.

To learn more about migraines, visit our on-demand CE webinar, Understanding the Clinical and Economic Data of Botulinum Toxin in Chronic Migraines.

This activity is supported by an educational grant from Allergan, Inc.

CASE IN POINT Test your problem-solving skills!

Here are snippets from our AJMC Supplement, Pseudobulbar Affect: Considerations for Managed Care Professionals.

Try to answer the question and then check your answer by participating in this online CE activity.

This activity is supported by an educational grant from Avanir Pharmaceuticals, Inc.

FM is a 41-year-old man diagnosed with posttraumatic stress disorder. FM indicates that he has bouts of crying even when he does not feel sad and that these bouts have increased in frequency. After screening for PBA, FM was prescribed dextromethorphan/quinidine by his primary care physician at the recommended starting dose of 1 capsule daily for 7 days before increasing to the maintenance dose.

What is the recommended maintenance dose?

A. 2 capsules once daily
B. 1 capsule every 8 hours
C. 1 capsule every 12 hours
D. 2 capsules every 12 hours

For the correct answer, please see the bottom of this page.
Answer to Case in Point is C.