Detaillierte Beitrags-Information
| Beitragstitel | The presence of positive signs for functional neurological disorders is associated with pain frequency and intensity in migraine |
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| Beitragscode | P19 |
| Autor:innen | |
| Präsentationsform | Freie Mitteilung + Poster |
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| Abstract-Text |
Background: Positive signs (PS) are the hallmark of functional neurological disorders (FND). However, in clinical practice, PS can also be found in migraine patients without known FND. Our aim was to evaluate the role of PS among migraine patients. Material and Methods: This study recruited patients treated at the headache consultation of the Inselspital, Bern, Switzerland. Inclusion criteria were a diagnosis of migraine according to criteria of the International Headache Society and actual complaints about headache in the three last months prior to consultation. Exclusion criterion was a diagnosis of FND. All patients underwent a single bedside examination of the following PS: give-away, co-contraction, sternocleidomastoid sign, trapezius elevation test, head flexion test, drift without pronation, Hoover I & II, spinal injury test, arm drop test, lip pulling sign, midline splitting, splitting of vibration sign and expressive behavior sign. SPSS served for statistical analyses. Results: A total of 72 patients were included (mean age: 37.6 +/-15.1yo; 75% female). Among these, 31 patients (43.1%) presented PS, and 20 of them only had one PS. The most frequent PS was splitting of vibration (20 patients; 28% of the cohort); the other PS were present among 8% of the cohort or less. Three positive signs were not found (trapezius elevation test, spinal injury test, arm drop test). In terms of significant differences and compared to patients without PS, patients with PS were older, had more comorbidities, more headache days and exacerbation days per month, more motor deficits, higher headache intensity at the time of the consultation, and a longer history of migraine. Even after adjusting for age and comorbidities, the association between the presence of PS and the number of headache days per month remained significant (OR: 1.058; 95% CI (1.000; 1.119); p=0.049) as well as between the presence of PS and the subjective headache intensity at consultation (OR 1.277; 95% CI (1.030; 1.582); p=0.026). Conclusions: PS are frequent among migraine patients, mostly as isolated signs. Patients with PS have more headache exacerbations per month and a longer duration of migraine, which points toward a more severe migraine condition. PS are also associated with headache frequency and intensity. Our findings highlight the complexity of the clinical spectrum of migraine. |