Interictal Gastric Motility in Patients with Migraine

J Korean Neurol Assoc > Volume 29(4); 2011 > Article

Journal of the Korean Neurological Association 2011;29(4): 291-294.

편두통 환자에서 비두통기 상부위장관 운동장애

정유리, 황민호 강규식 권오현 박종무 이정주 조윤주 a 김병건

을지대학교 을지병원 신경과, 내과 a

Interictal Gastric Motility in Patients with Migraine

Yu-Ri Jeong

Departments of Neurology and Internal Medicine a , Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea

Abstract

Background: Nausea and vomiting are predominant accompanying symptoms of migraine attacks. Although the underlying mechanism is not yet clear, gastric stasis is assumed to be the main factor. However, few studies have used direct methods to establish delayed gastric emptying of migraine patients. We compared interictal gastric motility between migraine patients and normal controls with the aid of gastric scintigraphy.
Methods: The study population comprised patients who had been diagnosed with episodic migraine, according to the International Classification of Headache Disorders, edition II. The entire study population was completely free of gastrointestinal symptoms during the headache-free period. Gastric scintigraphy was performed to determine the time to half emptying (T1/2 ) and the percentage of radioactive material remaining in the stomach (%RMR) at 30, 60, 90, and 120?min.
Results: Twenty-six migraine patients and 12 normal controls were recruited. The mean T1/2 did not differ between the two groups (101.8 vs 95.2?min; p=0.432). The %RMR values in the stomach at 30, 60, 90, and 120?min also did not differ significantly between the two groups [87.5% vs 88% (p=0.900), 70.8% vs 71.2% (p=0.950), 54.2% vs 53.3% (p=0.753), and 39.0% vs 37.3% (p=0.583), respectively].
Conclusions: There is no gastric stasis in patients with episodic migraine during headache-free periods. Our results suggest that the main mechanism underlying the nausea and vomiting in migraine patients is not a gastric stasis in interictal periods, but rather a central process, as a result of changes occurring in the brainstem during acute migraine attacks. Key Words: Migraine, Nausea, Vomiting, Gastric stasis, Gastric scintigraphy