Migraine headache in patients with Tourette syndrome.
BACKGROUND: Tourette syndrome (TS) is recognized as one of the most common childhood movement disorders, characterized by motor and phonic tics often associated with neurobehavioral comorbidities, such as obsessive-compulsive disorder. Neurotransmitter dysregulation, particularly involving the serotonin system, has been implicated in the pathogenesis of TS, obsessive-compulsive disorder, and migraine headache. OBJECTIVES: To investigate the possible association between migraine headache and TS and to report preliminary findings of family history of migraine headache in patients with TS. METHODS: Subjects diagnosed as having TS at the Baylor College of Medicine Parkinson's Disease Center and Movement Disorders Clinic were administered a migraine headache questionnaire based on the migraine criteria established by the Headache Classification Committee of the International Headache Society. RESULTS: Of 100 patients with TS, 25 (25.0%) satisfied the diagnostic criteria for migraine headache, significantly greater than the estimated 10% to 13% in the general adult population (P<.001) and the estimated 2% to 10% in the general pediatric population (P<.04). There was no significant (P =.44) difference in the presence of comorbid obsessive-compulsive traits in the TS migraine and TS nonmigraine sample groups. Furthermore, our TS group with migraines was not more likely to have features of obsessive-compulsive disorder compared with attention-deficit/hyperactivity disorder. Of patients with TS, 56.0% reported a family history of migraines, 44.0% of whom were first-degree relatives. CONCLUSIONS: The frequency of migraine headache in a clinic sample of TS subjects was nearly 4-fold more than the frequency of migraines reported in the general population. Contrary to previous reports, the co-occurrence of migraines and TS in our sample group may possibly be attributed to another TS comorbidity, other than obsessive-compulsive traits.
Kwak, C; Vuong, KD; Jankovic, J
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