Serum Calcitonin Gene-Related Peptide Is Elevated in Patients With Migraine and Ophthalmoplegia

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Title Serum Calcitonin Gene-Related Peptide Is Elevated in Patients With Migraine and Ophthalmoplegia
Creator Aastha Takkar; K. V. Anil Kumar; Deeksha Katoch; Paramjeet Singh; Ranjana Minz; Shashi Anand; Soundappan Kathirvel; K. Ravishankar; Vivek Lal; Louis R. Caplan
Affiliation Departments of Neurology (AT, VL), Internal Medicine (KVAK), Ophthalmology (DK), Radiodiagnosis (PS), Immunopathology (RM, SA), and Community Medicine and School of Public Health (SK), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India ; The Headache and Migraine Clinics (KR), Jaslok and Lilavati Hospitals, Mumbai, India; and Beth Israel Deaconess Medical Center (LC) (LRC), and Department of Neurology (LC), Harvard University, Boston, Massachusetts
Abstract Background: There is ongoing debate about whether the oculomotor (III), trochlear (IV), or abducens (VI) nerve paresis in patients with migraine is directly attributable to migraine (ophthalmoplegic migraine [OM]) or is due to an inflammatory neuropathy (recurrent painful ophthalmoplegic neuropathy [RPON]). As migraine is associated with elevated serum calcitonin gene-related peptide (CGRP) levels, we studied serum CGRP levels among patients with OM/RPON to determine whether they are elevated during and between attacks. This is the first study assessing CGRP levels in the serum of patients with OM/RPON. Methods: The aim of this case-control study was to assess serum CGRP levels in patients with ophthalmoplegia and a headache consistent with migraine according to ICHD-3 criteria. Serum CGRP levels were measured during the ictal and interictal phases in 15 patients with OM/RPON and compared with age-matched and sex-matched controls without migraine (12 patients). Results: The median serum CGRP levels were significantly elevated ( P = 0.021) during the ictal phase (37.2 [36.4, 43.6] ng/L) compared with controls (32.5 [30.1, 37.3] ng/L). Serum CGRP levels during the attack correlated with the total duration of ophthalmoplegia. A CGRP level of 35.5 ng/L in the ictal phase of the attack had a sensitivity of 86.7% and specificity of 75.0% in diagnosing a patient with OM/RPON.Conclusions: Elevated serum CGRP levels during the ictal phase of OM/RPON favor migraine as the underlying cause of episodic headache with ophthalmoplegia.
Subject Calcitonin Gene-Related Peptide; Case-Control Studies; Headache / diagnosis; Humans; Migraine Disorders / complications; Migraine Disorders / diagnosis; Ophthalmoplegia / diagnosis; Ophthalmoplegic Migraine / diagnosis
OCR Text Show
Date 2023-09
Date Digital 2023-09
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Source Journal of Neuro-Ophthalmology, September 2023, Volume 43, Issue 3
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s6mvqb3d
Setname ehsl_novel_jno
ID 2538087
Reference URL https://collections.lib.utah.edu/ark:/87278/s6mvqb3d
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