Article

Intracellular and plasma magnesium in familial hemiplegic migraine and migraine with and without aura

Department of Neurology, University Hospital Leiden, The Netherlands.
Cephalalgia (Impact Factor: 4.12). 03/1994; 14(1):29-32. DOI: 10.1046/j.1468-2982.1994.1401029.x
Source: PubMed

ABSTRACT Familial hemiplegic migraine (FHM) is an autosomal dominant type of migraine and probably represents the most extreme end of migraine with aura. Reduced magnesium facilitates the development of spreading depression and possibly aura. Cellular magnesium levels are under genetic control. We hypothesized that FHM patients would have significantly reduced intracellular magnesium levels. We determined intracellular and plasma magnesium levels in blood of 38 afflicted and 11 non-afflicted members of three families with FHM and in 32 migraine patients (9 with and 23 without aura) and 32 age and sex matched healthy controls. We found no significant differences between the magnesium levels in the five study groups. We conclude that reduced blood magnesium is unlikely to be related to migraine pathophysiology.

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    • "Since 1988 [31], more than 12 different groups of medical researchers have reported a systemic or local magnesium deficiency in migraine or a favorable response of migraine patients to dietary supplementation with magnesium [21] [37]. There is also one recent report of negative results [26]. "
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    ABSTRACT: Introduction: Nowadays, many studies consider a role for magnesium and calcium in pathophysiology and treatment of migraine. We evaluated serum ionized magnesium and calcium level in migraineurs -during interictal period-and control group. Methods: Migraineurs -according to the IHS criteria-enrolled in this study. Serum Mg²+ and Ca²+ level were determined by atomic absorption spectrophotometry. Mean values were compared, using t-test. Results: 40 migraineurs and 40 healthy subjects (34 (85%) female and 6 (15%) male in each group) enrolled the study with mean age of 34.8±9.9 and 35.7±9.1 years, respectively. There were no significant difference between Mg²+ levels in cases vs. healthy subjects (1.55±0.27 vs. 1.55±0.29 meq/l) but serum Ca²+ level was lower in healthy subjects. (8.04±1.18 vs. 7.56±0.82 meq/l, P<0.05). Migraineurs without aura had lower serum Mg²+ level (1.56±0.26 vs. 1.76±0.24 meq/l) and higher serum Ca²+ level (8.10±1.23 vs. 7.64±0.65 meq/l) than with aura migraineurs. Migraineurs with "monthly attack rate ≥4" had lower Mg²+ and Ca²+ level (1.48±0.23 vs. 1.58±0.29 meq/l) and (7.95±0.42 vs. 8.09±1.85 meq/l) than those with lower attack rate. Females whose attacks aggravated by menstruation had lower serum Mg²+ and Ca²+ level in comparison with those their attacks didn't aggravate by menstruation (1.46±0.25 vs. 1.77±0.25 and 7.77±0.59 vs. 8.80±2.77, P<0.05). Conclusion: In our study, severity of migraine had correlation with reduced serum Mg²+ and higher Ca²+ level which confirms the role of reduced magnesium level on lowering the threshold of attacks. Also, lower Mg²+ and higher Ca²+ level in migraineurs without aura could exhibit a demonstrable calcium channelopathy, but also raises questions about possibility of different mechanisms for "with and without aura" migraine. However, it seems that further studies with larger sample size and intra cellular (RBC and monocyte) Mg²+ assessment, is needed. Introduction Headache is a prevalent complaint among clinics clients. (1) It strikes 1 out of each 3 persons all over the world in at least one stage of life. (2) Approximately, 90% of cases with recurrent headaches are primary in etiology like Migraine, tension and cluster headaches. (3) Among them common migraine is the most prevalent one. (4) In America migraine prevalence is 6% in males and 17.6% in females. (3) Migraine is a chronic disease by episodic attacks that also induces levels of disability during attacks intervals. (3) In the U.S reduction of worker productivity for headache is about 6.5-17.2 billions dollars annually, in comparison to 2.6 for diabetes. (5) Despite the importance and prevalence of migraine, unfortunately our knowledge is limited about it and in spite of the marked progression on pathophysiology and pharmacology of migraine, which have been made during recent 15 years, its mechanism is still unknown (3) and different theories has been given about it's pathogenesis, genetics and neurotransmitters, involved in it, that some are the base of the new treatments. Some have categorized headache in hyper-excitability syndrome and have considered a role for the variable calcium and magnesium body level in its etiology. (5) During recent years, some investigators, has attached a great importance to the role of magnesium in pathophysiology and treatment of migraine. Among different investigations on Mg2+ and migraine pathogenesis, there are different results. Some has detected decreased level of serum and RBC Mg2+ level during attacks intervals (6) and some in migraine attacks. (7) While in other studies there were no significant differences in platelet ionized magnesium level (8) and also serum Mg2+ level (9) among migraineurs and control group. Despite other studies, in the latter study, it's being concluded that Mg2+ level decrement dose not have any role on Migraine pathophysiology. (9) These discrepancies and disagreement continues to magnesium therapeutic role in migraineurs. Some believe on its positive therapeutic role in acute attacks (7) and also during attacks intervals (10,11) and some investigators are suspicious to its preventive role. (12) In this study we compared serum magnesium and calcium level in migraineurs, during interictal period and in control group.
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