What you need to know about migraine in Hughes syndrome patients. (March 2023)

• Record Type: Journal Article
• Authors: Schofield, JR; Hassell, KL
• Is Part Of: Lupus. Volume 32:Number 3(2023)
• Page Start: 319
• Page End: 324
• Publication Date: 2023-03
• Subjects: Hughes syndrome -- antiphospholipid syndrome -- antiphospholipid antibodies -- migraine -- antithrombotic therapy; Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1177/09612033231153790
• Languages: English
• ISSNs: 0961-2033

Abstract

Background: Headache, often migrainous, is common in patients with antiphospholipid antibodies, whether or not they meet Sydney criteria for a definite diagnosis of Hughes syndrome. Migraine may be a harbinger of stroke in this patient population and even refractory migraine may be highly responsive to antithrombotic therapy in this clinical context. Purpose: To summarize what is known to date about managing this important manifestation of the immune-mediated hypercoagulable Hughes syndrome. Results: We provide a suggested management algorithm for refractory headache in this unique patient population. Conclusion: Most neurologists don't see or recognize many aPL-positive patients in their practice, so hematologists and rheumatologists who see these patients should recognize that refractory headache may be a manifestation of their immune-mediated hypercoagulable disorder and understand that the potential risks of not addressing this issue may be high.