Abstract | OBJECTIVES/HYPOTHESIS: STUDY DESIGN: Study participants were recruited from a UK specialist service, and online following advertisement by the HHT Foundation International. They completed a nonbiased questionnaire in which paired questions on nosebleeds and migraines were separated by at least 17 other questions. METHODS:
Migraines were defined as headaches with associated autonomic and/or neurological features. The reported frequencies and precipitants of epistaxis and migraines were compared using numerical scales applied equally for each condition. RESULTS: The 220 HHT-affected respondents reported frequent nosebleeds, 153 (69.5%) used iron tablets, and 39 (17.7%) had received at least 10 blood transfusions. Migraines displaying typical features were reported by 51 (23.2%), and were more common with pulmonary or cerebral arteriovenous malformations. Thirty of 51 (58.8%) migraine sufferers reported that nosebleeds occurred at the same time as their migraines. More frequent migraines were reported by patients with more frequent nosebleeds (r2=15%, P=.007), or transfusions (r2=16.9%, P=.004). In menstrual, lifestyle, and dietary analyses, consistency was observed between factors having no effect, and those provoking both nosebleeds and migraines in multiple patients (premenses; activity; lack of sleep; stress; caffeine, cheese, alcohol, and chocolate). CONCLUSIONS: We demonstrate an unexpected and provocative association between nosebleeds and migraines in HHT patients. Evaluation of whether antimigraine approaches limit HHT nosebleeds may be appropriate. LEVEL OF EVIDENCE: 4.
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Authors | Amy Elphick, Claire L Shovlin |
Journal | The Laryngoscope
(Laryngoscope)
Vol. 124
Issue 7
Pg. 1521-8
(Jul 2014)
ISSN: 1531-4995 [Electronic] United States |
PMID | 24458873
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
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Copyright | © 2013 The American Laryngological, Rhinological and Otological Society, Inc. |
Topics |
- Adult
- Aged
- Aged, 80 and over
- Epistaxis
(epidemiology, etiology)
- Female
- Humans
- Incidence
- Male
- Middle Aged
- Migraine Disorders
(epidemiology, etiology)
- Retrospective Studies
- Risk Factors
- Surveys and Questionnaires
- Telangiectasia, Hereditary Hemorrhagic
(complications, epidemiology)
- United Kingdom
(epidemiology)
- Young Adult
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