Migraine Headaches in Patients with Upper Extremity Compressive Neuropathy.
Academic Article
Overview
abstract
BACKGROUND: Upper extremity nerve compression syndromes and migraines caused by nerve entrapment have many similarities including patient presentation, anatomic findings, and treatment by surgical decompression of affected nerves. Parallels between the two conditions point towards the possibility of shared predisposition. The aim of this study was to evaluate the relationship between migraine and upper extremity nerve compression. METHODS: 9,558 patients that underwent nerve decompression surgery of the upper extremity (median, ulnar, radial and thoracic outlet) as identified by Current Procedural Terminology and International Classification of Diseases (ICD) codes were included in the analysis. ICD codes for migraine and comorbidities included as part of the Elixhauser comorbiditiy index were identified. Bivariate and multivariable logistic regression was performed. RESULTS: Median nerve decompression (OR: 1.3, 95% CI: 1.0-1.8, p=0.046) and multiple nerve decompressions (OR: 1.7, 95% CI: 1.2-2.5, p=0.008) were independently associated with higher rates of migraine compared to ulnar nerve decompression and thoracic outlet syndrome. Older age and male gender had a negative association with migraine. History of psychiatric disease, rheumatoid arthritis/collagen vascular diseases, hypothyroidism, hypertension, and chronic pulmonary disease were independently associated with migraine headache. CONCLUSION: Patients who undergo median and multiple nerve decompression are more likely to suffer from migraine headache. It is important to recognize this overlap and provide comprehensive patient screening for both conditions. This shared predisposition and better understanding of a common disease mechanism and genetics, may provide greater insight into the pathogenesis, and therefore treatment of these clinical problems.
