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Nervenheilkunde 2007; 26(01/02): 27-31
DOI: 10.1055/s-0038-1626827
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Migräne und offenes Foramen ovale — Was ist gesichert?

Migraine and patent foramen ovale — What’s firmed?
S. Evers
1   Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster
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Publication History

Publication Date:
19 January 2018 (online)

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Zusammenfassung

Fallberichte über ein Sistieren von Migräne durch den Verschluss eines offenen Foramen ovale (PFO) haben in letzter Zeit zu epidemiologischen und therapeutischen Studien über diesen Zusammenhang geführt. Dabei konnte gezeigt werden, dass die Prävalenz eines PFO bei Patienten mit Migräne ca. doppelt so hoch ist wie in der Allgemeinbevölkerung. In retrospektiven offenen Studien zeigten sich auch Besserungsraten von zum Teil über 70% der Migränefrequenz nach Verschluss eines PFO. In einer jüngst vorgestellten randomisierten, doppelblinden, Placebo-kontrollierten Studie konnte kein Effekt des Verschlusses eines PFO auf die Beschwerdefreiheit von Migräne nachgewiesen werden, allerdings zeigte sich auch hier ein signifikanter Rückgang der Migränefrequenz nach dem Verschluss. Weitere Studien bleiben abzuwarten. Bis dahin kann der Verschluss eines PFO zur Behandlung der Migräne nicht empfohlen werden.

Summary

Case reports on the relief of migraine after closure of a patent foramen ovale (PFO) have lead to epidemiological and therapeutic studies on this association. It has been shown that the prevalence of PFO in migraine patients is about double as high as in the normal population. Retrospective open studies showed improvement of migraine frequency by more than 70% after closure of PFO. A very recently reported randomized double-blind, placebo-controlled trial could not confirm the efficacy of PFO closure with respect to absence of migraine. However, also in this study a significant decrease of migraine frequency was noted. Further studies are warranted. Meanwhile, the closure of PFO in order to treat migraine cannot be recommended.

Schlüsselwörter

Migräne - offenes Foramen ovale - Katheterverschluss

Keywords

Migraine - patent foramen ovale - catheter closure
 

  • Literatur

  • 1 Anzola GP, Magoni M, Guindani M, Rozzini L, Dalla GVolta. Potential source of cerebral embolism in migraine with aura: a transcranial Doppler study. Neurology 1999; 52: 1622-5.
    CrossrefPubMedGoogle Scholar
  • 2 Anzola GP, Frisoni GB, Morandi E, Casilli F, Onorato E. Shunt-associated migraine responds favorably to atrial septal repair: a case-control study. Stroke 2006; 37: 430-4.
    CrossrefPubMedGoogle Scholar
  • 3 Azarbal B, Tobis J, Suh W, Chan V, Dao C, Gaster R. Association of interatrial shunts and migraine headaches: impact of transcatheter closure. J Am Coll Cardiol 2005; 45: 489-92.
    CrossrefPubMedGoogle Scholar
  • 4 Carod-Artal FJ, da Silveira LRibeiro, Braga H, Kummer W, Mesquita HM, Vargas AP. Prevalence of patent foramen ovale in migraine patients with and without aura compared with stroke patients.A transcranial Doppler study. Cephalalgia 2006; 26: 934-9.
    CrossrefPubMedGoogle Scholar
  • 5 Del Sette M, Angeli S, Leandri M, Ferriero G, Bruzzone GL, Finocchi C, Gandolfo C. Migraine with aura and right-to-left shunt on transcranial Doppler: a case-control study. Cerebrovasc Dis 1998; 08: 327-30.
    CrossrefPubMedGoogle Scholar
  • 6 Engel GL, Webb JP, Ferris EB, Romano J, Ryder H, Blankenhorn MA. A migraine-like syndrome complicating decompression sickness. War Med 1944; 05: 304-14.
    Google Scholar
  • 7 Finocchi C, Del Sette M, Angeli S, Rizzi D, Gandolfo C. Cluster headache and right-to-left shunt on contrast transcranial Doppler: a case-control study. Neurology 2004; 63: 1309-10.
    CrossrefPubMedGoogle Scholar
  • 8 Giardini A, Donti A, Formigari R, Salomone L, Prandstraller D, Bonvicini M, Palareti G, Guidetti D, Gaddi O, Picchio FM. Transcatheter patent foramen ovale closure mitigates aura migraine headaches abolishing spontaneous right-to-left shunting. Am Heart J. 2006 151. 922.e1–5.
    PubMedGoogle Scholar
  • 9 Morandi E, Anzola GP, Angeli S, Melzi G, Onorato E. Transcatheter closure of patent foramen ovale: a new migraine treatment?. J Interv Cardiol 2003; 16: 39-42.
    CrossrefPubMedGoogle Scholar
  • 10 Morelli N, Gori S, Cafforio G, Gallerini S, Baldacci F, Orlandi G, Murri L. Prevalence of rightto-left shunt in patients with cluster headache. J Headache Pain 2005; 06: 244-6.
    CrossrefPubMedGoogle Scholar
  • 11 Mortelmans K, Post M, Thijs V, Herroelen L, Budts W. The influence of percutaneous atrial septal defect closure on the occurrence of migraine. Eur Heart J 2005; 26: 1533-7.
    CrossrefPubMedGoogle Scholar
  • 12 Onorato E, Melzi G, Casilli F, Pedon L, Rigatelli G, Carrozza A, Maiolino P, Zanchetta M, Morandi E, Angeli S, Anzola GP. Patent foramen ovale with paradoxical embolism: mid-term results of transcatheter closure in 256 patients. J Interven Cardiol 2003; 16: 43-50.
    CrossrefPubMedGoogle Scholar
  • 13 Post MC, Letteboer TG, Mager JJ, Plokker TH, Kelder JC, Westermann CJ. A pulmonary right-toleft shunt in patients with hereditary hemorrhagic telangiectasia is associated with an increased prevalence of migraine. Chest 2005; 128: 2485-9.
    CrossrefPubMedGoogle Scholar
  • 14 Post MC, Thijs V, Schonewille WJ, Budts W, Snijder RJ, Plokker HW, Westermann CJ. Embolization of pulmonary arteriovenous malformations and decrease in prevalence of migraine. Neurology 2006; 66: 202-5.
    CrossrefPubMedGoogle Scholar
  • 15 Reisman M, Christofferson RD, Jesurum J, Olsen JV, Spencer MP, Krabill KA, Diehl L, Aurora S, Gray WA. Migraine headache relief after transcatheter closure of patent foramen ovale. J Am Coll Cardiol 2005; 45: 493-5.
    CrossrefPubMedGoogle Scholar
  • 16 Sandler M. Migraine a pulmonary disease?. Lancet 1972; 01: 618-9.
    Google Scholar
  • 17 Schwerzmann M, Nedeltchev K, Lagger F, Mattle HP, Windecker S, Meier B, Seiler C. Prevalence and size of directly detected patent foramen ovale in migraine with aura. Neurology 2005; 65: 1415-8.
    CrossrefPubMedGoogle Scholar
  • 18 Schwerzmann M, Wiher S, Nedeltchev K, Mattle HP, Wahl A, Seiler C, Meier B, Windecker S. Percutaneous closure of patent foramen ovale reduces the frequency of migraine attacks. Neurology 2004; 62: 1399-401.
    CrossrefPubMedGoogle Scholar
  • 19 Sztajzel R, Genoud D, Roth S, Mermillod B, Le Floch-Rohr J. Patent foramen ovale, a possible cause of symptomatic migraine: a study of 74 patients with acute ischemic stroke. Cerebrovasc Dis 2002; 13: 102-6.
    CrossrefPubMedGoogle Scholar
  • 20 Wilmshurst P, Nightingale S. Relationship between migraine and cardiac and pulmonary rightto-left shunts. Clin Sci (Lond) 2001; 100: 215-20.
    CrossrefPubMedGoogle Scholar
  • 21 Wilmshurst PT, Nightingale S, Walsh KP, Morrison WL. Effect on migraine of closure of cardiac right-to-left shunts to prevent recurrence of decompression illness or stroke or for haemodynamic reasons. Lancet 2000; 356: 1648-51.
    CrossrefPubMedGoogle Scholar
  • 22 Wilmshurst PT, Pearson MJ, Nightingale S, Walsh KP, Morrison WL. Inheritance of persistent foramen ovale and atrial septal defects and the relation to familial migraine with aura. Heart 2004; 90: 1315-20.
    CrossrefPubMedGoogle Scholar