Preventing disturbing migraine aura with lamotrigine: an open study.
BACKGROUND
Lamotrigine has been suggested as possibly effective for preventing migraine aura.


OBJECTIVE
To describe our experience with a series of patients with disturbing migraine aura treated with lamotrigine.


METHODS
The members of the Headache Group of the Spanish Society of Neurology were sent an ad hoc questionnaire to collect patients treated with lamotrigine due to disturbing migraine aura. The main outcome parameter ("response") was a >50% reduction in the mean frequency of migraine auras at 3 to 6 months of treatment.


RESULTS
A total of 47 patients had been treated with lamotrigine due to severe migraine aura. Three could not complete the protocol as a result of developing skin rashes. Thirty (68%) patients responded. These were 21 females and 9 males whose ages ranged from 19 to 71 years. Eight suffered from migraine with "prolonged" aura, 8 typical aura with migraine headache (but had frequent episodes including speech symptoms), 6 basilar-type migraine, 6 typical aura without headache, and 2 hemiplegic migraine. Fifteen had been previously treated, without response, with other preventatives. The mean monthly frequency of migraine auras in these 30 patients changed from 4.2 (range: 1 to 15) to 0.7 (range: 0 to 6). Response was considered as excellent (>75% reduction) in 21 cases (70% of responders). Auras reappeared in 2 months in 9 out of 13 patients where lamotrigine was stopped, and ceased as soon as this drug was reintroduced.


CONCLUSIONS
Lamotrigine should be considered in clinical practice for the preventive treatment of selected patients with disturbing migraine auras. Lamotrigine seems worthy of a controlled trial as prophylaxis of migraine aura.
Pascual
Julio
J
University Hospital M. de Valdecilla, Neurology, Santander, Cantabria, Spain.
Caminero
Ana B
AB
Mateos
Valentín
V
Roig
Carlos
C
Leira
Rogelio
R
García-Moncó
Carlos
C
Laínez
Miguel J
MJ
D000328:Adult; D000368:Aged; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D020325:Migraine with Aura / Q000517:prevention & control*; D016896:Treatment Outcome; D014227:Triazines / Q000009:adverse effects / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D014227:Triazines; D000077213:Lamotrigine