Recurrent syncope, hypotension, asthma, and migraine with aura: role of metoclopramide.
Migraine associated with asthma or symptomatic orthostatic hypotension is a particularly difficult subgroup to manage. Metoclopramide is a useful pharmacological agent for orthostatic hypotension. I present the case report of a migraine patient with asthma and recurrent hypotensive syncope. Metoclopramide relieved recurrent syncope as well as migraine attacks in this patient. Metoclopramide has a striking influence on arginine vasopressin (AVP) secretion. AVP promotes antinociception and influences vasomotor and behavior control, which actions possibly keep migraine in remission. Further studies are necessary to confirm the migraine prophylactic value of metoclopramide.
Gupta
Vinod K
VK
Dubai Police Medical Services, United Arab Emirates.
D000328:Adult; D001127:Arginine Vasopressin / Q000097:blood; D001249:Asthma / Q000150:complications*; D001794:Blood Pressure / Q000187:drug effects; D018492:Dopamine Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000150:complications*; D008787:Metoclopramide / Q000627:therapeutic use*; D008881:Migraine Disorders / Q000150:complications* / Q000188:drug therapy*; D013575:Syncope / Q000150:complications*
D018492:Dopamine Antagonists; D001127:Arginine Vasopressin; D008787:Metoclopramide