Steroids and aseptic osteonecrosis (AON) in migraine patients.
Osteonecrosis is a bony infarction caused by disruption of blood supply to the bone. Aseptic osteonecrosis should be rare with intermittent use of steroids in disabling and refractory migraine cases. We present 3 cases of patients who had severe migraine and developed aseptic osteonecrosis with short-term, intermittent pulse doses of corticosteroids. Migraine has been mentioned as a possible risk factor for aseptic osteonecrosis, and we speculate that severe migraine may be a risk factor for developing aseptic osteonecrosis. Furthermore, migraineurs who develop aseptic osteonecrosis may or may not have associated white matter changes in the brain. We noted a triad of severe migraine, osteonecrosis, and migraine-related white matter lesions in only 1 case. In severe cases of migraine, steroids should be used cautiously.
Hussain
Aamir
A
Department of Neurology, Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Young
William B
WB
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000473:pathology; D010020:Osteonecrosis / Q000139:chemically induced* / Q000473:pathology; D013256:Steroids / Q000009:adverse effects*
D013256:Steroids