Relationship between high prolactin levels and migraine attacks in patients with microprolactinoma.
The pathophysiology of pituitary-associated headache is unknown, although structural and functional features of the tumour are proposed mechanisms. The objective of this study was to evaluate whether headache in a population with pituitary micro-adenomas was related to hyperprolactinemia. We recruited 29 patients with microprolactinoma and headache: 16 with migraine (group A) and 13 with tension-type-headache (group B). The prolactin (PRL) levels measured during attacks of headache were significantly higher in nine patients (56%) of group A and in one patient (8%) of group B. In four of the nine patients of group A, PRL increased after thyrotropin-releasing-hormone (TRH) test and induced severe attacks. After dopamine-agonist (DA) treatment, the headache improved in seven (44%) patients of the group A and in two (15%) patients of the group B. Three of the four patients in whom the TRH-test induced headache attacks, improved after DA treatment. We suggest that hyperprolactinemia may contribute to development of pain in migraine subgroups and further TRH-test could be used to predict which patients could benefit by DA therapy.
Bosco
D
D
Operative Unit of Neurology, S Giovanni di Dio Hospital, Via Largo Bologna, 88900 Crotone, Italy. nico_bosco@libero.it
Belfiore
A
A
Fava
A
A
De Rose
M
M
Plastino
M
M
Ceccotti
C
C
Mungari
P
P
Iannacchero
R
R
Lavano
A
A
D000328:Adult; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006966:Hyperprolactinemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000097:blood* / Q000150:complications* / Q000188:drug therapy; D010911:Pituitary Neoplasms / Q000097:blood / Q000150:complications*; D011388:Prolactin / Q000097:blood*; D015175:Prolactinoma / Q000097:blood / Q000150:complications*
D018491:Dopamine Agonists; D011388:Prolactin