Influence of physiologic hormonal modification and of hormonal treatment in a patient with a history of migraine with aura.
We present the case of 48-year-old woman suffering from migraine with aura (MA) since menarche. During her life the patient frequently presented catamenial MA attacks with an increasing frequency during pregnancy in particular in the second and third trimesters, and then during breast-feeding. Treatment with oral contraceptive (OC) for endometriosis and later with cyclophosphamide, methotrexate, fluorouracil (CMF) for breast cancer produced a higher number of attacks. Instead, she referred an improvement with gonadotropin releasing hormone agonist (GnRH-a) for the treatment of endometriosis and then with tamoxifen as hormonal therapy after mastectomy and chemotherapy for breast cancer. We highlight the importance of physiological hormonal modification and hormonal therapies on the course of MA.
Maggioni
Ferdinando
F
Headache Centre, Department of Neurosciences, University of Padua, Padua, Italy. ferdinando.maggioni@unipd.it
Palmieri
Antonio
A
Tropea
Michele
M
Zanchin
Giorgio
G
D000639:Amitriptyline / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000009:adverse effects; D004715:Endometriosis / Q000188:drug therapy; D005260:Female; D005444:Flunarizine / Q000627:therapeutic use; D005472:Fluorouracil / Q000009:adverse effects; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects; D008875:Middle Aged; D020325:Migraine with Aura / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology*; D011247:Pregnancy; D020845:Selective Estrogen Receptor Modulators / Q000627:therapeutic use; D013629:Tamoxifen / Q000627:therapeutic use; D017329:Triptorelin Pamoate / Q000627:therapeutic use
D000700:Analgesics; D018931:Antineoplastic Agents, Hormonal; D003278:Contraceptives, Oral, Hormonal; D020845:Selective Estrogen Receptor Modulators; D017329:Triptorelin Pamoate; D013629:Tamoxifen; D000639:Amitriptyline; D007987:Gonadotropin-Releasing Hormone; D003520:Cyclophosphamide; D005444:Flunarizine; D005472:Fluorouracil; D008727:Methotrexate