title: Does pramipexole treatment improve headache in patients with concomitant migraine and restless legs syndrome?
abstract: BACKGROUND
  Recent studies have suggested a strong link between migraines and restless legs syndrome (RLS). It is possible that these disorders share a dopaminergic dysfunction in the hypothalamic A11 nucleus that contributes to this association. However, there have been no clinical studies to evaluate the effect of dopaminergic treatment on migraine symptoms in patients with concomitant migraines and RLS.
  
  
  METHODS
  We present an illustrative patient with concomitant RLS and migraine who showed improvement in her headache frequency and RLS symptoms following immediate-release pramipexole (P-IR) treatment and provide review results from the medical records of patients who experienced both migraines and RLS in our previous cross-sectional study.
  
  
  RESULTS
  Ten patients (nine patients from the previously completed single-center study) received P-IR treatment were included in the study. RLS symptoms improved markedly in all of the subjects. Five out of the 10 patients (50%) reported improvement in migraine headaches. Of these five patients, four (80%) had reported morning headaches before P-IR treatment.
  
  
  CONCLUSIONS
  Our results indicate that the identification of RLS in migraine patients is clinically significant and that dopaminergic treatment may improve both migraines, particularly morning headache (80% improvement in this study), and RLS symptoms. However, further clinical studies are warranted to verify our results.
authors.affiliation: Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Suzuki
authors.forename: Shiho
authors.initials: S
authors.lastname: Suzuki
authors.forename: Masayuki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Ayaka
authors.initials: A
authors.lastname: Numao
authors.forename: Yuka
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Ryotaro
authors.initials: R
authors.lastname: Takashima
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
keywords: Pramipexole; dopaminergic dysfunction; migraine; morning headache; restless legs syndrome