Tanasescu, R.; Nicolau, Adriana; Ticmeanu, Marina; Cojocaru, Inimioara; Ene, Amalia; Caraiola, Simona; Ionescu, R.; Baicus, C.
June 2007
Romanian Journal of Neurology;Jun2007, Vol. 6 Issue 2, p71
Academic Journal
The antiphospholipid syndrome (APS) is defined by the constant presence of antiphospholipid antibodies (aPL), together with diverse systemic clinical manifestations such as thrombosis, and recurrent spontaneous abortions. By the actual classification criteria, the only neurological manifestation diagnostic of APS is ischemic stroke. However, other neurological manifestations have been repeatedly reported in case studies of APS patients. Among these manifestations, headache and especially migraine was commonly reported in APS patients and is one of the classical features described by Hughes as related to aPL. However, controversies were raised by studies who failed to confirm this association. We studied the association between aPL and headache syndromes in a retrospective manner in 428 patients with inflammatory connective tissue diseases. We found that migraine alone, not headache all types, is significantly associated with aPL in patients with systemic immune disease. The presence of cerebral ischemia was also studied in patients with headache and aPL. In SLE patients, headache (all types) is significantly associated with positive titers of aPL, and cerebral ischemic lesions are significantly encountered. Even that the association migraine - aPL can be explained also by their separate high frequency in patients with immune systemic disease, the association of ischemic lesions in these patients suggest the need to define a sub-group at risk, for whom headache can be a marker and anticoagulants can be discussed.


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