Highly sensitive and specific methods for assaying IgE and IgG4 for antibodies in serum have been developed in order to test a recent suggestion that food allergy is a major cause of migraine. Sera were collected from 208 adults--74 with dietary migraine, 45 with non-dietary migraine, 29 with cluster headache and 60 controls. No significant differences were identified between any of the groups with the one exception that cluster headache patients had significantly raised levels of total serum IgE: this difference may be explained by the high proportion of smokers. Mean IgG4 titres to cheese, milk and chocolate were very similar in the dietary and non-dietary migraine patients and the control subjects, though lower in the cluster headache patients. There was, therefore, no evidence that the food intolerance often associated with migraine headaches is associated with a conventional allergic mechanism.
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