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33 The link between migraine and functional neurological disorder
  1. Will Nash,
  2. Jasmine Bavington,
  3. Jan Coeburgh
  1. St George’s, University of London & Department of Neurology, St George’s Hospital, London

Abstract

Objective/Aims To determine the prevalence of migraine in functional neurological disorder (FND) (data still to collect). Of which patients with concomitant migraine and FND, what proportion of’patients have adequate migraine treatment and prophylaxis.

Methods Patient data was collected from clinic letters, ‘migraine’ was cross referenced across all electronic clinic letters from a regional functional neurology clinic between 2018–2019.

The number of patients with and without holistic migraine treatment, appropriate attack treatment and prophylactic treatment was recorded. The predisposing, precipitating and perpetuating factors for patients’ FND was also recorded.

By cross referencing ‘functional neurological disorder’ across the electronic clinic letters over the same period then prevalence data was obtained (data still to collect)

Results 50 patients with FND over the study period were identified to have a history of migraine, with 48 reporting active migraine and 2 reporting previous migraine.

Of these 39 had inadequate attack treatment, and 31 had inadequate migraine prophylaxis.

Migraine is a predisposing, precipitating and largely a perpetuating factor in 6, 8 and 24 FND patients respectively.

Migraine as a contributing perpetuating factor for FND in 24 patients was more common than other factors: 6 patients had anxiety, 5 patients had a mood disorder, and 3 patients had a traumatic life event.

Conclusions There is minimal literature on the link between undertreated migraine and functional neurological disorder.

These results suggest an overall lack of treatment control of migraine in FND patients.

Seeing as migraine can play a role in predisposing, precipitating and perpetuating migraine it shows the importance of treating FND patients holistically.

It shows the importance of early detection, asking FND patients about migraine symptoms and ensuring treatment regimens are in place.

In the future, larger scale research into the link between migraine and FND will improve patient quality of life and how we treat functional neurological disorders.

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