Increased prevalence of migraine in Marfan syndrome

Objective: A high prevalence of migraine has been described in various forms of congenital heart disease, with and without shunt. In this study we investigated the prevalence of migraine in patients with Marfan syndrome (MFS). Methods: All 457 adult patients with MFS from the participating centres and 194 controls received a validated questionnaire about headache. Migraine was diagnosed according to the International Headache Society criteria, by three independent neurologists, blinded to patient files. Results: Response rate was 68% and 56% in Marfan patients and controls, respectively. Forty percent of the 309 responding MFS patients (mean age 40 ± 14 years; 51% females) and 28% of the 102 controls (mean age 43 ± 15 years; 58% females), suffered from migraine (p = 0.03). The prevalence of migraine with aura (MA) was 22% in MFS patients and 14% in controls (p = 0.06). We found MFS to be an independent risk factor for having overall migraine (OR 1.7; 95%CI 1.1-2.8), also after adjustment for age and gender (OR 1.9; 95%CI 1.1-3.1; p = 0.02) and for MA after adjustment for gender (OR 2.0; 95%CI 1.1-3.7; p = 0.04). In patient with MFS, previous aortic root surgery appeared to be an independent risk factor for having MA (OR 2.2; 95%CI; 1.2.-4.0, p = 0.01) adjusted for gender. Conclusion: MFS is an independent risk factor for having overall migraine and MA. Moreover, we found that a history of aortic root surgery seems to be associated with an increased risk of MA.