What you need to know about migraine in Hughes syndrome patients.

BACKGROUND

Headache, often migrainous, is common in patients with antiphospholipid antibodies, whether or not they meet Sydney criteria for a definite diagnosis of Hughes syndrome. Migraine may be a harbinger of stroke in this patient population and even refractory migraine may be highly responsive to antithrombotic therapy in this clinical context.

PURPOSE

To summarize what is known to date about managing this important manifestation of the immune-mediated hypercoagulable Hughes syndrome.

RESULTS

We provide a suggested management algorithm for refractory headache in this unique patient population.

CONCLUSION

Most neurologists don't see or recognize many aPL-positive patients in their practice, so hematologists and rheumatologists who see these patients should recognize that refractory headache may be a manifestation of their immune-mediated hypercoagulable disorder and understand that the potential risks of not addressing this issue may be high.