Shibata Yasushi
Department of Neurosurgery, Headache Clinic, Mito Medical Center, University of Tsukuba, Ibaraki 310-0015, Japan.
Neurol Int. 2024 Oct 29;16(6):1279-1284. doi: 10.3390/neurolint16060097.
Anti-calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are clinically effective in preventing the migraine attacks, photophobia, and migraine auras associated with headaches. However, no study has yet investigated the effectiveness of CGRP mAbs in preventing migraine aura without headache.
A female patient of 49 years old presented with a long history (since age 10) of photosensitivity and typical migraine auras without a headache. The symptoms slightly responded to oral medication, lomerizine chloride, but did not completely resolve. Just one day after the administration of galcanezumab, her photo-hypersensitivity and migraine aura had completely resolved. Consequently, the administration of the oral migraine preventive medication was discontinued. Monthly galcanezumab at a dose of 120 mg was continuously given and she did not re-experience any auras or headaches.
The use of CGRP mAbs can be considered as a potential treatment in preventing migraine aura without headache. Currently, CGRP mAb is indicated only for migraines with and without auras. Given our findings and the promising effects of this medication for this migraine subtype, a large clinical trial is required to better assess the effects and potential adverse events of CGRP mAb in patients with migraine aura without headache.
抗降钙素基因相关肽单克隆抗体（CGRP单克隆抗体）在预防与头痛相关的偏头痛发作、畏光和偏头痛先兆方面具有临床疗效。然而，尚无研究调查CGRP单克隆抗体在预防无头痛的偏头痛先兆方面的有效性。
一名49岁女性患者有长期（自10岁起）的光敏性和典型的无头痛偏头痛先兆病史。症状对口服药物氯美噻唑有轻微反应，但未完全缓解。在使用加卡尼单抗一天后，她的光敏性和偏头痛先兆完全缓解。因此，停用了口服偏头痛预防药物。持续每月给予120mg加卡尼单抗，她没有再次出现任何先兆或头痛。
CGRP单克隆抗体的使用可被视为预防无头痛偏头痛先兆的一种潜在治疗方法。目前，CGRP单克隆抗体仅适用于有或无先兆的偏头痛。鉴于我们的研究结果以及该药物对这种偏头痛亚型的良好效果，需要进行大规模临床试验，以更好地评估CGRP单克隆抗体对无头痛偏头痛先兆患者的疗效和潜在不良事件。
