INVESTIGATION OF LATE-ONSET MIGRAINE

Sixty-nine patients presenting with migraine, with or without aura, af ter age 40 were investigated with CT or MRI brain scanning, carotid ul trasound and serum antibody studies. A 2:1 female:male predominance wa s found, the mean age of presentation being 51.6 years. Migraine with aura was reported in 86% of patients: 46% of the females had active me nopausal symptoms. No significant haematological or serological abnorm alities were detected. CT or MRI brain imaging was normal in 93% of ca ses; 4 patients had evidence of cerebral infarction. No cerebral tumou r or vascular malformation was found Three patients had evidence of mi ld - moderate carotid atheroma on ultrasound scanning. Routine detaile d investigation of late-onset migraine is unlikely to be of value unle ss the history is atypical or abnormalities are present on clinical ex amination.