COLD-INDUCED ACRAL VASOSPASM IN MIGRAINE AS ASSESSED BY NAILFOLD VIDEO-MICROSCOPY - PREVALENCE AND RESPONSE TO MIGRAINE PROPHYLAXIS

In order to learn the prevalence of cold-induced vasospasm in migraine patients, blood cell velocity measurements of finger nailfold capilla ries were performed in 58 consecutive patients suffering from migraine with and without aura. In 5 (8.6%) patients capillaroscopy could not be performed because of reduced nailfold transparency; 21 of the remai ning 53 patients (39.6%) showed blood flow stop due to vasospasm under cold provocation. There was no significant difference (P=0.69) in the occurrence of vasospastic reaction between migraine with (12 of 32 pa tients = 37.5%) and without (9 of 21 patients = 42.9%) aura. The clini cal and capillaroscopic course under migraine prophylaxis was observed in 18 vasospastic patients. After sixteen weeks 14 patients showed go od clinical improvement of their migraine. The vasospastic reaction pe rsisted in only 1 patient. This patient and 3 others with abolished va sospasm were still suffering from migraine. These findings suggest tha t observing blood cell velocity noninvasively in nailfold capillaries under cold provocation could be useful for objectively monitoring the response to prophylactic treatment in migraine patients or for testing new potentially antimigraine drugs.