Neuromuscular transmission in migraine patients with prolonged aura

P/Q Ca2+ channels are genetically abnormal in most cases of familial hemipl egic migraine (FHM): and may be involved in other types of migraine. They a re also found at the neuromuscular junctions, where they control stimulatio n-induced acetylcholine release. Prolonged aura is a very frequent clinical feature in FHM patients. The objective of this study was thus to explore n euromuscular transmission in migraine with typical and prolonged aura patie nts. We performed single fiber electromyography (SFEMG) in such patients an d compared them to a group of healthy volunteers. Results were expressed as mean jitter (MCD) and percentage of single endplate abnormalities. Mean MC D was on average comparable in controls and migraineurs. By contrast, singl e endplate abnormalities were only found in patients (p <0.01), especially in those with prolonged aura (p <0.001). These results suggest subtle impai rment of neuromuscular transmission in a subgroup of migraineurs characteri zed by prolonged aura, which might be due to dysfunctioning P/Q Ca2+-channe ls.