Neurological Sciences

, Volume 34, Issue 8, pp 1397–1402 | Cite as

Cutaneous allodynia in patients with episodic migraine

  • Hayat GüvenEmail author
  • Aslı Ece Çilliler
  • Selim Selçuk Çomoğlu
Original Article


Cutaneous allodynia may be observed in patients with migraine and this reflects the central sensitization of the trigeminal neurons. We aimed to investigate the frequency of cutaneous allodynia in patients with episodic migraine and to compare clinical characteristics of migraine patients with and without allodynia. One hundred and eighty-six consecutive patients with episodic migraine attacks were prospectively included in the study. The cutaneous allodynia symptoms that occurred during headache attacks were documented using a questionnaire for assessing cephalic and extracephalic cutaneous allodynia. One hundred and fourteen patients (61.3 %) were observed to develop allodynia during migraine attacks and the ratio of the female gender was found higher among the patients with allodynia (p < 0.001). Migraine disease duration was longer (p = 0.004) and accompanying nausea and phonophobia were more common (p = 0.003 and p = 0.005, respectively) in the patients with allodynia. Menstrually related migraine was found to be associated with both allodynia (p = 0.049) and its severity (p = 0.003). The results of present study revealed that cutaneous allodynia was rather frequent in episodic migraine, particularly in patients having longer disease duration. Higher frequency of allodynia in women and its association with menstrually related migraine may be related to the effects of hormonal factors on cutaneous pain thresholds and central sensitization. Association of nausea and phonophobia with allodynia may be interpreted as the common pathways are shared in the development of these symptoms.


Headache Migraine Cutaneous allodynia Central sensitization 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Goadsby PJ (2005) Migraine, allodynia, sensitisation and all of that…. Eur Neurol 53(1):10–16PubMedCrossRefGoogle Scholar
  2. 2.
    Lipton RB, Bigal ME, Ashina S, Burstein R, Silberstein S, Reed ML, Serrano D, Stewart WF; American Migraine Prevalence Prevention Advisory Group (2008) Cutaneous allodynia in the migraine population. Ann Neurol 63(2):148–158CrossRefGoogle Scholar
  3. 3.
    Lovati C, D’Amico D, Rosa S, Suardelli M, Mailland E, Bertora P, Pomati S, Mariani C, Bussone G (2007) Allodynia in different forms of migraine. Neurol Sci 28(Suppl 2):S220–S221PubMedCrossRefGoogle Scholar
  4. 4.
    LoPinto C, Young WB, Ashkenazi A (2006) Comparison of dynamic (brush) and static (pressure) mechanical allodynia in migraine. Cephalalgia 26(7):852–856PubMedCrossRefGoogle Scholar
  5. 5.
    Bigal ME, Ashina S, Burstein R, Reed ML, Buse D, Serrano D, Lipton RB; AMPP Group (2008) Prevalence and characteristics of allodynia in headache sufferers: a population study. Neurology 70(17):1525–1533CrossRefGoogle Scholar
  6. 6.
    Lovati C, D’Amico D, Bertora P (2009) Allodynia in migraine: frequent random association or unavoidable consequence? Expert Rev Neurother 9(3):395–408PubMedCrossRefGoogle Scholar
  7. 7.
    Tietjen GE, Brandes JL, Peterlin BL, Eloff A, Dafer RM, Stein MR, Drexler E, Martin VT, Hutchinson S, Aurora SK, Recober A, Herial NA, Utley C, White L, Khuder SA (2009) Allodynia in migraine: associated with comorbid pain conditions. Headache 49(9):1333–1344PubMedCrossRefGoogle Scholar
  8. 8.
    Lovati C, D’Amico D, Bertora P, Raimondi E, Rosa S, Zardoni M, Bussone G, Mariani C (2010) Correlation between presence of allodynia and sleep quality in migraineurs. Neurol Sci 31(Suppl 1):S155–S158PubMedCrossRefGoogle Scholar
  9. 9.
    d’Agostino VC, Francia E, Licursi V, Cerbo R (2010) Clinical and personality features of allodynic migraine. Neurol Sci 31(1):S159–S161PubMedCrossRefGoogle Scholar
  10. 10.
    Lovati C, D’Amico D, Bertora P, Rosa S, Suardelli M, Mailland E, Mariani C, Bussone G (2008) Acute and interictal allodynia in patients with different headache forms: an Italian pilot study. Headache 48(2):272–277PubMedCrossRefGoogle Scholar
  11. 11.
    Jakubowski M, Silberstein S, Ashkenazi A, Burstein R (2005) Can allodynic migraine patients be identified interictally using a questionnaire? Neurology 65(9):1419–1422PubMedCrossRefGoogle Scholar
  12. 12.
    Ashkenazi A, Sholtzow M, Shaw JW, Burstein R, Young WB (2007) Identifying cutaneous allodynia in chronic migraine using a practical clinical method. Cephalalgia 27(2):111–117PubMedCrossRefGoogle Scholar
  13. 13.
    Mathew NT, Kailasam J, Seifert T (2004) Clinical recognition of allodynia in migraine. Neurology 63(5):848–852PubMedCrossRefGoogle Scholar
  14. 14.
    Burstein R, Yarnitsky D, Goor-Aryeh I, Ransil BJ, Bajwa ZH (2000) An association between migraine and cutaneous allodynia. Ann Neurol 47(5):614–624PubMedCrossRefGoogle Scholar
  15. 15.
    Guy N, Marques AR, Orliaguet T, Lanteri-Minet M, Dallel R, Clavelou P (2010) Are there differences between cephalic and extracephalic cutaneous allodynia in migraine patients? Cephalalgia 30(7):881–886PubMedGoogle Scholar
  16. 16.
    Schürks M, Diener HC (2008) Migraine, allodynia, and implications for treatment. Eur J Neurol 15(12):1279–1285PubMedCrossRefGoogle Scholar
  17. 17.
    Burstein R, Jakubowski M, Garcia-Nicas E, Kainz V, Bajwa Z, Hargreaves R, Becerra L, Borsook D (2010) Thalamic sensitization transforms localized pain into widespread allodynia. Ann Neurol 68(1):81–91PubMedCrossRefGoogle Scholar
  18. 18.
    Landy S, Rice K, Lobo B (2004) Central sensitisation and cutaneous allodynia in migraine: implications for treatment. CNS Drugs 18(6):337–342PubMedCrossRefGoogle Scholar
  19. 19.
    Goadsby PJ (2007) Recent advances in understanding migraine mechanisms, molecules and therapeutics. Trends Mol Med 13(1):39–44PubMedCrossRefGoogle Scholar
  20. 20.
    Bigal ME, Lipton RB (2011) Migraine chronification. Curr Neurol Neurosci Rep 11(2):139–148PubMedCrossRefGoogle Scholar
  21. 21.
    Aurora SK, Kulthia A, Barrodale PM (2011) Mechanism of chronic migraine. Curr Pain Headache Rep 15(1):57–63PubMedCrossRefGoogle Scholar
  22. 22.
    Edelmayer RM, Vanderah TW, Majuta L, Zhang ET, Fioramanti B, De Felice M, Chichorro JG, Ossipov MH, King T, Lai J, Kori SH, Nelsen AC, Cannon KE, Heinricher MM, Porreca F (2009) Medullary pain facilitating neurons mediate allodynia in headache-related pain. Ann Neurol 65(2):184–193PubMedCrossRefGoogle Scholar
  23. 23.
    Burstein R (2009) Almotriptan efficacy in migraine with developing allodynia is as high as the efficacy in migraine without allodynia–but is it the same in migraine with established allodynia? Headache 49(3):364–365PubMedCrossRefGoogle Scholar
  24. 24.
    Burstein R, Jakubowski M (2010) Managing migraine associated with sensitization. Handb Clin Neurol 97:207–215PubMedCrossRefGoogle Scholar
  25. 25.
    Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders: 2nd edition. Cephalalgia 24(Suppl 1):9–160Google Scholar
  26. 26.
    Young WB, Richardson ES, Shukla P (2005) Brush allodynia in hospitalized headache patients. Headache 45(8):999–1003PubMedCrossRefGoogle Scholar
  27. 27.
    Ashkenazi A, Silberstein S, Jakubowski M, Burstein R (2007) Improved identification of allodynic migraine patients using a questionnaire. Cephalalgia 27(4):325–329PubMedCrossRefGoogle Scholar
  28. 28.
    Gazerani P, Andersen OK, Arendt-Nielsen L (2005) A human experimental capsaicin model for trigeminal sensitization. gender-specific differences. Pain 118(1–2):155–163Google Scholar
  29. 29.
    Palmeira CC, Ashmawi HA, Posso Ide P (2011) Sex and pain perception and analgesia. Rev Bras Anestesiol 61(6):814–828PubMedCrossRefGoogle Scholar
  30. 30.
    Matos R, Wang K, Jensen JD, Jensen T, Neuman B, Svensson P, Arendt-Nielsen L (2011) Quantitative sensory testing in the trigeminal regions: site and gender differences. J Orofac Pain 25(2):161–169PubMedGoogle Scholar
  31. 31.
    Aguggia M, Saracco MG (2010) Pathophysiology of migraine chronification. Neurol Sci 31(Suppl 1):S15–S17PubMedCrossRefGoogle Scholar
  32. 32.
    Kelman L, Tanis D (2006) The relationship between migraine pain and other associated symptoms. Cephalalgia 26(5):548–553PubMedCrossRefGoogle Scholar
  33. 33.
    Ruggiero DA, Underwood MD, Mann JJ, Anwar M, Arango V (2000) The human nucleus of the solitary tract: visceral pathways revealed with an “in vitro” postmortem tracing method. J Auton Nerv Syst 79(2–3):181–190PubMedCrossRefGoogle Scholar
  34. 34.
    Ashkenazi A, Yang I, Mushtag A, Oshinsky ML (2010) Is phonophobia associated with cutaneous allodynia in migraine? J Neurol Neurosurg Psychiatry 81(11):1256–1260PubMedCrossRefGoogle Scholar
  35. 35.
    Bolay H, Reuter U, Dunn AK, Huang Z, Boas DA, Moskowitz MA (2002) Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model. Nat Med 8(2):136–142PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Hayat Güven
    • 1
    Email author
  • Aslı Ece Çilliler
    • 1
  • Selim Selçuk Çomoğlu
    • 1
  1. 1.Ankara Dışkapı Yıldırım Beyazıt Training and Research HospitalSecond Neurology ClinicAnkaraTurkey

Personalised recommendations