Comorbidity of Migraine with Asthma and Other Atopic Disorders

  • Aynur Özge
  • Kentaro Kuwabara
Part of the Headache book series (HEAD)


Migraine headache and atopic disorders including asthma are both common functional syndromes of childhood in which nature of the relationship is still debated. Attacks may induce in both disorders upon exposure to potential triggers to attacks in genetically susceptible individuals. Clinical phenotype of both disorders manifests by temporary dysfunction of target tissue mediated by inflammation triggered by specific agents. Clinical features also changes after puberty due to the partial effect of female sex hormones on the process. Appropriate definition of the syndrome and differentiating from other disorders are necessary not only for correct diagnosis but also for planning of management strategies in children and adolescents. Allergic rhinosinusitis needs to be differentiated specifically from migraine even in experienced clinics. Questioning the presence of cranial autonomic symptoms is important clue in the differential diagnosis. Atopic disorder screening is particularly required in the diagnosis of migraine in childhood and adolescents. The link between both disorders of childhood seems to be far from a coincidence and some common inflammatory mechanisms are shared.

 As for conclusion, based on clinical features, laboratory findings and some practical clues in children and adolescents, accurate diagnosis of migraine and atopic disorders are very critical for physicians, pediatricians and algologists. This chapter focuses on the causal and clinical associations of migraine and atopic disorders, with supporting data from specific investigations of each of the disorders.


Migraine Atopic disorders Asthma Atopic dermatitis Rhinosinusitis Conjunctivitis Inflammation Comorbidity 


  1. 1.
    Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd edition (beta version). Cephalalgia. 2013; 33(9):629–808.Google Scholar
  2. 2.
    Özge A, Yalin OÖ. Chronic migraine in children and adolescents. Curr Pain Headache Rep. 2016;20(2):14.CrossRefPubMedGoogle Scholar
  3. 3.
    Ozge A, Ozge C, Oztürk C, et al. The relationship between migraine and atopic disorders—the contribution of pulmonary function tests and immunological screening. Cephalalgia. 2006;26(2):172–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Gryglas A. Allergic rhinitis and chronic daily headaches: is there a link? Curr Neurol Neurosci Rep. 2016;16:33.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Sillanpää M, Aro H. Headache in teenagers: comorbidity and prognosis. Funct Neurol. 2000;15(Suppl 3):116–21.PubMedGoogle Scholar
  6. 6.
    Artto V, Wessman M, Nissilä M, et al. Comorbidity in Finnish migraine families. J Headache Pain. 2006;7(5):324–30.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Eidlitz-Markus T, Zolden S, Haimi-Cohen Y, Zeharia A. Comparison of comorbidities of migraine and tension headache in a pediatric headache clinic. Cephalalgia. 2016 Sep 1. pii: 0333102416665870Google Scholar
  8. 8.
    Almqvist C, Bradding PB, Chakir J, et al. Developments in the field of allergy in 2008 through the eyes of Clinical & Experimental Allergy. Clin Exp Allergy. 2009;39(10):1482–98.CrossRefPubMedGoogle Scholar
  9. 9.
    Zannolli R, Morgese G. Does puberty interfere with asthma? Med Hypotheses. 1997;48(1):27–32.CrossRefPubMedGoogle Scholar
  10. 10.
    Muñoz-Jareño N, Fernández-Mayoralas DM, Martínez-Cervell C, Campos-Castelló J. Relationship between migraine and atopy in childhood: a retrospective case-control study. Rev Neurol. 2011;53(12):713–20.PubMedGoogle Scholar
  11. 11.
    Mortimer MJ, Kay J, Gawkrodger DJ, Jaron A, Barker DC. The prevalence of headache and migraine in atopic children: an epidemiological study in general practice. Headache. 1993;33(8):427–31.CrossRefPubMedGoogle Scholar
  12. 12.
    Özge A, Öksüz N, Ayta S, et al. Atopic disorders are more common in childhood migraine and correlated headache phenotype. Pediatr Int. 2014;56(6):868–72.CrossRefPubMedGoogle Scholar
  13. 13.
    Noseda R, Burstein R. Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, CSD, sensitization and modulation of pain. Pain. 2013;154 Suppl 1.Google Scholar
  14. 14.
    Davey G, Sedwick P, Maier W, Visick G, Strachan DP, Anderson HR. Association between migraine and asthma: matched case-control study. Br J Gen Pract. 2002;52:723–7.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Hestbaek L, Leboeuf-Yde C, Kyvik KO, et al. Comorbidity with low back pain: a cross-sectional population-based survey of 12- to 22-year-olds. Spine. 2004;29(13):1483–91.CrossRefPubMedGoogle Scholar
  16. 16.
    Silverberg JI. Association between childhood eczema and headaches: an analysis of 19 US population-based studies. J Allergy Clin Immunol. 2016;137:492–9.CrossRefPubMedGoogle Scholar
  17. 17.
    Ronchetti R, Villa MP, Matricardi PM, et al. Association of asthma with extra-respiratory symptoms in schoolchildren: two cross-sectional studies 6 years apart. Pediatr Allergy Immunol. 2002;13(2):113–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Özge A, Öztürk C, Dora B, et al. Is there an association between migraine and atopic disorders? The results of multicenter migraine attack study. J Neurol Sci (Turkish). 2008;25(3):136–47.Google Scholar
  19. 19.
    Yilmaz IA, Ozge A, Erdal ME, Edgünlü TG, Cakmak SE, Yalin OO. Cytokine polymorphism in patients with migraine: some suggestive clues of migraine and inflammation. Pain Med. 2010;11(4):492–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Kaleagasi H, Özgür E, Özge C, Özge A. Bronchial hyper-reactivity in migraine without aura: is it a new clue for inflammation? Headache. 2011;51(3):426–31.CrossRefPubMedGoogle Scholar
  21. 21.
    Saunes M, Smidesang I, Holmen TL, Johnsen R. Atopic dermatitis in adolescent boys is associated with greater psychological morbidity compared with girls of the same age: the Young-HUNT study. Br J Dermatol. 2007;156:283–8.CrossRefPubMedGoogle Scholar
  22. 22.
    Strachan DP, Butland BK, Anderson HR. Incidence and prognosis of asthma and wheezing illness from early childhood to age 33 in a national British cohort. BMJ. 1996;312:1195–9.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Martin VT, Taylor F, Gebhardt B, et al. Allergy and immunotherapy: are they related to migraine headache? Headache. 2011;51(1):8–20.CrossRefPubMedGoogle Scholar
  24. 24.
    Lateef TM, Merikangas KR, He J, et al. Headache in a national sample of American children: prevalence and comorbidity. J Child Neurol. 2009;24(5):536–43.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Alpay K, Ertas M, Orhan EK, et al. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010;30:829–37.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Cady RK, Schreiber CP. Sinus headache or migraine? Considerations in making a differential diagnosis. Neurology. 2002;58(9 Suppl 6):S10–4.CrossRefPubMedGoogle Scholar
  27. 27.
    Lai TH, Fuh JL, Wang SJ. Cranial autonomic symptoms in migraine: characteristics and comparison with cluster headache. J Neurol Neurosurg Psychiatry. 2009;80:1116–9.CrossRefPubMedGoogle Scholar
  28. 28.
    Riesco N, Pérez-Alvarez AI, Verano L, et al. Prevalence of cranial autonomic parasympathetic symptoms in chronic migraine: usefulness of a new scale. Cephalalgia. 2016;36(4):346–50.CrossRefPubMedGoogle Scholar
  29. 29.
    Rosario D, Pinto G. Role of gender and serum immunoglobulin E (IGE) levels on severity of migraine. J Clin Diagn Res. 2014;8(2):57–8.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Ference EH, Tan BK, Hulse KE, Chandra RK, Smith SB, Kern RC. Commentary on gender differences in prevalence, treatment, and quality of life of patients with chronic rhinosinusitis. Allergy Rhinol. 2015;6:e82–8.CrossRefGoogle Scholar
  31. 31.
    Guven H, Cilliler AE, Comoglu SS. Unilateral cranial autonomic symptoms in patients with migraine. Acta Neurol Belg. 2013;113:237–42.CrossRefPubMedGoogle Scholar
  32. 32.
    Kari E, DelGaudio JM. Treatment of sinus headache as migraine: the diagnostic utility of triptans. Laryngoscope. 2008;118:2235–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Professor of Neurology, Department of Neurology, Algology and Clinical NeurophysiologyMersin University School of MedicineMersinTurkey
  2. 2.Department of PediatricsHiroshima City Hiroshima Citizens Hospital 7-33HiroshimaJapan

Personalised recommendations