Clinicians should be on the look-out for adolescents presenting with recurrent headache who also have asthma and allergic rhinitis as the combination is highly suggestive of migraine, advise Israeli researchers following a large-scale analysis of 17-year olds.
Of 113,671 adolescents in an electronic database of 17-year-old draftees between 1987-2010, 4% were diagnosed with asthma and 1.9% with migraine. Migraine was significantly more prevalent among adolescents with asthma (3.8%) than those without asthma (1.8%) (OR=2.17, 95% CI 1.86-2.55; p<0.001). Rates of migraine among subjects with and without allergic rhinitis were 6.3% and 1.7%, respectively (OR=4.04, 95%CI 3.58-4.56; p<0.001). Multivariate analysis showed a significant association between migraine and both asthma (OR 1.42, 95% CI 1.19-1.68) and allergic rhinitis (OR 3.18, 95% CI 2.80-3.63).
The researchers concluded that adolescents with recurrent headache, asthma and allergic rhinitis warrant a different diagnosis and treatment approach from sinusitis.
Graif Y, Shohat T, Machluf Y et al. Association between asthma and migraine – a cross-sectional study of over 110,000 Adolescents. Clin Respir J. 2018 Jul 13. doi: 10.1111/crj.12939. [Epub ahead of print]