Migraine Headache Confounding the Diagnosis of Acute Mountain Sickness

Karle, Francis J.; Auerbach, Paul S.

doi:10.1016/j.wem.2013.10.006

Cited by 12 publications

(4 citation statements)

References 28 publications

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“…During a mountain medicine consultation, it is common to evaluate people with migraine who ask advice for traveling at HA or who have already experienced a worsening of their headache. It is not easy to distinguish between HAH also associated with AMS and migraine crises, 109 therefore a neurologist with specific experience is needed. The presence of additional symptoms in AMS may help since the Lake Louise score define AMS as the presence of headache plus one or more adjunctive symptoms (anorexia, nausea/vomiting, fatigue, dizziness/vertigo) in an unacclimatized person who rapidly ascend >2500 m. Headache is usually bilateral and described as stabbing or dull pain whereas migraine typically is unilateral and describes as throbbing or pulsing pain.…”

Section: Literature and Research Methodsmentioning

confidence: 99%

Recommendations for traveling to altitude with neurological disorders

Falla

Giardini²,

Angelini

2021

J Cent Nerv Syst Dis

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Background Several neurological conditions might worsen with the exposure to high altitude (HA). The aim of this review was to summarize the available knowledge on the neurological HA illnesses and the risk for people with neurological disorders to attend HA locations. Methods A search of literature was conducted for several neurological disorders in PubMed and other databases since 1970. The neurological conditions searched were migraine, different cerebrovascular disease, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, delirium, dementia, and Parkinson’s disease (PD). Results Attempts were made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation and advice for or against traveling to altitude. Individual cases should be advised after careful examination and risk evaluation performed either in an outpatient mountain medicine service or by a physician with knowledge of HA risks. Preliminary diagnostic methods and anticipation of neurological complications are needed. Conclusions Our recommendations suggest absolute contraindications to HA exposure for the following neurological conditions: (1) Unstable conditions–such as recent strokes, (2) Diabetic neuropathy, (3) Transient ischemic attack in the last month, (4) Brain tumors, and 5. Neuromuscular disorders with a decrease of forced vital capacity >60%. We consider the following relative contraindications where decision has to be made case by case: (1) Epilepsy based on recurrence of seizure and stabilization with the therapy, (2) PD (± obstructive sleep apnea syndrome-OSAS), (3) Mild Cognitive Impairment (± OSAS), and (4) Patent foramen ovale and migraine have to be considered risk factors for acute mountain sickness.

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Section: Literature and Research Methodsmentioning

confidence: 99%

Recommendations for traveling to altitude with neurological disorders

Falla

Giardini²,

Angelini

2021

J Cent Nerv Syst Dis

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“…21 Although we observed a fall-off in incidence even during the first 12 months, this does not establish the extent of acclimatization associated with intermittent high altitude exposure. Finally, there were certain risk factors that we were unable to take into account; for example, history of migraine headache (a risk factor for AMS in other studies) 22 or rapidity of ascent (all of the workers studied travel up to the site in the same commuting arrangement). 23…”

Section: Limitationsmentioning

confidence: 95%

Smoking Increases the Risk of Acute Mountain Sickness

Vinnikov

Brimkulov

Blanc

2015

Wilderness & Environmental Medicine

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“… 22 , 23 While the place of headache in the diagnosis of AMS is being debated, an algorithm has been developed for assessing individuals with headache at altitude, using a pragmatic approach, taking into account a past medical history of headache-associated illness and other features consistent with AMS. 24 …”

Section: Diagnosis Of Amsmentioning

confidence: 99%

Wilderness medicine at high altitude: recent developments in the field

Shah

Hussain

Cooke

et al. 2015

OAJSM

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Travel to high altitude is increasingly popular. With this comes an increased incidence of high-altitude illness and therefore an increased need to improve our strategies to prevent and accurately diagnose these. In this review, we provide a summary of recent advances of relevance to practitioners who may be advising travelers to altitude. Although the Lake Louise Score is now widely used as a diagnostic tool for acute mountain sickness (AMS), increasing evidence questions the validity of doing so, and of considering AMS as a single condition. Biomarkers, such as brain natriuretic peptide, are likely correlating with pulmonary artery systolic pressure, thus potential markers of the development of altitude illness. Established drug treatments include acetazolamide, nifedipine, and dexamethasone. Drugs with a potential to reduce the risk of developing AMS include nitrate supplements, propagators of nitric oxide, and supplemental iron. The role of exercise in the development of altitude illness remains hotly debated, and it appears that the intensity of exercise is more important than the exercise itself. Finally, despite copious studies demonstrating the value of preacclimatization in reducing the risk of altitude illness and improving performance, an optimal protocol to preacclimatize an individual remains elusive.

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Migraine Headache Confounding the Diagnosis of Acute Mountain Sickness

Cited by 12 publications

References 28 publications

Recommendations for traveling to altitude with neurological disorders

Recommendations for traveling to altitude with neurological disorders

Smoking Increases the Risk of Acute Mountain Sickness

Wilderness medicine at high altitude: recent developments in the field

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