Headaches linked to painful skin sensations

NEW YORK (Reuters Health) - Many patients with chronic headaches are often overly sensitive to touch and ordinary activities like rubbing the head or combing the hair cause pain, according to findings from the American Migraine Prevalence and Prevention Study.

This problem, technically referred to as "cutaneous allodynia," is nearly twice as common among patients with migraines as among those with other types of headache.

As reported in the journal Neurology, Dr. Marcelo E. Bigal, at Merck Research Laboratories in Whitehouse Station, New Jersey, and his group analyzed questionnaires completed by nearly 17,000 headache sufferers.

Up to 69 percent of migraine patients had cutaneous allodynia, the results indicate, compared with just 37 percent of patients with other types of chronic headache. Severe allodynia was noted in 12 to 29 percent of migraine patients, but in no more than 6 percent of patients with other types of headache.

"Cutaneous allodynia appears to map onto migraine biology and to the migraine spectrum," the authors note.

In all headache types, allodynia was more common among women, and severity was associated with symptoms of depression. In migraine patients, allodynia was associated with high attack frequency, long disease duration, obesity and younger age.

In a journal press release, Bigal suggests that cutaneous allodynia "may be a risk factor for migraine progression, where individuals have migraines on more days than not."

"It may be," he continues, "that individuals with allodynia should be more aggressively treated in order to prevent migraine progression, as well as to decrease this sensitivity on the skin."

SOURCE: Neurology, April 22, 2008.