Serum Homocysteine In Patients With Migraine Headache At Kenyatta National Hospital.

Abstract

Migraine is a common disorder characterized by recurrent disabling attacks of headache associated with nausea, vomiting, and hypersensitivity to light, sound, and smell and in a third of patients, neurological aura symptoms usually consisting of visual disturbance. Significant genetic mechanisms underlie its aetiology. Homozygous C677T mutation in the MTHFR gene is a genetic risk factor for migraine. These homozygotes have elevated blood homocysteine levels.

The purpose of this study was to measure serum homocysteine as a marker of C677T mutation in the MTHFR gene in patients with migraine as compared with controls in our setup.

The study was a cross-sectional descriptive survey.

Kenyatta National Hospital adult neurology clinic, medical outpatient clinics, medical wards and the accident and emergency department

All patients in the above departments with headache consistent with migraine in accordance with the international headache society diagnostic criteria and who fit the other eligibility criteria were included in the study. We studied 50 migraine patients aged between 18 to 58 years. The mean age was 33.5 and a median of32.0 (27.0-40.0). The mode was 40. The males were 320/0and the females were 680/0.

All patients with headache were interviewed and examined. Those who met the international headache society diagnostic criteria for migraine and consented to the study were guided by the investigator to fill a study questionnaire. Homocysteine assay was then performed on each of the cases. Control group was picked from patients' non related escorts and from gynaecological and surgical outpatient clinics. They were matched for age to the nearest year and for gender.

The Statistical Package for Social Sciences version 14.2 software for windows was used to analyze the data.

A total of 50 patients were recruited in the study. 580/0had migraine with aura, 38%had migraine without aura and 40/0had catamenial form of migraine variant. Onepatient had a seizure complication. When we did homocysteine assay we found no difference between the cases and the controls. The mean homocysteine in test subjects was 21.8~mol/1 and in the controls was 21.1~mol with a p-value of 0.770. The median in test subjects was 2l.1 (13.9-28.8) whereas in controls it was 20.7 (12.8-27.6).

There is no association between migraine and hyperhomocysteinemia and by extension the C677T gene mutation in our setup.