Electromyographical ischemic test, clinical symptoms related to neuromuscular hyperexcitability, and intra- and extracellular Mg++ levels in headache patients

Abstract

We observed the occurrence of neuromuscular hyperexcitability, assessed with electromyographic ischemic tests, in headache patients in relation to Mg++ levels in serum, red blood cells and mononuclear cells. Clinical symptoms most significantly associated with neuromuscolar hyperexcitability and magnesium derangements were also investigated. A total of 36 patients with migraine without aura (MwoA), 18 patients with episodic tension-type headache (ETTH) and 22 patients with chronic tension-type headache (CTTH) were examined during interictal periods. The electromyographic (EMG) ischemic test was positive in 91.7% of MwoA patients, in 27.7% of ETTH and in 13.6% of CTTH patients. In patients with MwoA, the Mg++ levels in red blood cells were significantly less than those in the other two groups of patients with tension-type headache (ANOVA, p<0.001). Positive EMG ischemic tests were significantly associated with decreased erythrocyte Mg++ levels in MwoA patients (χ2, p<0.01). The clinical symptoms in patients with MwoA most frequently suggest the presence of neuromuscular hyper-excitability and are more strictly associated with reduced red blood cell Mg++ levels. They include fasciculations (91.7%), asthenia (91.7%), blepharospasm (75.8%) and paresthesiae (47.2%). Anxiety and depression most often occurred in tension-type headache patients, but were not related to modifications in intra- and extracellular Mg++ levels.