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Abstract
Objective: The aim of our study was to test the hypothesis that ketamine would affect aura in a randomized controlled double-blind trial, and thus to provide direct evidence for the role of glutamatergic transmission in human aura.
Methods: We performed a double-blinded, randomized parallel-group controlled study investigating the effect of 25 mg intranasal ketamine on migraine with prolonged aura in 30 migraineurs using 2 mg intranasal midazolam as an active control. Each subject recorded data from 3 episodes of migraine.
Results: Eighteen subjects completed the study. Ketamine reduced the severity (p = 0.032) but not duration of aura in this group, whereas midazolam had no effect.
Conclusions: These data provide translational evidence for the potential importance of glutamatergic mechanisms in migraine aura and offer a pharmacologic parallel between animal experimental work on cortical spreading depression and the clinical problem.
Classification of evidence: This study provides Class III evidence that intranasal ketamine is effective in reducing aura severity in patients with migraine with prolonged aura.
GLOSSARY
- CSD=
- cortical spreading depression
Footnotes
Go to Neurology.org for full disclosures. Funding information and dislcosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received December 23, 2011.
- Accepted October 10, 2012.
- © 2013 American Academy of Neurology
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