CherubinoDi Lorenzo, University Centre for Adaptive Disorders and Headache (UCADH), University of Rome, via Franco Faggiana, 3404100 Latina, Italycherub@inwind.it
Submitted July 22, 2009
I thank Brenner for his comments on our article. However, pending further research on metabolic enhancers and other preventive anti-migraine treatments, it is not possible to comment on his assertions.
The reduction of nonspecific white matter lesions (WML), typical in the migraineur brain, might be considered as another possible outcome for high-dose riboflavin prolonged treatment. WML have to be distinguished by mitochondrial encephalopathy with lactic acidosis, stroke-like episodes (MELAS), or other forms of leukoencephalopathy and vasculitis. [5] WLM could have a mitochondrial pathogenesis, and a treatment with metabolic enhancers could be effective to reduce them, confirming the theory regarding their pathogenesis.
Our experience shows that long-term treatment with high-dose riboflavin has been safe. We have treated patients for both mitochondriopathy and migraine without major complications. These observations are consistent with Brenner’s suggestion regarding lifelong treatment to prevent chronic migraine.
Reference
5. Porter A, Gladstone JP, Dodick DW. Migraine and white matter hyperintensities. Curr Pain Headache Rep. 2005;9:289-293.
I thank Brenner for his comments on our article. However, pending further research on metabolic enhancers and other preventive anti-migraine treatments, it is not possible to comment on his assertions.
The reduction of nonspecific white matter lesions (WML), typical in the migraineur brain, might be considered as another possible outcome for high-dose riboflavin prolonged treatment. WML have to be distinguished by mitochondrial encephalopathy with lactic acidosis, stroke-like episodes (MELAS), or other forms of leukoencephalopathy and vasculitis. [5] WLM could have a mitochondrial pathogenesis, and a treatment with metabolic enhancers could be effective to reduce them, confirming the theory regarding their pathogenesis.
Our experience shows that long-term treatment with high-dose riboflavin has been safe. We have treated patients for both mitochondriopathy and migraine without major complications. These observations are consistent with Brenner’s suggestion regarding lifelong treatment to prevent chronic migraine.
Reference
5. Porter A, Gladstone JP, Dodick DW. Migraine and white matter hyperintensities. Curr Pain Headache Rep. 2005;9:289-293.
Disclosure: The author reports no disclosures.