RT Journal Article
SR Electronic
T1 A randomized controlled trial of intranasal ketamine in migraine with prolonged aura
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 642
OP 647
DO 10.1212/WNL.0b013e3182824e66
VO 80
IS 7
A1 Shazia K. Afridi
A1 Nicola J. Giffin
A1 Holger Kaube
A1 Peter J. Goadsby
YR 2013
UL http://n.neurology.org/content/80/7/642.abstract
AB 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.CSD=cortical spreading depression