Change in the biologic pattern of the migraine with aura after the use of tetrabenazine: case report

ELCIO JULIATO PIOVESAN, MARCOS CRISTIANO LANGE, HÉLIO AURÉLIO GHIZONI TEIVE, CLÁUDIO ESTEVES TATSUI, PEDRO ANDRÉ KOWACS, LICIANE MAIA PIOVESAN, LINEU CESAR WERNECK

The influence of the dopaminergic system on the pathophysiology of migraine has been suggested as a result of recent genetic discoveries. A possible hyper-reactivity of the dopaminergic receptors DRD2 reinforced the evidence regarding this. We describe a 31 years-old male patient affected by a generalized dystonia secondary to perinatal hypoxia. At age 16, the patient started having headache crises that met the criteria for migraine with aura. After three years of treatment for dystonia with tetrabenazine, a clear reduction in the frequency, intensity and duration of the crises was perceived. During two periods longer than two months, the interruption of the treatment with tetrabenazine brought about an aggravation of the migraine crises. We present this case as being the first description in the literature showing the beneficial effects of tetrabenazine, a blocker of dopaminergic receptors, on the behavior of migraine with aura.