Are Carpal Tunnel Syndrome and Migraine Related?

Background: Compression neuropathies have previously been associated with one another. Migraine has not been considered a type of compression neuropathy but, some recent studies found that some types of migraines may be treated by targeted peripheral nerve decompression. So, the association between migraines and carpal tunnel syndrome (CTS), {the most common compression neuropathy} may exists.

Objective: The aims of this study are to found whether there is a relationship between carpal tunnel syndrome and migraine, and if so to determine the factors causing this relationship.

Methods: The present study is a cross-sectional case control study of 120 patients with CTS in addition to age and sex matched 120 healthy controls. It was conducted at Mansoura University Hospitals, Egypt in the period from July, 2017 through June, 2018. All subjects underwent neurological examination, nerve conduction study of median nerve bilaterally, and evaluation according to headache by the International Headache Society, 2016 criteria. Also, the clinical severity of CTS was assessed and calculation of body mass index (BMI) was done. Evaluation of patients by Boston questionnaire form (BQF) {composed of two parts, Symptom Severity Scale (SSS) and the Functional Status Scale (FSS)}. Lastly, assessment of patients by Beck Depression Inventory (BDI).

Results: Patients had significantly higher rates of migraine headache (28.3 %) either alone (17.5 %) or combined with tension headache (10.8 %) when compared to controls. No statistically significant differences were found between the studied groups regarding the frequency of isolated tension headache. However, the total rate of cases with tension headache (n=43) including those in association with migraine is significantly higher in patients when compared to controls. Patients had significantly higher rates of various grades of symptoms severity. All patients but 17 are functionally affected while none of the controls group is affected. Patients had significantly higher rates of borderline and moderate depression when compared to controls. Univariate logistic regression analysis for predictors of migraine headache in the studied patients shows that, older age (P value = 0.0001), female sex (P value = 0.003), being manual worker (P value = 0.005), obesity class 11 (P value = 0.023), very severe functional severity scale (P value = 0.001), borderline and moderate depression (P value = 0.008 and 0.002 respectively) were significant predictors of migraine.

Conclusion: There is a significant association between CTS and migraine headache. This association suggests the possibility of a common risk factors for development of migraine headache include older age, female gender, obesity, low functional and high symptoms scores and depressive symptoms.