2025 American Academy of Neurology Abstract Website

Objective:

A retrospective study of the correlations between neuropathic pain and headaches.

Background:

Neuropathic pain (NPP) is frequently encountered in Neurology practice. Most patients with NPP undergo diagnostic studies for peripheral neuropathy, including a diagnostic skin biopsy (SB), nerve conduction studies/electromyography (NCV/EMG), and autonomic function tests (AFT). Patients who have NPP and autonomic symptoms (AS) often have headaches. However, their correlations need to be better elucidated.

Design/Methods:

Four hundred fifty patients with NPP and AS underwent a SB at the Massachusetts General Hospital were included in the study. The prevalence of documented NPP and AS were analyzed for statistical correlations with headaches and migraine. In addition, the results of SB, NCV/EMG, and AFT testing were analyzed for their statistical correlations with NPP, AS, and headaches

Results:

Most (73.8%) of the patients who underwent a skin biopsy were females. The mean age was 46.8, and the mean body mass index was 27.1. Most patients had NPP (61.3%)and 48% had AS. The prevalence of headache symptoms was 48.2%, with 73.2% of headache patients fulfilling the migraine criteria.

Female dominance was detected in both headache symptoms and migraine groups but not in NPP and AS groups. There were strong correlations between headache symptoms and NPP (p< 0.0001) and AS ( p< 0.01). A similar trend was detected in migraine and NPP (p<0.05) but not with AS. Only AS has a significant correlation with positive AFT results. Otherwise, the skin biopsy, EMG, and AFT results had no significant correlations with NPP, headaches, and migraine.

Conclusions:

There is a significant correlation between NPP and the prevalence of headaches and migraine. However, these correlations were not associated with positive diagnostic test results for peripheral neuropathy. Our study suggests there are central mechanisms that connect NPP to headaches ad migraine.