New migraine-related syndrome defined by US doctors

Migraine-anxiety related dizziness (MARD) is a newly defined condition wherein patients present with a combination of all three symptoms, say doctors in Pittsburgh.Cases of both migraine and anxiety have been reported as occurring commonly in association with dizziness. In a recent editorial, doctors from the University of Pittsburgh School of Medicine in the US state that each of the three conditions may occur co-morbidly with one or more of the others and that aetiological relationships may exist between them (eg, dizziness causing migraine, or anxiety influencing the presentation of a balance disorder). They suggest that it is, therefore, not surprising that some patients will manifest migraine, anxiety, and a balance disorder. The authors propose that this symptom complex be known as MARD, adding that it is unlikely to be simply the chance combination of the three conditions.The authors predict that patients with MARD may be misdiagnosed if one or more of the components go unrecognised. They add that the nature of the symptoms means that the care of such patients will be spread across many disciplines - creating awareness of MARD among physicians will enable them to appreciate the primary complaint but will also stimulate them to look for the other components. The choice of treatment(s) for patients with MARD should be made according to perceived aetiological relationships, if any, and by the relative severity of the various co-morbidities, the authors recommend. They go on to suggest specific treatments to be used in various scenarios based on their own experience with such patients. The authors state that the pathophsyiology of MARD is probably related principally to monoaminergic pathways important for migraine, anxiety, the central vestibular system, and their interconnections. They conclude: "Recognising MARD is important as management requires amelioration of each of the underlying conditions, preferably by implementing treatments that benefit more than one component of the disorder."Reference...