Posted by: Tedmosby | 2009-03-03

migraine and PFO

Dr. Shevel,

Exactly how strong is the link between migraine and PFO (patent foramen ovale)? I' ve read reports that 40-60% of migraine aura sufferers have a PFO, but am sceptical about these results. I myself suffer from migraine with aura and am wondering if I should have an echocardiogram (TTE) performed. I would appreciate any help you can give!

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Our expert says:
Expert ImageHeadache expert

Dear Ted,

There seems to be a link in some people, but there is still a lot of controversy about it. But even if there is a link, that is certainly not the first choice of route to follow, unless you have previously had a stroke.

The better way to get to the root of the problem is to have what is called a “multidisciplinary assessment”. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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