Magnesium
SERUM IONIZED MAGNESIUM LEVELS (IMg2+) IN 500 PATIENTS WITH HEADACHES
A Mauskop
New York, NY
BT Altura, RQ Cracco, BM Altura
Brooklyn, NY
Serum IMg2+ levels below 0.54 mmol/L predict the response of patients
with migraine and cluster headaches to IV infusions of MgSO4. IMg2+
levels are a more sensitive indicator of Mg deficiency than total Mg
levels. The objective of this study was to measure IMg2+ in 500
patients with headaches and to correlate IMg2+ with clinical features.
All patients presenting to our headache clinic were asked to consent to
have blood drawn for IMg2+ measurement. There were 127 men and 373
women; 22 were under 18, 401 between ages 18 and 49, and 77 older than
49. Tension headaches was the main diagnosis in 45 patients, chronic
tension headaches in 83, migraine without aura in 208, migraine with
aura in 38, chronic daily headache in 81, and cluster headache in 45.
IMg2+ was below 0.54 mmol/L in 29% of patients. The only clinical
feature that correlated with low IMg2+ was pulsatile quality of pain
(P<0.03). These results indicate a high incidence of low IMg2+ in
patients with headaches. In a prior study, in patients during an acute
migraine attack, we found this incidence to be as high as 53%. The
latter patients responded to IV MgSO4. Pulsatile quality of pain may be
a useful clinical indicator of low lMg2+.
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