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+.