Food allergy in migraine.

There is a long history associating food allergy with migraine which has been reviewed recently (Monro, 1982). In all, seventeen studies were reported involving investigations on over 1236 patients. The diagnostic methods used to define allergy were mainly elimination diets and challenge and skin tests. Two specific cases, however, are worth emphasizing. Goltman (1936) reported the case of a woman who was operated on during an attack of migraine. Her brain was found to be oedematous but no other abnormality was found. Later, when given wheat, similar oedema was palpable through the skull opening. Another report is of a patient subject to migraine who contracted mumps and thereafter had electromyographic evidence of weakness in the left quadriceps muscle when challenged with a known allergen, egg (Kailin & Hastings, 1970). The diagnosis of migraine is used interchangeably with vascular headaches. It includes the categories of common, classical, hemiplegic and ophthalmoplegic migraines and cluster headache, the latter being segregated by some into a different category and termed migrainous neuralgia. The clinical syndromes are distinct at the time but individuals subject to one type may get another type at other periods. In common migraine, periodic headaches occur accompanied sometimes by nausea and dizziness. Classical migraine is a much more fulminating condition with unilateral hemicranial headache giving its name to the condition. It is a complex symptom in which headache predominates and may last from a few hours to a few days and in which visual disturbances precede the headache. Teichopsia with scintillating scotomata occurs with perhaps a heightened perception of sound or scent and photophobia. Then nausea and vomiting, constipation or diarrhoea, urinary retention followed by diuresis, complaints of feeling cold and associated pallor may occur. When sensory disturbances such as unilateral tingling, numbness and weakness occur on the contralateral side to that of the headache the condition is termed hemiplegic migraine and indeed the headaches may lead to permanent hemiplegic signs or disturbances of speech. Ophthalmoplegic migraine is another variant in which ocular palsies occur associated with the headaches-they are usually unilateral third nerve palsies and are generally transient. Horton’s neuralgia and histamine headache are synonyms for cluster headache. The diathesis is. somewhat different from the other forms of migraine as it occurs in phases or clusters with recurrent attacks followed by an interval of remission which can be prolonged. The headache is often extremely severe and conforms to the distribution of the external carotid artery. Accompanying the headache is a profuse