Hyperventilation during migraine attacks.

Hyperventilation during migraine attacksWe have recently seen four patients who hyperventilated during the headache phase of some of their migraine attacks.The symptoms frightened the patients and raised diagnostic difficulties for their family practitioners. Case reportA 24-year-old film projectionist (case 1) had had common migraine from the age of 10.During the past two years he had had four severe attacks with additional features, in two of which he was taken to hospital by ambulance.During these recent episodes he had numbness round the mouth "like a dental anaesthetic," paraesthesiae ascending the limbs, a tightness round the mouth that interfered with his speech, a constricting sensation round his chest that made him "fight for breath," and a stiffening of the hands that he imitated by flexing the wrists and metacarpophalangeal joints and extending the interphalangeal joints.These added symptoms, associated with clouding of memory, occurred one hour after the headache started and lasted one to