Key result
POTS is linked to migraine-like headaches in ~96% of patients alongside frequent orthostatic headaches.
Observational (n=24)
Orthostatic headache and migraine are highly prevalent in patients with POTS, highlighting the need to assess and manage these comorbidities in this population.
High headache burden in POTS supports clinical evaluation; leaves open causal links and treatment effects pending randomized data.
OBJECTIVE: Orthostatic and non-orthostatic headache spectrum was prospectively studied in 24 consecutive patients with postural orthostatic tachycardia syndrome (POTS). METHODS: Patients were interviewed about clinical aspects of headache and its precipitation during head-up tilt (HUT). Autonomic functions were assessed using a standard battery of tests. The relationship of orthostatic headache to cardiovascular variables was examined using unpaired two-tailed t-test. RESULTS: Orthostatic headache occurred during daily activity in 14 patients (58.3%) and during HUT in 15 patients (62.5%). Age under 30 years and increasing duration of tilt were predictive for orthostatic headache. Of the 24 patients, 23 (95.8%) had non-orthostatic headache fitting the criteria of migraine or probable migraine. CONCLUSIONS: Orthostatic headache affected two-thirds of POTS patients, especially those under age 30. Patients with orthostatic headache should be clinically assessed for POTS and informed of this association to reduce short-term morbidity. Migraine afflicted almost all POTS patients. This co-morbidity should be considered in management of POTS.
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Khurana et al. (2010) conducted an observational in Postural orthostatic tachycardia syndrome (POTS) (n=24). Postural orthostatic tachycardia syndrome (POTS) was evaluated on Orthostatic headache during daily activity. Postural orthostatic tachycardia syndrome was associated with orthostatic headache in 58.3% of patients during daily activity and migraine-like non-orthostatic headache in 95.8% of patients.
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