Migraine and Gastroparesis

Curr Neurol Neurosci Rep. 2022 Dec;22(12):813-821. doi: 10.1007/s11910-022-01241-3. Epub 2022 Nov 12.

Abstract

Purposeof review: Migraine is a chronic and disabling disease affecting a significant proportion of the world's population. There is evidence that gastroparesis, a gastrointestinal (GI) dysmotility disorder in which transit of gastric contents is delayed, can occur in the setting of migraine. This article aims to review recent literature on overlap in the pathophysiology and clinical manifestations of migraine and gastroparesis and highlight management considerations when these disorders coexist.

Recent findings: There has been increasing recognition of the importance of the connection between the GI tract and the brain, and mounting evidence for the overlap in the pathophysiology of migraine and gastroparesis specifically. There exists a complex interplay between the central, autonomic, and enteric nervous systems. Studies show that gastroparesis may be present during and between acute migraine attacks necessitating modification of management to optimize outcomes. Gastric dysmotility in the setting of migraine can impact absorption of oral migraine medications and alternate formulations should be considered for some patients. Noninvasive vagus nerve stimulation has been FDA cleared for migraine treatment and is also being studied in gastroparesis. Dysfunction of the autonomic nervous system is a significant feature in the pathophysiology of gut motility and migraine, making treatments that modulate the vagus nerve attractive for future research.

Keywords: Autonomic; Gastric emptying; Headache; Nausea and vomiting; Neuromodulation.

Publication types

  • Review

MeSH terms

  • Autonomic Nervous System
  • Gastroparesis* / diagnosis
  • Gastroparesis* / etiology
  • Gastroparesis* / therapy
  • Humans
  • Migraine Disorders* / drug therapy