The Lacosamide's Effect on Calcitonin Gene-related Peptide in Migraine Patients

Two hundred episodic migraine patients, according to the International Classification of Headache Disorders 3rd edition, aged 10-55 years with migraines. We divided them into two groups first one received Ibuprofen 200-400 mg as a treatment for acute migraine attacks and lacosamide 50 mg Bid for 3 months, and the other group received only Ibuprofen 200-400 mg as a treatment for acute migraine attacks. Our selected patients were naive and didn't receive any other prophylactic therapy for migraine.

for each patient, the investigators did

• detailed history taking with stress on Age, sex, and criteria and type of migraine
• general examination
• full neurological examination: Full neurological examination
• Laboratory investigations include: Serum creatinine, Liver functions test to exclude any metabolic disorder.
• Approximately 5 ml of venous blood was drawn from all participants and centrifuged at 1000×g for 10 min. Serums were separated from the blood sample and stored at - 20 ℃. The serum calcitonin gene-related peptide (CGRP) concentrations will be measured by adapting the enzyme-linked immunosorbent assay (ELISA) kit following manufacturer protocols.
• Serum level CGRP before starting treatment and after three months of treatment
• MRI T1, T2, and flair to exclude any secondary cause of headache.

Inclusion criteria

• Naive migraine patients according to the International Classification of Headache Disorders 3rd edition aged 10-55 years,

Exclusion criteria

• Patients with major neurological disorders such as ( epilepsy, ischemic or hemorrhagic stroke, multiple sclerosis, mitochondrial diseases, brain tumors, and patients with essential tremors.
• patients with major systemic diseases such as malignancy, collagen diseases, liver diseases, and renal diseases.
• patients with cardiovascular diseases like hypertension (systolic blood pressure of more than 130 and/or diastolic blood pressure of more than 85 mm/Hg on at least three different occasions, diabetes (fasting plasma glucose level >126 mg/dl and/or a casual plasma glucose >200 mg/dl and/or HbA1C more than 6.5.
• patients with valvular and ischemic heart diseases,
• patients who received prophylactic treatment for migraine,
• patients with any contraindications to lacosamide.