PO-89 | Alcohol and headache: an update

Alessandro Panconesi,^1,2 Maria Letizia Bartolozzi¹ | ¹Headache Centre, Department of Neurology, Health Authority, Empoli; ²Clinical Research Institute Ecomedica, Empoli, Italy

Background: The role of alcoholic drinks as a migraine trigger has been repeatedly debated and reviewed. A notable discrepancy has been highlighted regarding the frequency and triggering role of the various types of primary headache. Many factors may affect the reliability of survey data, including the headache classification by the International Headache Society (IHS) and the type of studies (generally retrospective). The objective of this update was to evaluate whether recent studies concerning the controversial relationship between alcoholic drinks (AD) and headache had brought confirmation or innovation.

Methods: Prospective studies concerning the triggering role of AD, vasodilation as a possible mechanism, alcohol consumption, the effect of alcohol infusion, and the role of alcohol-induced analgesia were evaluated and discussed.

Results and Conclusion: This update reports many recent prospective studies confirming the limited role of AD as a triggering factor. Furthermore, the lower consumption of AD in migraine patients is once again and definitively highlighted by recent studies, and it is discussed whether this is due to reverse causality. Since many substances have been tested to provoke migraine and correlate with cerebrovascular dilatation, it is once again underlined why ethanol, a natural trigger with vasodilating properties, has not been tested until now in migraine patients. Some studies show that ethanol infusion does not provoke headache within 5 to 8 hours, but only a delayed hangover headache in some subjects. Finally, since alcohol analgesia is used as self-medication and moderate alcohol consumption may be associated with a decreased likelihood of developing chronic pain, it is debated why this does not happen in migraineurs.