الفهرس 
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Abstract
This study was designed to determine calcitonin gene-related peptide (CGRP) level in peripheral blood of migraine patients as a potential biomarker for migraine (with and without aura).
It also aimed to evaluating and correlating between calcitonin gene related peptide (CGRP) and different types of migraine (episodic, chronic), in cluster headache and in tension type headache and to compare it with control group through cross-sectional study.
Each patient in this study was subjected to thorough medical and neurological history, interview about their history of headache using headache sheet.
This study was carried out on 80 subjects:
- 20 Patients have chronic migraine attack (7 males and 13 females).
- 20 Patients have episodic migraine attack (6 males and 14 females).
- 20 Patients have other types of primary headache Cluster headache and Tension type headache (8 males and 12 females).
- 20 control subjects without history of headache (10 males and 10 female The subjects were submitted to the following:
1- Standardized headache sheet and thorough general and neurological examination
2- Estimation of serum CGRP from anticubital vein.
3- Computerized tomography (CT) or Magnetic resonance imaging (MRI) of the brain.
4- Electroencephalography (EEG) in-between the migraine attacks.
5- Fundus examination.
The results of this study showed that:
A. Demographic results:
The age of the chronic migraine patients ranged from 20 to 56 years, with a mean of 35.60±10.40 years, in episodic migraine patients ranged from 17 to 48 years, with a mean of 33.05 ± 10.44, in tension type headache and cluster headache 18 to 52 years, with a mean of 33.0 ± 9.58 and in control group ranged from 24 to 53 years, with a mean of 37.0 ± 8.68, this results showed that no statistically significant difference regarding age between migraine patients and controls.
There is no statistically significant difference regarding gender between migraine patients and controls.
B. Clinical results:
Frequency of attacks per month was higher in patients with tension type headache and cluster headache (12.90 ± 6.7) than in patients with chronic migraine (10.75 ± 2.7) and in patients with episodic migraine (5.6 ± 1.76).
Duration of the attacks (hours) were significant longer in patients with chronic migraine (50.4 ± 11.9) than in patients with episodic migraine (44.2 ± 17.5) and in patients with tension type and cluster headache (16.9 ± 23.4).
There is a statistically significant difference regarding associated symptoms (nausea, vomiting, phonophobia and photophobia) between migraine patients and tension type and cluster headache.
Nausea occurs in almost 90 percent of migraine patients, while vomiting occurs in about one third of migraine patients.
Many patients experience sensory hyperexcitability manifested by photophobia, phonophobia.
The migraine aura is a complex of focal neurological symptoms that precedes or accompanies migraine in about 15% of chronic migraine patients, 20% of episodic migraine patients. Most aura symptoms develop over 5-20 min and last about 60 min.
There is no statistically significant difference between migrainous patients and control group regarding distribution of CT/MRI brain scan.
There is no statistically significant difference between migrainous patients and control group regarding distribution of Fundus examination.
There is no statistically significant difference between migrainous patients and control group regarding E.E.G.
There is a statistically significant difference regarding CGRP levels frequency and type of migraine.
CGRP levels were significant higher in patients with chronic migraine (165.0±17.9ng/L) as compared with control group (70.5 ± 8.36ng/L) than in patients with episodic migraine (94.1± 17.83 ng/L) and in patients with tension type headache and cluster headache (87.2 ± 13.8ng/L).
CGRP levels in chronic migraine were significant higher in patients with aura (191.32 ± 5.09) than without aura (160.30 ± 14.93).
CGRP levels in episodic migraine were significant higher in patients with aura (109.88 ± 7.54) than without aura (90.16 ± 17.56).
There is no statistically significant difference regarding relation between severity of attack and calcitonin gene related peptides level in migraine patients.
There is no statistically significant difference between calcitonin gene related peptides level in male and female.
There is no statistically significant difference between calcitonin gene related peptides level and age of patients in different types.
There is no statistically significant difference between calcitonin gene related peptides level and severity of headache attack in different types.
There is no statistically significant difference between calcitonin gene related peptides level and frequency of attacks.
There is no statistically significant difference between calcitonin gene related peptides level and duration of attack.