Case Report Increase in Body Temperature During Migraine Attacks

Introduction. Intermittent fever has been occasion- ally related to migraine, either as a migraine equiva- lent or as a migraine accompaniment. We present a case of recurrent increase in body temperature con- sistently associated with migraine headaches. Methods. A 15-year-old girl reported a 3-year lasting history of migraine without aura, with a feeling of warmthoccurringineachepisode.Ancillarytestsdid not show any evidence of secondary headaches or anysystemicdisease.A2-monthheadachediarywas obtained, with daily records of headache intensity (0, noheadache;1,mildpain;2,moderatepain;3,severe pain) and simultaneous measurements of axillary temperature. Both parameters were registered in the evening, at 6:00 PM every day. The distribution of headache intensity and body temperature as well as the relationship between both variables over time were analyzed with nonparametric tests. Results. The number of days without pain was 28 (45.2%); a mild headache was present on 13 days (21%), a moderate headache on 15 days (24.2%), and a severe headache on 6 days (9.7%). Headache days were associated with higher body temperature than headache-free days (median values: 37.3°C vs 36.6°C; Mann-Whitney U-test, P < 0.001). Moreover, a positive correlation was found between headache intensity and body temperature (Spearman's rho coefficient: 0.83, P < 0.001). Conclusions. Recurrent increase in body tempera- ture may be another manifestation of the complex clinical spectrum of migraine. This symptom is probably related to hypothalamic involvement.