Introduction A cyclic pattern of gastroparesis (GP) has recently been described and shown to differ from noncyclic patterns (NGM abstract, 2006). Likewise, cyclic patterns have been associated with migraine, which is felt to be maternally inherited. We investigated the hypothesis that GP patients with a cyclic pattern might have a more maternal pattern of inheritance for migraine and related overlap syndromes.
Patients From a database of 345 consecutive patients seen, 48 patients (8 M, 40 F, mean age 41.5 years)-with the following diagnoses: 18 idiopathic, 27 diabetes mellitus, and 3 postsurgical disorders-presented with the symptoms of GP. Most patients were drug refractory and referred for possible gastric electrical stimulation (GES). Patients were 35 (3 M, 32 F) with cyclic symptoms (Cyc), and 13 (1 M, 12 F) with no cyclic symptoms (NoCyc). Thirty-eight of 48 patients (25 Cyc and 13 NoCyc) underwent implantation of permanent GES, mean of 33 months.
Methods Family history of overlap syndromes and related disorders was determined by interview. Both maternal and paternal family histories were compiled for several overlap syndromes, as previously described (NGM, above).
Results Maternal prevalence of migraine and related overlap syndromes was nearly universally higher in patients with cyclic symptoms (Table) versus those with noncyclic symptoms.
Conclusions GP patients with cyclic symptoms have a much higher female predominance of migraine and related overlap syndromes. These findings raise the possibility of a genetic, possibly mitochondrial DNA-linked biologic component in the cyclic nature of their symptoms.
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