Abstract

We report two cases of migraine accompanying epistaxis. These attacks of epistaxis are not explained by reasons other than migraine attack. A 49-year-old woman had migraine with epistaxis for 6 years. She had nasal plastic surgery 15 years ago but rhinoscopy revealed no focal bleeding focus on Kisselbach plexus. Blood tests including platelet count and coagulation factors were normal. We prescribed her daily dose of acetaminophen 975mg along with dichloral- phenazone 300mg and isometheptene mucate 195mg. The incidence and severity of migraine reduced and epistaxis did not relapse. A 19-year-old woman had migraine attack once every one or two days for one month and experienced accompanying epistaxis one third of the frequency of headache attacks. Brain computed tomography, rhinoscopy, platelet count and coagulation factor tests were normal. Epistaxis following migraine attacks did not relapse after daily dose of acetaminophen 1,875mg. These cases suggest that migraine with epistaxis shares same pathophysiology.