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MIGRAINE: Title and subTitle BreakRESULTS OF TREATMENT BY KETOGENIC DIET IN FIFTY CASES

CLIFFORD J. BARBORKA, M.D.
[+] Author Affiliations

Read before the Section on Nervous and Mental Diseases at the Eighty-First Annual Session of the American Medical Association, Detroit, June 27, 1930.


ROCHESTER, MINN.

From the Division of Medicine, the Mayo Clinic.


JAMA. 1930;95(24):1825-1828. doi:10.1001/jama.1930.02720240035010
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Early in my experience with the ketogenic diet,1 it was tried in cases of migraine. Since then Lennox and Cobb,2 in their monograph on epilepsy, have stated that it would be of interest to know whether the induction of acidosis is of benefit in cases of migraine. Since the original report from the Mayo Clinic,3 Schnabel4 has reported his experience with a ketogenic diet in cases of migraine.

Some of the recent etiologic theories and therapeutic suggestions are of interest in considering the justification of a ketogenic regimen in cases of migraine. R. and S. Weissmann-Netter5 found apparent changes in the acid-base balance: the hydrogen ion concentration and alkali reserve are normal in the periods of freedom from

attacks but a tendency to alkalosis develops forty-eight hours prior to an attack. The recent method of studying acid-base equilibrium by hyperpnea or overventilation of the lungs,

REFERENCES

Barborka, C. J.:  Ketogenic Diet Treatment of Epilepsy in Adults , J. A. M. A. 91:73-78 ( (July 14) ) 1928;
 The Ketogenic Diet and Its Use , M. Clin. North America 12: 1639-1653 ( (May) ) 1929;
 Epilepsy in Adults: Results of Treatment by Ketogenic Diet in One Hundred Cases , Arch. Neurol. & Psychiat. 23:904-914 ( (May) ) 1930;.
Lennox, W. G., and Cobb, Stanley: Epilepsy , Baltimore, Williams and Wilkins Company, 1928;, p. 145.
Pollock, L. W., and Barborka, C. J.:  Abdominal Migraine , M. Clin. North America 11:1665-1667 ( (May) ) 1928;.
Schnabel, T. G.:  Experience with Ketogenic Dietary in Migraine , Ann. Int. Med. 2:341-347 ( (Oct.) ) 1928;.
Weissmann-Netter, R., and Weissmann-Netter, S.:  Equilibre acidebase et migraine , Compt. rend. Soc. de biol. 92:341-343 ( (Feb. 7) ) 1925;.
Muck, D.:  Hyperventilationsmigräne , München. med. Wchnschr. 73:982-983 ( (June 11) ) 1926;.
Bigland, A. D.:  Treatment of Migraine by Calcium Lactate , Brit. M. J. 2: 1133-1135 ( (Dec. 15) ) 1923;.
Pagniez, P.; Vallery-Radot, Pasteur: and Nast, A.:  Essai d'une thérapeutique préventive de certaines migraines , Presse méd. 27: 172:174 ( (April 3) ) 1919;.
Pagniez, P.:  De quelques traitements de la migraine , Presse méd. 29: 45-47 ( (Jan. 15) ) 1921;.
Miller, J. L., and Raulston, B. O.:  Treatment of Migraine with Peptone , J. A. M. A. 80:1895 ( (June 30) ) 1923;.
Vaughan, W. T.:  Allergic Migraine , J. A. M. A. 88:1383-1386 ( (April 30) ) 1927;.
Rowe, A. H.:  Allergy in the Etiology of Disease , J. Lab. & Clin. Med. 13: 31-40 ( (Oct.) ) 1927;.
Curtis-Brown, R.:  Protein Poison Theory: Its Application to Treatment of Headache and Especially Migraine , Brit. M. J. 1:155-156 ( (Jan. 24) ) 1925;.
Chiray, M., and Triboulet, F.:  Rôle of Stasis in Gallbladder in Migraine , Presse méd. 33:313-315 ( (March 11) ) 1925;.
Duval, P., and Roux, J. C.:  Duodenal migraine , Arch. d. mal. de l'app. digestif. 14:74-79 ( (Jan.) ) 1924;.
Diamond, J. S.:  Liver Dysfunction in Migraine with a Report of Thirty-Five Cases , Am. J. M. Sc. 174:695-702 ( (Nov.) ) 1927;.
Hetinyi, G.:  Hyperbilirubinemia in Migraine , Arch. f. Verdauungskr. 31: 247-251, 1923;.
McClure, C. W., and Huntsinger, Mildred E.:  Observations on Migraine , Boston M. & S. J. 196:270-273 ( (Feb. 17) ) 1927;.
Brown, T. R.:  Rôle of Diet in Etiology and Treatment of Migraine and Other Types of Headache , J. A. M. A. 77:1396-1400 ( (Oct. 29) ) 1921;
 Treatment of Migraine and Hypertrophic Arthritis Based on Metabolic Studies , Tr. A. Am. Physicians 44:215-220, 1929;.
Hare, Francis: Food Factor in Disease , London, Longmans Green & Co., 1905;.
Minot, G. R.:  The Role of a Low Carbohydrate Diet in the Treatment of Migraine and Headache , M. Clin. North America 7:715-728 ( (Nov.) ) 1923;.
Boyden, E. A.:  An Analysis of the Reaction of the Human Gallbladder to Food , Anat. Rec. 40: 147-191 ( (Oct.) ) 1928;.

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Barborka, C. J.:  Ketogenic Diet Treatment of Epilepsy in Adults , J. A. M. A. 91:73-78 ( (July 14) ) 1928;
 The Ketogenic Diet and Its Use , M. Clin. North America 12: 1639-1653 ( (May) ) 1929;
 Epilepsy in Adults: Results of Treatment by Ketogenic Diet in One Hundred Cases , Arch. Neurol. & Psychiat. 23:904-914 ( (May) ) 1930;.
Lennox, W. G., and Cobb, Stanley: Epilepsy , Baltimore, Williams and Wilkins Company, 1928;, p. 145.
Pollock, L. W., and Barborka, C. J.:  Abdominal Migraine , M. Clin. North America 11:1665-1667 ( (May) ) 1928;.
Schnabel, T. G.:  Experience with Ketogenic Dietary in Migraine , Ann. Int. Med. 2:341-347 ( (Oct.) ) 1928;.
Weissmann-Netter, R., and Weissmann-Netter, S.:  Equilibre acidebase et migraine , Compt. rend. Soc. de biol. 92:341-343 ( (Feb. 7) ) 1925;.
Muck, D.:  Hyperventilationsmigräne , München. med. Wchnschr. 73:982-983 ( (June 11) ) 1926;.
Bigland, A. D.:  Treatment of Migraine by Calcium Lactate , Brit. M. J. 2: 1133-1135 ( (Dec. 15) ) 1923;.
Pagniez, P.; Vallery-Radot, Pasteur: and Nast, A.:  Essai d'une thérapeutique préventive de certaines migraines , Presse méd. 27: 172:174 ( (April 3) ) 1919;.
Pagniez, P.:  De quelques traitements de la migraine , Presse méd. 29: 45-47 ( (Jan. 15) ) 1921;.
Miller, J. L., and Raulston, B. O.:  Treatment of Migraine with Peptone , J. A. M. A. 80:1895 ( (June 30) ) 1923;.
Vaughan, W. T.:  Allergic Migraine , J. A. M. A. 88:1383-1386 ( (April 30) ) 1927;.
Rowe, A. H.:  Allergy in the Etiology of Disease , J. Lab. & Clin. Med. 13: 31-40 ( (Oct.) ) 1927;.
Curtis-Brown, R.:  Protein Poison Theory: Its Application to Treatment of Headache and Especially Migraine , Brit. M. J. 1:155-156 ( (Jan. 24) ) 1925;.
Chiray, M., and Triboulet, F.:  Rôle of Stasis in Gallbladder in Migraine , Presse méd. 33:313-315 ( (March 11) ) 1925;.
Duval, P., and Roux, J. C.:  Duodenal migraine , Arch. d. mal. de l'app. digestif. 14:74-79 ( (Jan.) ) 1924;.
Diamond, J. S.:  Liver Dysfunction in Migraine with a Report of Thirty-Five Cases , Am. J. M. Sc. 174:695-702 ( (Nov.) ) 1927;.
Hetinyi, G.:  Hyperbilirubinemia in Migraine , Arch. f. Verdauungskr. 31: 247-251, 1923;.
McClure, C. W., and Huntsinger, Mildred E.:  Observations on Migraine , Boston M. & S. J. 196:270-273 ( (Feb. 17) ) 1927;.
Brown, T. R.:  Rôle of Diet in Etiology and Treatment of Migraine and Other Types of Headache , J. A. M. A. 77:1396-1400 ( (Oct. 29) ) 1921;
 Treatment of Migraine and Hypertrophic Arthritis Based on Metabolic Studies , Tr. A. Am. Physicians 44:215-220, 1929;.
Hare, Francis: Food Factor in Disease , London, Longmans Green & Co., 1905;.
Minot, G. R.:  The Role of a Low Carbohydrate Diet in the Treatment of Migraine and Headache , M. Clin. North America 7:715-728 ( (Nov.) ) 1923;.
Boyden, E. A.:  An Analysis of the Reaction of the Human Gallbladder to Food , Anat. Rec. 40: 147-191 ( (Oct.) ) 1928;.
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