Throbbing pain is related to Queckenstedt's test effect in migraine patients

The Queckenstedt's (Q)-test can aggravate headache intensity during migraine attacks (Q-test effect). The objective of this study was to delineate the Q-test effect in patients experiencing migraine attacks. We performed a 30-s Q- and a sham test on 39 patients with acute migraine attacks in both supine and sitting positions. Headache intensities during and 30 s after the Q- or sham tests were recorded on a 0-10 verbal scale. Brushing allodynia (BA) was recorded after using a gauze-brushing test over the patient's face and forearms. The Q- but not the sham test aggravated headache intensity in both sitting and supine positions. The presence of throbbing pain and higher pain intensities was associated with the Q-test effect in the supine position. However, the presence or absence of BA was not correlated. We concluded that the Q-test effect is likely to be related to peripheral sensitization of the meninges but not central sensitization. The Q-test effect may be used as an objective marker for peripheral sensitization.