ABSTRACT
Migraine as the most popular vascular headache was always been the topic of discussion in the medical literatures. Regarding the theories underlying pathophysiology of migraine, various methods for treatment of this disorder have been proposed. Menthol is the most important active agent in peppermint and various mechanisms of action for it have been proposed till now, many of them focused on it's analgesic effect through TRPMs, a group of the transient receptor protein TRP. In previous interventional studies also, a solution of peppermint extract in ethanol significantly reduced the clinical tension type headache intensity. Regarding numerous therapeutic effects of menthol, we performed this study to evaluate the effect of cutaneous application of menthol on reducing headache intensity in migraine acute attacks. Twenty five female patients enrolled in this interventional uncontrolled study. They all used the 10% menthol solution the way they were informed. During the consumption, they filled out some questionnaires containing information about intensity of headache and associated symptoms. Within 33 well recorded attacks of migraine, 50% relief of pain occurred after 1.85 hours and sustained pain-free efficacy was achieved after 6.76 hours. Seventy one percent of migraine patients who had nausea/vomiting and 43% of those who were suffering from photophobia and photophobia associated with headache became symptom-free after 2 hours. This study demonstrates that cutaneous consumption of 10% menthol in ethanol solution is well tolerated by the patients and relives the pain and associated symptoms. However, further controlled studies are needed to confirm these observations