OBJECTIVE: We aim to find if there are significant differences in migraine patient’s facial thermophysiological responses between their asymptomatic period and their migraine headache attacks.BACKGROUND: Evidence suggests specific thermographic patterns can be seen during a migraine headache attack and normalize interictally. Such findings, however, have not been uniform.DESIGN/METHODS: We prospectively collected facial videos using a thermal camera (FLIR systems, FLIR SC 4000, Boston, MA, USA) from eight migraine patients during two different sessions: symptomatic ("Migraine") and asymptomatic ("Baseline"). Each recording lasted approximately 5 minutes. All patients had episodic migraine with or without aura per ICHD-2. Patients taking daily preventive medications and those with chronic migraine were excluded. Because we have two tests (supraorbital thermal signal and periorbital thermal signal) we used the Bonferroni correction for the level of significance (αc=0.05/2=0.025).RESULTS: Every subject had a significantly higher mean supraorbital temperature in the baseline session compared to the migraine session. In the two-sample t-test for each subject, the mean supraorbital response variable had significant differences between the baseline and migraine sessions, all p-values were far less than αc=0.025. In 7 out of 8 subjects the baseline session had a significantly higher mean periorbital temperature compared to the migraine session. In one subject there was no significant difference. In the two-sample t-test for each subject, the mean periorbital response variable had significant differences between the baseline and migraine sessions, all the p-values but one were far less than αc=0.025.CONCLUSIONS: In this study, a characteristic facial thermal signature (supraorbital and periorbital cooling) identifies migraine headache attack presence. The mechanisms behind this thermophysiologic response require further study. We envision this thermal signature may help convey migraine presence in patients who can’t verbally communicate. In verbal patients, the thermal signature may allow identification and treatment of unsuspected migraine headache attacks early in their course before full development.Supported by: Mainly by the National Science Foundation and in small part by the Texas Medical Center and Methodist Hospital.Disclosure: Dr. Garza has received personal compensation in an editorial capacity for UpToDate, Inc and Current Neurology and Neuroscience Reports. Dr. Montakhabi has nothing to disclose. Dr. Lindner has nothing to disclose. Dr. Tsiamyrtzis has nothing to disclose. Dr. Swanson has received personal compensation in an editorial capacity for UpToDate, Inc. Dr. MacBride has nothing to disclose. Dr. Krouskop has received personal compensation in an editorial capacity for Wounds Journal. Dr. Pavlidis has nothing to disclose.Thursday, March 21 2013, 7:30 am-12:00 pm