Living With Migraine And The Search For New Treatments
http://thedianerehmshow.org/shows/2012-08-16/living-migraine-and-search-new-treatments
For those who suffer from migraine headaches, the pain can be devastating. Intense throbbing and sensitivity to light or sound often keeps people from their normal lives for hours or even days on end. The World Health Organization ranks migraine as one of the most debilitating diseases, and more than 10 percent of the population suffers from it. Yet migraine is not widely understood and is often misdiagnosed. But patients can find relief with the right treatments. As scientists learn more about the cause of migraines, doctors and patients have their sights on better medication. Diane and her guests discuss living with migraines and the search for new treatments.
Guests
Dr. Perry Richardson
neurologist at George Washington University Hospital.
Teri Robert
author of "Living Well With Migraine Disease and Headache."
Dr. David Dodick
neurologist at the Mayo Clinic and chair of the American Migraine Foundation.
Dr. Story Landis
director of the National Institute of Neurological Disorders and Stroke at the National Institutes of Health.
Web Extra: Dr. David Dodick Answers Audience Questions
Is there a correlation between migraine and epilepsy? How are migraines diagnosed in children? Dr. David Dodick of the Mayo Clinic responded to these listener questions and more. Some questions have been edited for space and clarity.
Q: Is it common for children to experience migraines during puberty and then grow out of them? -- From Twitter user @A_Fountain
A: Migraine tends to be begin during adolescence, peak in the 20’s-40’s, and diminish thereafter. While the clinical course is highly variable and migraine can go into remission at any time, it is not common for migraine to remit in adolescence. In addition, the predisposition to migraine is believed to be genetic and therefore, the predisposition is lifelong, though for a significant proportion of individuals, the attacks tend to diminish over time.
Q: What is the correlation between stroke, birth control and migraine? -- From Twitter user @MigraineLand
A: The risk of stroke, particularly in women less than age 45, is increased two-fold in those who have migraine with aura. That risk is increased by up to 8-fold in women who have migraine with aura who also use an oral contraceptive pill. This risk is increased even further if the woman smokes. Therefore, all women with migraine with aura should be encouraged to quit smoking (if they smoke). In regards to the oral contraceptive pill, recommendations vary from never using the OCP in a woman with migraine with aura to using if aura is infrequent and limited to visual symptoms only. In general, for those young women with frequent migraine with aura, or aura that is prolonged (lasting longer than 60 minutes), or in those whose aura started or worsened after starting the OCP, it is recommended that alternative means of birth control be explored to minimize the risk of stroke.
Also, please keep in mind that while the relative risk of stroke is increased by a factor of 2 in those with migraine with aura, the baseline risk of stroke in young women without migraine with aura is very low (approximately 4 per 100,000 women). That means that while the risk is double, the risk of stroke is still very small (8 per 100,000 women) and even when the OCP is added, the risk is approximately 60 per 100,000. Those individuals with a family or personal history of blood clotting disorder (deep venous thrombosis, pulmonary embolus, should certainly avoid the OCP)
Q: Are there any studies that establish a correlation between fibromyalgia and migraines? -- From Twitter user @araaajoooo
A: Yes, fibromyalgia and other chronic pain disorders are considered to be “comorbid” with migraine. That means that they are more often associated with migraine than one would expect to occur by change alone. This is likely due to abnormal function of the internal pain modulating networks in the brain in migraine, and this dysfunction leads migraine sufferers to be susceptible to other chronic pain conditions.
Q: I get cluster headaches which are often mistaken for migraines. Is it because I am female, or are they that similar? -- From Twitter user @MJnTJ
A: Cluster headache does share some features with migraine. For example, cluster headaches are almost always unilateral (migraine is unilateral about 50% of the time), and cluster headaches may be associated with sensitivity to light (photophobia) and noise (phonophobia), and, less commonly, with nausea. However, cluster headache can usually be distinguished easily from migraine because cluster headache is almost always unilateral, side-locked (which means they occur on the same side), last a shorter period of time (30minutes to 3 hours; compared to the 4-72 hours of migraine), are associated with prominent tearing, reddening of the eye and nasal congestion, on the same side as the pain, and patients with cluster often need to pace during an attack while migraine sufferers generally like to be at rest and still. Cluster usually occurs once to three times per day for a period of months and then go into remission for months to years (hence the name cluster). Finally, in those with cluster, attacks that awaken individuals from sleep are very common. While cluster used to be considered a disorder that affected men 20-times more commonly than women, we now know what the ratio is much smaller and while cluster is still more common in men, the ratio is more like 3:1.
Q: Are most migraines onset due to triggers? What are common triggers? -- From Twitter user @JoanneDavidhiza
A: The extent to which triggers are present varies considerably from one individual to another. It is certainly time well invested to keep a diary to determine which triggers may be relevant for you. Common triggers include stress, relief from stress, sleep deprivation, alcohol, certain medications (e.g. nitroglycerin), overuse of analgesics, triptans, narcotics, certain foods (processed meats, aged cheese, monosodium glutamate, aspartame, caffeine), menstruation, exercise, high altitude.
Q: Are the mental health issues mentioned by your guests also a concern for those who have aural migraines? -- From Twitter user @Tom_Godell
A: Yes, the mental health issues are equally a concern for those who have migraine with aura. For those who have chronic migraine (headache more than 15 days per month), mental health issues are even more common. Rates of depression and anxiety for example are higher in chronic migraine sufferers than in those with episodic migraine (less than 15 headache days per month). This association is very likely due to similar underlying biology – in other words, the altered chemistry in the brain in depression and anxiety may be similar in some ways to migraine. This may explain in part why some antidepressants are effective for the prevention of migraine.
Q: Is there a comorbidity or other correlation between migraine and epilepsy? -- From Twitter user @MmrghHmph
A: Yes, migraine sufferers are twice as likely to experience epilepsy and vice-versa. This is very likely due to a similar underlying biology. In other words, epilepsy and migraine are both due to abnormally excitable brain cells and networks in the brain. And, in fact, several of the most effective medications for the prevention of migraine are antiepileptic drugs.
Q: What research is being done regarding long term impact of migraine on the brain and long term (20+ years) exposure to daily meds? -- From Twitter user @nikki_d
A: There have been a number of studies that have evaluated the long-term neurological effects of migraine, particularly with respect to cognitive function. A very recent and large study that evaluated over 6,300 women over the age of 65 at the time of the evaluation, and who had migraine with and without aura throughout their lives, found that cognitive decline was no more significant or rapid in those with migraine (with or without aura) compared to those without migraine. However, there is evidence that migraine sufferers are at an increased risk of stroke and brain lesions, particular those with migraine with aura. These individuals are at double the risk of stroke and up to 15-times more likely to develop brain lesions. It is not clear whether these lesions have an effect on these particular migraine sufferers over time compared to those without these lesions.
With regard to the long-term effects of migraine medications that are taken daily, while there are adverse effects associated with all medications, and the type and severity of adverse effects vary between patients and depending on the particular medication, there is no definitive evidence that there are serious long-term effects of preventive migraine medications taken daily for migraine. All of the preventive drugs taken for migraine are used long-term for other disorders such as epilepsy, depression, high blood pressure, and other disorders, so there is extensive evidence that the long-term effects of these medications taken for other purposes appear to be relatively safe long-term.
Q: Biofeedback machines, watching my state of mind and breathing techniques changed my migraines substantially. I had been a serious sufferer from 12 until 21 years old and still get them, but not nearly as often. Please discuss application of meditation and breathing techniques. Was this my imagination? -- From Facebook user Kathleen Galt
A: Biofeedback has been demonstrated to be effective and is recommended for the preventive treatment of migraine. By becoming aware of your body’s automatic responses to pain and stress, and learning to control those responses, some individuals are able to lessen your pain. Biofeedback monitors and measures your body’s involuntary physical responses to pain and stress, such as breathing patterns, heart rate, body temperature, and muscle tension. The monitors provide feedback to the patient during a session and with this information, individuals can better understand how their body reacts in certain situations and how they can modify these responses to reduce pain. These techniques are felt to exert control over the autonomic (‘involuntary’) nervous system and engage the internal pain modulation system in the brain and in these, and potentially other ways, have a positive impact on migraine.
Q: Is there any relationship between the brain disorder that causes migraines and trigeminal neuralgia? -- From Facebook user Donna Mitchell MacKinney
A: No, trigeminal neuralgia and migraine are felt to be distinctly different disorders. They each have a unique biology and are treated differently.
Q: I was wondering if you can have migraines that do not manifest as headaches? I had ear pains that literally gave me vertigo so bad that I had to use my medical leave. We were never able to figure out what caused the ear pain. -- From Facebook user Valerie Garza Estes
A: Migraine is a neurological disorder that can cause a wide variety of different symptoms, of which headache is one. However, other symptoms of migraine may appear without pain. In particular, the aura of migraine (e.g. visual disturbance may occur without pain), vertigo, and other symptoms may occur in the absence of headache. In children, abdominal pain, vomiting, and other symptoms may also occur in the absence of pain. The presence of ear (especially inner ear pain) with vertigo may be due to disorders other than migraine.
Q: I have suffered for over 30 years and now I am getting nocturnal migraines. Any idea why they are happening while I am sleeping? I have also suffered two episodes of cluster headaches in 1990 and 1996. Any input on what could have triggered my cluster headaches? -- From Facebook user Chris DeBottis
A: It's very common for cluster headache to occur during sleep and in fact, its also common for migraine to occur during sleep or upon awakening. While sleep sometimes provides relief of migraine, it can also sometimes trigger migraine. This may be due to inactivation of certain regions in the brain that may lead to activation of the pain pathways and other brain networks involved in generating a migraine attack. One should also beware that there may be sleep disordered breathing (sleep apnea), elevated blood pressure during sleep, and other disorders that can either trigger cluster headache or migraine during sleep. If patients whose attacks begin to occur during sleep, or occur exclusively or predominantly during sleep, a sleep evaluation, sometimes with overnight sleep studies (polysomnography) is recommended.
Q: My 5-year-old son has been suffering from weekly headaches for just over a year. They can be debilitating if we don't treat them with Tylenol or Ibuprofen immediately. His pediatrician has prescribed Periactin nightly. How are migraines diagnosed in children, and is there more we could be doing? -- From Marla via Website
A: Migraine is a clinical diagnosis, based on characteristics of the headache and associated symptoms. In other words, there is no blood test, x-ray, or brain scan that can make the diagnosis of migraine. These tests are used to exclude other disorders that can mimic migraine. While there may be some differences between migraine in children and adults (e.g headache may lasts shorter period of time), in general, the attacks are similar. Cyproheptadine (Periactin) is a commonly prescribed medication used in children to prevent attacks. There are a variety of treatment options, both pharmacological (drug) and non-drug treatments that can be used to effectively manage migraine in children. For those children who do are not responding to conventional treatment, and who are suffering from frequent and disabling headaches, one could consider a referral to a pediatric migraine specialist.
Q: I've heard that migraines are also associated with a higher incident of stroke. Does the latest research, which moves the disease from the vascular space to the neurological space, support that? -- From acdames via Website
A: Yes, there is now considerable evidence that women who have migraine with aura are at an increased risk of stroke. Even though the migraine aura and the migraine headache is now not considered to be due to constriction and dilation o f blood vessels, migraine may be triggered in some patients by alterations within the brain blood vessels (e.g. reduced blood flow, particles in the blood). Also, during migraine attacks, there may be secondary changes in the blood vessels that affect blood flow and increase the risk of stroke. For example, during migraine with aura attacks, there may be a reduction in brain blood flow as a result of changes in brain activity. Also, individuals with migraine, especially with aura, are also at an increased risk for other disorders (patent foramen ovale, arterial dissection) that may increase the risk of stroke.
Q: Could there be a correlation between gastrointestinal diseases and migraine headaches? You discussed in detail on the show the numerous neurological conditions that have a strong relationship to migraines, but is there any research being done about possible relationships between Inflammatory Bowel Diseases and migraines? -- From Schandra via Website
A: There is evidence of a relationship between migraine and irritable bowel syndrome. There is also evidence that gastric stasis (reduced movement or motility of the stomach) may be present during and in between migraine attacks. However, there is not yet convincing evidence that migraine is related to or more commonly associated with inflammatory bowel disorders that would occur by chance.
Q: What is the difference between migraine and Benign Paroxysmal Vertigo syndrome? If you have BPVS, will you become a migraine sufferer? -- From Facebook user Deborah Couch
A: Benign Paroxysmal Positioning Vertigo (BPPV) is an inner ear disorder and unrelated to migraine. However, paroxysmal vertigo (episodes of vertigo) may occur in association with migraine attacks, whether or not the migraine attack is accompanied by the headache. This has been termed migraine associated vertigo or vestibular migraine. In fact, in young women, migraine is one of the most common causes of unexplained episodes of vertigo.
Q: While going through peri-menopause, I started suffering from the most painful headaches that often came in the middle of the night and often induced vomiting. Is there a link between migraine and menopause? I have a younger sister who is now going through the same symptoms I had at about the same time in her life. -- From Facebook user Candy Allen-Smith
A: Yes, migraine is often affected by changes in hormonal cycles in women. For example, the onset of menstruation during adolescence, the menstrual cycle, pregnancy, hormone replacement therapy, oral contraceptive therapy, and menopause all may have a dramatic effect of migraine. However, there is considerable variation in the effect of each of these periods, including menopause, among individuals. Certainly, a significant number of women improve after menopause, but a substantial number of women worsen while going through menopause. The effect of fluctuating levels of female hormones during menopause appear to have an effect on the excitability of brain networks, including pain systems, that may adversely effect women with migraine and those genetically susceptible to migraine.
Q: Are ocular migraines related in any way to migraine headaches? Are they connected to any type of brain disorder, or something completely different? -- From Facebook user Suzanne Rose
A: The formal or accurate term for “Ocular migraine” is migraine aura without headache. The visual symptoms experienced by these individuals is the same as those who experience the visual symptoms associated with the headache. One can think of the visual symptoms and the headache as two of many symptoms of the migraine attack. Sometimes they occur together, sometimes they occur in isolation.
Q: I have had dizzy spells for months, which some doctors think are related to migraine. I have tried physical therapy with mixed success to "retrain" the brain. Do you think this approach makes sense? -- From Facebook user Barbara Carney-Coston
A: Yes, vestibular rehabilitation therapy is recommended for those with vesibular symtoms, whether related or unrelated to migraine. There are other potential approaches to treatment as well, and guidance from a neuro-otologist or migraine specialist may be useful if you do not make progress with physical/vestibular therapy.
Q: I still get the visual auras and as my migraines became less [severe], I began to have acute tinnitus. Is there a connection between tinnitus and migraines? I am 63. -- From Facebook user Virginia Ann Ullrich-Serna
A: Yes, there appears to be a relationship between tinnitus and migraine. A number of migraine sufferers report tinnitus during migraine attacks. However, age-related tinnitus can have other causes as well, the most common of which is sensori-neural hearing loss.
Q: I think I have visual migraine when I exercise vigorously or I'm dehydrated. I have jagged lines in my field of vision, but no pain or sensitivity. It happens one or two times a year. Is that a migraine? -- From Facebook user Janie Moretz
A: Yes, that is a migraine aura without headache. It has the same underlying biology as when these symptoms are associated with headache.
Q: My migraines seem to be triggered by hormones and seem to be getting worse as I approach menopause (I'm 45). Are there different approaches for hormonally-triggered migraines? Can I expect some relief after I go through menopause? -- From Facebook user Lisa Tait
A: As noted above, migraine may worsen while individuals are progressing through menopause and may improve after menopause. This of course is not true for all. While treatment approaches may be the same as for migraine that is not associated with hormonal changes, there may be very specific strategies for treatment that include hormonal replacement therapy. It is highly advisable however that you enlist your doctor’s advice and guidance regarding the pros and cons of hormonal therapy.
Q: Has marijuana shown any promise as a treatment for migraines? -- From Facebook user Lionel Hubbs
A: There is no evidence to support the use of marijuana for the treatment of migraine.
Q: If as much as 10% of the population suffers from migraines, why does the medical community lack basic knowledge of common symptoms and treatments? What will it take to put migraines on doctors' radars? -- From Erin via Website
A: That is an excellent question but complex to answer. A misunderstanding of the biological nature of migraine for centuries, an underestimation of the impact and suffering experienced by a substantial number of individuals with migraine, and the lack of education in undergraduate and post-graduate medical education of physicians and health care providers are certainly leading reasons. It’s also true that it takes approximately 15 years for advances in medical knowledge to make it into clinical practice. With the emergence of the internet and direct-to-consumer advertising, patients have and will continue to become more empowered and engaged in the management of their illness, and seek the most appropriate medical care for their condition. Also, as medicine moves toward reimbursement (“pay”) for performance rather than “pay-for-service”, physicians and health care providers will need to integrate evidence-based guidelines and best practices to ensure optimal patient outcomes.
Comments
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I wish more doctors were familiar with migraines. I don't expect everyone to be an expert, and I do have a Neurologist that treats me regularly, but I wish other types of doctors would think about how their treatments can possibly help my migraines as well. For example, I had a hysterectomy at age 38. I remember discussing with my Gynecologist how I hoped that my hysterectomy would also help my migraines. She gave me a vague "Yes, it might". Later, I found out that if I really wanted to help my migraines that way, I should have had my ovaries removed (which I had a choice, and declined). If my Gynecologist would have at least been familiar, I could have made a better choice. Now I have to wait for menopause to see if it would have helped. I'm only 46...that's going to be quite a wait.
This is only one example. I have been in treatment for migraines for 25 years. There are many other issues I have that can affect my migraines (sinus problems, allergies, stress, etc...)and see different Docs for each one. I would like more of a "global" approach to my health care, especially since I sometimes get 4 migraines in one week. It is my number one health concern.
Secondly, I've tried just about every medication, and the only one that has ever worked for me are the Imitrex injections. Now that I have been taking them for so many years (20ish), I am noticing that they are not working as well as they used to. I'm so worried that I will not find a replacement drug when it finally gives out. What new medications are on the horizon.
One more thing. I have seen a treatment with an implant under your scalp that is something new. What are your thoughts on that type of treatment, and do you think that insurance companies will cover such treatments?
THANK YOU Diane, for doing an in-depth discussion on Migraines. We need more people to care about finding a cure!
If as much as 10% of the population suffers from migraines, why does the medical community lack basic knowledge of common symptoms and treatments? What will it take to put migraines on doctors' radars?
I've suffered from migraines for three years. After family and dear friends, my neurologist is the most important person to me. After months of tests, specialists' appts, and desperation, he was the only doctor I met with a knowledge of migraines. I'm thankful to live in an area that attracts such doctors and often wonder what I’d do if I were back in my rural hometown.
True, migraines are complex and lack uniformity, but there are some basic treatments that often work. Why aren’t doctors aware of them? One of my first migraines sent me to the ER. I spent over five hours with various residents and attendings, in so much pain that I lost awareness and bodily functions. When I could speak, I asked the doctor when I’d receive morphine. He responded that I'd already received 2 full IV bags, and that he was out of solutions so I had to be admitted. After he left, the nurse—in a conspiratorial hush--told me to ask for a caffeine bag. Although my husband found it odd that the nurse couldn't say as much to the doctor, we were desperate, so he made the request. Ten minutes after the drip began, I was laughing. Thirty minutes later, I was walking out of the ER unassisted and asking about dinner.
Since then, I've learned caffeine is a common preventative and curative intervention (although it can be a trigger for some). I don't think I've met a migraine sufferer or someone who knows one that isn’t aware of this. Yet, how many doctors did I see--both in that ER and while searching for my neurologist--who never knew this info, acted upon it, or shared it? I feel certain that had I been able to use a computer then, I would’ve found a migraine sufferers' message board and discovered this info for myself faster than I did through the medical community.
Cheryl and Erin,
Our hearts and prayers go out to you and all others suffering from this serious ailment. We surely hope this broadcast holds some information that would help you all.
Migraines run in my family, I used to get them at least once or twice a week, fortunately I out grew them at about 45 years old. It does appear that women suffer this problem more intensely then men. The only over the counter medication that helped at all was Extra Strength Excedrin which does have a considerable amount of caffeine in it. I always keep this near by just in case, I also found that taking it at the earliest signs of a new migraine coming on also helped. I am also sorry to report that two women members in my family sought professional aggressive help which if I remember right included steroid injections. It is my non professional opinion that none of it was worth the pain and effort, however there was a reduction of the severity of the migraines with aging.
Migraines have numerous contibuting causes, they don't all happen for the same reason. Deriving a solution comes in large part from determining the source. Like having an allergic reaction, you know the symptom, but need to ferret out the allergen from the tens of thousands of things that could be causing the symptoms. Migraines are only a symptom, not an explanation. They could be chemical, environmental, emotional, mechanical...
I was fortunate to determine the source of mine. My neurologist said that I would continue to always have tension-based migraines so long as I had the kind of stress that caused me to be tense. No headache medication ever helped before, but then it wasn't a headache, I had to overcome the root cause, stress.
I was also fortunate that a former employer knew a remedy I'd never heard of before, orange blossom water (or here we'd call it tea), from her home country of Spain. It took forever to find it, but amazingly it was the first thing that ever stopped one of my tension-based migraines once it was in progress. Unlike anxiety medications that can make you numb, sleepy, disconnected, or otherwise muzzy, orange blossom tea simply took down the intensity level from screaming to whispering for me. I'm extremely grateful to Dr. Purser for her recommendation. And I'm equally glad that Aztec Herbals carries orange blossom tea, appropriately labeled Tranquil Person.
Although I was lucky enough not to have migraines several times a week, when they came, they were completely incapacitating. It can be hard to explain to someone else who doesn't even get headaches how intense and overwhelming and sickening that kind of pain can be. And people in pain are often not the most friendly either, not always able to be rational. It will be interesting to hear this program and what's new in this field.
I was released from hospital yesterday after three days. I have been diagnosed with complex migraine. I had an episode where language was garbled and I was briefly confused. MRI and cat scan showed no stroke. Please explain this type of migraine. I do not have traditional pain but more stroke symptoms. I am receiving excellent treatment. Thank you. Andrea. Watertown, new york
My 5 year old son has been suffering from weekly headaches for just over a year. They can be debilitating if we don't treat with Tylenol/Ibuprofen immediately. His pediatrician has prescribed Periactin nightly. How are migraines diagnosed in children, and is there more we could be doing?
I've had 4 experiences, each about 6 to 8 months apart, that my doctor said were migraine aura, but they were not accompanied by pain. Were these migraines? Should I have an MRI of the brain, as my G.P. recommends?
Diane - Please, please ask your guests to address treatments specific to pregnant and nursing mothers.
I have chronic migraine....10 or more a month. I have tried everything...preventative meds, beta blockers, calcium channel blockers, depakote, topamax, botox, accupuncture, accupressure, meditation, relaxation, TMJ treatment, but the only thing that seems to work are triptans....sumatriptan specifically. No I don't have food allergies. I'm sure, after keeping a diary for years....it's related to fluctuations in barometric pressure. Anything besides moving to San Diego that might decrease the frequency? Is there anything new on the horizon besides brain surgery?
I've had migraines since I was in my teens and when Imitrix came out, it was an hallelujuah moment for me. Imitrix really changed my life for years. And then a couple of years ago, I went to the ER with crushing chest pain and ended up diagnosed, after an emergency catherization, with an unusual heart condition, prinz metals (sp?), and haven't been able to take the Imitrix since then.
I take topamax, which has cut down a lot on the number of headaches I have, but I still get enough of them to be troubled. And all I can take are the old drugs which leave me drugged, hung-over, and not functional. Are there any new drugs on the horizon for me?
I have suffered from Ocular Migraines all of my life. Doctors have never been able to pinpoint the cause, other than to comment that these can be hereditary. My father also experiences these, so that point is valid. However, not one doctor that I have consulted with over the years has been able to offer any remedy other than "wait it out".
These migraines do not involve much pain, but vision impairment is acute. I experience "floater" across my vision, auras, and flashes of light. They come on unexpectedly and last anywhere from one half hour to several hours. They have been dangerous when occurring during activities such as driving.
I actually had one while undergoing a thorough eye exam and the doctor could see the event....that doctor suggested that eye strain could be the cause.
Please ask your experts about this type of migraine.
Question for the Mayo Clinic physician: I've heard that migraines also are associated with a higher incident of stroke. Does the latest research, which moves the disease from the vascular space to the neurological space, support that?
Suffering from migraines for the past 45 years, I would like to know what the link to episodes is to low pressure weather changes in the atmosphere.
Thank you, Barbara Andress, Miami
I have migraines about once every 3 months. During a migraine I'm extremely sensitive to light, fragrances and sounds. That's fairly typical. I'm completely deaf in one ear, with 40% capacity in the other ear. Yet during a migraine I can hear things that I would not normally hear. How can that be?
Is there any evidence of migraines originating for patients that have PTSD? Is there any stress relation to them for any patients?
Thank you!
LOVE LOVE LOVE YOU DIANE REHM! Thank you for what you do!!!
If you respond well to Imitrex, does that mean that the headache is a migraine?
Thanks.
For myself, I'm very grateful that this condition has been identified as an issue with the brain rather than the vascular system. I especially notice feeling depressed and have difficulty speaking [I can't verbally articulate what I'm thinking] for a day or two after my migraines. Classifying this as a brain disorder at least makes these symptoms seem more "logical" if that makes any sense.
Can you ask your guests to comment on abdominal migraines?
Naomi from Rochester, NY
I want to ask the doctors about the use of NSAID with migraine and rebound syndrome with chronic migraine. Nan
I had terrible headaches intermittantly through childhood all the way into my 20s, but then they just seemed to become a rarer and rarer event. I am in my 50s and haven't had one for several years. Can one "grow out of" susceptibility to migraines?
My brother is 60 years old and has been afflicted with" hide in the dark", migraines. He takes over the counter medicines and prescriptions, but he is miserable for days.
He is also affected by certain foods, chocolates, coffee,and some vegetables. Does this "prove" it's triggered by food enzymes?
This is interesting to hear that it is not a "headache", but connected to another or several causes. I don't think his regular doctor is sufficient.
How do I find what kind of doctor could help him?
"function not structure" please explain further. Had serious migraines from the age of 12/13 until 21 when I did some work with a bio feed back machine practicing breathing techniques, meditation techniques when I would feel the early triggers coming on. Had had the spots in front of eyes, peripheral vision loss , vomiting, hours, days of pounding headache. When I learned these breathing techniques could cut off the upcoming migraine off at the pass. Also started drinking coffee at the age of 21 Still get migraines but maybe once a year.
Can you discuss the use of breathing meditation techniques to curb migraines and the use of caffeine?
I'm interested to hear the Dr's thoughts on painless and abdominal migraines? After having my first baby, I started experiencing symptoms cyclically at the time of my period which included visual auras, ears ringing, and intense vomiting, nausea and loss of apatite. I did not experience headaches however. I was at this same time experiencing incredible work stress as well. My Dr diagnosed me with dysmennorea, but could it have been migraines?
Listening to the show. Very interesting to hear that we have "excited sensory function" in-between Migraines. I am a "super-smeller" and a "super-taster". I never thought these things could be related.
Also, I forgot to mention in my earlier comment that I have passed Migraine Disease on to my daughter. As much as I love my children, I would not have had children had I known I might pass this along. I wish someone would have told me.
First came the blind spot, about twenty minutes after the blind spot went away would come the aura, and during the aura the pain started. In my early 20's I remember the pain being so intense I had the thought(s) that 'if I cut my head off it wouldn't be there to hurt anymore'. I'm now in my 50's and I'm now getting aura without noticing the blind spot and the pain isn't nearly as intense, sometimes easily dismissed. Worst part of the migraine was and is the scrambling of the thought process. I'm glad the Doctor just mentioned difficulty in speaking and understanding, because the words just floated around in my head I thought I was also having a stroke.
...
Too much to write about this, I aggressively pursued treatment twenty years ago, when the neurologists shrugs their shoulders what are you going to do?
My wife is diagnosed with chronic migranes as well as fibromyalgia. Is there a known relationship between the two conditions? Where can we find physicians experienced with both?
Thank you for this program!
What about people who have been hit by a car, and are suffering from post-traumatic migraine? Is it the same treatment, or are we talking about a different type of headache? After a car hit me, I suffer from migraines nearly daily. I had to give up my career, among many other things, family, social life, etc. What are the differences between post-traumatic migraines, and your "regular" migraine. thanks!!
I seem to have inherited my migraines from my mother and her mother. Women on my father's side also have had them. I had episodic migraines as a teenager. While I was in my late twenties, I started to get the strange and horrible development of the migraines that became common in my thirties. Now I am 52 years old. They are not nearly as severe as they were in my thirties, but I believe that this is due to the fact that my medications help to control and limit the frequency. Sadly, I still experience them at least twelve days in a month. Migraine effects my ability to think clearly and to speak fluently at times and forget certain words. The problem clears up when the migraine is gone. The triptan medications were a life saver.