March 27, 2006
A migraine headache....
Pronunciation: 'mI-"grAn, Brit often 'mE-
1 : a condition that is marked by recurrent usually unilateral severe
headache often accompanied by nausea and vomiting and followed by
sleep, that tends to occur in more than one member of a family,
and that is of uncertain origin though attacks appear to be precipitated
by dilatation of intracranial blood vessels"
... "is of uncertain
"The cause of migraine
is unknown. One theory is that the nervous system is reacting to
changes in the body or the environment. People with migraine may
have a more sensitive nervous system response than others do. During
an attack, changes in brain activity may cause blood vessels and
nerves around the brain to become inflamed."
Though many mysteries surround
the causes, certain people do have "triggers" that they
can reduce or avoid exposure to in order to reduce the frequency
and severity of their attacks.
"Most migraine attacks
occur for no apparent reason. However, something may trigger migraine
attacks in some people. Triggers can be all sorts of things. For
* Diet and foods. For example, dieting too fast, cheese, chocolate,
red wines, citrus fruits, and foods containing tyramine (a food
* Environmental. For example, smoking and smoky rooms, glaring light,
VDU screens or flickering TV sets, loud noises, strong smells.
* Psychological. Depression, anxiety, anger, tiredness, etc. In
some people migraines occur when relaxing following periods of stress.
(For example, during weekends or holidays.)
* Medicines. For example, hormone replacement therapy (HRT), some
sleeping tablets, and the contraceptive pill.
* Change in habits. For example, a change in sleep patterns (missing
sleep, lying in, etc), missing meals, long distance travel, jet
* Other. Periods (menstruation), shift work, the menopause.
...Some people need a combination of triggers to trigger a migraine.
For example, some women may only get a migraine if they drink red
wine and are having a period. Another example is that a food trigger
may only trigger a migraine if you are also over-tired, or stressed."
Some triggers can be avoided
and others can be managed, while others are unavoidable, or require
major lifestyle changes to eliminate.
"The frequency and
severity of painful migraine attacks increase as body weight increases,
suggest results of a telephone interview study of nearly 3800 migraine
sufferers. ... No association was observed between BMI and the prevalence
of migraine, Dr. Marcelo E. Bigal, of Albert Einstein College of
Medicine, Bronx, New York, and colleagues report in the journal
Neurology. However, as BMI increased, so did the frequency of migraine
attacks. The team notes that 4.4 percent of the normal weight group
had 10 to 15 headache days per month. This increased to 5.8 percent
in the overweight group, 13.6 percent in the obese group and 20.7
percent in the morbidly obese group. The percentage of subjects
who reported severe migraines also increased with BMI group, from
53 percent in subjects of normal weight to 57 percent in the overweight
group, 59 percent in the obese group and 65 percent in the morbidly
obese group, Bigal and colleagues report. A similar relationship
was observed between BMI and migraine-related disability, light
and sound sensitivity, which increased as weight increased."
Each patient is unique,
and it is important for people to work with their doctors to make
the lifestyle choices that best fit their situations.
"Many strategies can
be used to help prevent migraine. You can work with your doctor
* Identify and control triggers that start a migraine
* Make healthy behavior and lifestyle changes
* Evaluate cognitive and behavioral treatments
* Use medications to prevent attacks
A diary can help identify migraine triggers. It can also help track
the results of treatment and lifestyle changes."
Options are available.
"Drug therapy, biofeedback training, stress reduction, and
elimination of certain foods from the diet are the most common methods
of preventing and controlling migraine and other vascular headaches.
... Regular exercise, such as swimming or vigorous walking, can
also reduce the frequency and severity of migraine headaches. ...
During a migraine headache, temporary relief can sometimes be obtained
by applying cold packs to the head or by pressing on the bulging
artery found in front of the ear on the painful side of the head."
Prevention is the best
medicine, but the next best thing may be catching it early.
"In the first quarter
of Super Bowl XXXII last January, Denver Broncos running back Terrell
Davis was hit hard and walked off the field with a towel draped
over his head. A developing migraine made the sunlight difficult
to bear. So how did a person suffering from migraine, a condition
that can cause debilitating pain, return after halftime to score
the winning touchdown and earn Most Valuable Player status? The
answer: He recognized the early warning signs and immediately took
an effective drug to control his pain. ... About 15 to 20 percent
of migraine sufferers experience visual and other disturbances about
15 minutes before the head pain. ... According to news reports,
the Broncos' Davis experienced an aura during the Super Bowl, allowing
him to get early treatment to prevent a full-blown migraine."
Knowing personal triggers
Knowing how to catch it early is good.
Knowing what treatment to use is not always easy to determine, and
will vary from person to person.
"A recent survey of
30 managed care plans showed nearly 70 percent of prescriptions
written for patients with headaches are for narcotics. ... Specialists
are now sounding the alarm. Narcotics, they said, are an unproven
and risky treatment for headaches and should rarely be used. ...
Dr. Stephen Silberstein, president of the American Headache Society
at Thomas Jefferson University Hospital in Philadelphia, said long-term
use of narcotics can actually magnify headache pain and could render
other treatments ineffective. 'Not only does it deplenish your own
natural painkillers,' he said, 'but it destroys parts of the brain
that are responsible for fighting pain.' Narcotics bring other risks.
They can cause hormonal changes and intense physical dependency.
Still, many pain-management specialists insisted there were many
headache patients who, if carefully selected, will do well on narcotics
-- patients for whom no other drugs worked."
Questions of the Week:
How would those who are not personally affected by migraine headaches
benefit from knowing about them? How do you know if you have a migraine
verses a non-migraine headache? How would this knowledge affect
how you treat and/ or prevent your headaches? How can you identify
a migraine trigger? How can you develop the best prevention and/
or treatment plan for dealing with migraine headaches?
Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.
I look forward to reading
what you have to say.
Health Community Coordinator
Access Excellence @ the National Health Museum