MIGRANES - Relief for migraine sufferers

They are the mother of all headaches and can 

cripple those who suffer from them, 

but new research may hold the key to relief.

 

Help may be at hand for migraine sufferers who experience "aura" - which involves visual disruptions, numbness, tingling and weakness before a headache begins. US researchers have designed a hand-held device that can be used at home which delivers a magnetic pulse to the head.

For the study, participants were randomly given a fake stimulation device or a real one. Those who used the real device had less pain and recurring headaches and were less likely to need medication than those who used the fake device.

At this stage it's still unclear how expensive the treatment will be and how it should be administered for optimal effectiveness, however researchers also report that the device did not make symptoms worse or cause serious side effects.

Source: http://www.bodyandsoul.com.au/health/health+news/relief+for+migraine+sufferers,7615

HEALTH - How to beat a migraine

They are the heavyweights of headaches, 

but there are ways to beat the pain.

 

We all know what it's like to have a headache. That dull throb that has you furrowing your brow, squinting at your computer screen and wishing you could be transported to a masseuse for some relief. If you think a headache is bad, imagine being one of the roughly five to 10 per cent of the population who suffer from migraines, an extreme form of headache.

In a recent attack, mother of two Katrina Wait's migraine hit while she was driving on the opposite side of town to her home with her two children, aged two and five, strapped into the back of the car. The first signs that Wait's migraine was coming on were strange flashes of light popping into her vision, a classic warning sign. Less than 10 minutes later, she was unable to handle the daylight streaming in through the windscreen and was forced to pull over.As she spoke with her husband over the phone, waves of nausea washed through her. He told her to wait until he came to get her, but the pain was too extreme. Luckily, a friend was able to collect the kids in 10 minutes and put Wait in a taxi.

Signs that it is serious

A headache is usually associated with muscle tension in the scalp and can come on as a result of stress, neck injury, neck muscle spasms, a cold or flu, a knock to the head, dehydration, sinus problems or teeth clenching. A migraine is a severe form of headache caused by the dilation, and later restriction, of the blood vessels on the scalp which supply blood to the brain. Dr Brian Morton, from the Australian Medical Association, says there are a number of classic signs that a migraine is about to hit and they don't occur during the onset of a headache.

"The most common warning signs that a migraine is coming on are the flashes of light that appear in a particular way before the initial headache; then nausea and vomiting; sensitivity to light and noise; and, finally, the patient needs to go to bed in a dark and quiet room, sometimes for a number of hours or sometimes for days at a time," he says. "A small number of migraine sufferers can also get symptoms that mimic a stroke, such as pins and needles, and weakness or numbness in the limbs, but it is rare."

Interestingly, the brain doesn't have any nerve endings, so a migraine is not actually pain from the inside of the brain. "The pain comes from the upper lining of the brain and mostly from the scalp," Dr Morton says.

What are the causes?

Excessive glare or dehydration can bring on a migraine, but in the vast majority of cases there is a genetic or hormonal factor. "The precipitants for a migraine and headache are the same, but the difference between which one you are inclined to get usually relates to the person's genetic predisposition," Dr Morton says. "If your parents suffered from migraines, then you are more likely to suffer from them too."

There is also a hormonal link. Migraines are common in women aged between 20 and 50, but stop once menopause sets in. "The hormonal element is thought to be due to the oestrogen drop around the time of a woman's period," Dr Morton says. Naturopath Amelia Joseph says research suggests that migraine sufferers have abnormal serotonin metabolism. "We know low oestrogen is a definite cause of migraines, but naturopathy also teaches that depleted serotonin causes the blood vessels in your scalp to constrict and dilate, which affects the surrounding nerves.

"It is important to look at lifestyle risk factors such as motion sickness, smoking, stress and sensitivity to certain medications and foods or colourings. Foods that may contribute include citrus foods, dairy, wheat, coffee, tea, eggs, yeast, shellfish, pork, tomatoes and the nitrate food group that encompasses red wine, cheese and chocolate."

What are the treatments

The doctor: Dr Morton says the medical community has acute treatments for the moment when a migraine strikes and longer-term preventive treatments.

Acute treatment involves the usual pain relief options such as ibuprofen, paracetamol and simple painkillers containing codeine.

"The current treatment of choice is the triptan group of pharmaceuticals, which work specifically for a migraine," he says. "Sumatriptan is a popular one, but it's important for migraine sufferers to look at preventive treatments."

For longer-term management, Dr Morton says there are three main drug groups that can prevent vascular changes in the scalp. They include beta-blockers, some special antihistamines and a new group of neuroleptic medications, of which Topamax is the latest.

"The beta-blocker Inderal has been around since the 1960s and is used for blood pressure, angina and heart disease, and has very good results in preventing migraines," he says. For women whose migraines are linked to their hormones, the contraceptive pill is effective. "Some women continue with the active pill tablets for three months so they only have a period roughly four times a year. By reducing the frequency of their periods, they reduce the number of migraines they experience."

The naturopath: Joseph says there are a variety of things that can be done to relieve the symptoms and address the cause of migraines, usually in the areas of diet, lifestyle and stress. Traditional western diets usually include large amounts of processed food, red meat and cheap vegetable oils that are high in omega-6s and cause inflammation in the body, she says.

"Fish oils and other foods that are high in omega-3s, like nuts and seeds, are crucial to counteract this inflammation," Joseph says. "This won't deal with the cause of theinflammation, but rather it manages the system by bringing it back into balance." She also recommends taking vitamin B2 supplements morning and night as well as magnesium, antioxidants and herbal mixtures.

A headache or migraine diary will help pinpoint your triggers. Take notes about when you get your headache and what you've eaten in the 24 hours leading up to that point so you can identify any patterns surrounding the condition. If a food allergy is suspected to be the contributing factor, Joseph says an elimination diet can have great results.

"The elimination diet requires the client to eliminate all suspect foods for two weeks before rechallenging themselves with one food group at a time over a period of six weeks. This can reduce the onset of migraines for 30 to 90 per cent of this group," she says. Regular stretching, yoga, massage, being outdoors, walking and low-impact exercise will all help, too. Serotonin is a hormone produced by the pineal gland. It is lacking in people who experience high levels of stress or anxiety.

"Migraines relate to your crown energy centres, so if you're not getting relief from food elimination, yoga and fish oil, I'd consider disconnection as a possible cause," Joseph says. "If you're disconnecting with your purpose, then the part of your brain that produces serotonin will shut down, so you need to reconnect with something bigger than yourself again."

Source: http://www.bodyandsoul.com.au/

VIDEO - My Migraine Cure - What I did to stop my migraines !!

MIGRAINES - Transformed Migraine

Transformed Migraine - The Basics

by Teri Robert, MyMigraineConnection Lead Expert

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Transformed Migraine (TM) is Migraine which began manifesting in episodic Migraine attacks, increasing in frequency and changing characteristics, and resulting in almost daily less severe headaches punctuated by severe and debilitating Migraine attacks.

Patients with Transformed Migraine often share these characteristics:

•   A history of episodic Migraine beginning in their teens or twenties.
•   Most are women, 90% of whom have a history of Migraine with aura.
•   Medication overuse.

The process of transformation is often characterized by:

• Migraine attacks that became more frequent over a period of months or years.
• These attacks were accompanied by phonophobia, photophobia, and nausea, but these symptoms became less severe and less frequent.

Characteristics of Transformed Migraine:

•  A pattern of daily or almost daily headaches that seem to be a mixture oftension-type headaches and Migraine attacks.
•  Pain that drops in severity to mild to moderate.
• Pain isn't always accompanied by phonophobia, photophobia, or nausea.
•  Other Migraine symptoms may persist including unilateral pain, gastrointestinal symptoms, and aggravation by othertriggers.

Summary:

"Normal" episodic Migraines can increase in frequency and change in characteristics to produce almost daily headaches in addition to severe Migraine attacks. Medication overuse is a factor in approximately 80% of Transformed Migraine cases. Treatment generally involves discontinuing medications that are being overused and working to find effective preventive regimens. Often, when medication overuse is solved, the daily headache subsides and the Migraines return to being episodic and more easily managed.

MIGRAINES - Status Migrainous

Status Migrainous - The Basics

by Teri Robert, MyMigraineConnection Lead Expert

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Extended Migraines should not be ignored...

What is status Migrainous (also spelled Migrainousus)?
Migraine has now been shown to be a genetic neurological disease characterized by flare-ups often called "Migraine attacks." A headache can be one symptom of a Migraine attack, but it's just that -- one of the possible symptoms. Some Migraineurs (people with Migraine disease) have Migraine attacks without having a headache.

When a Migrainuer does experience the headache phase of a Migraine attack, it generally lasts from 4 to 72 hours (untreated or unsuccessfully treated). The International Headache Society's International Classification of Headache Disorders, 2nd Edition, defines status Migrainous as:

Description: A debilitating Migraine attack lasting for more than 72 hours.

Diagnostic Criteria:

A. Typical of previous attacks except for duration.

B. Headache has both of the following features:

1. unremitting for more than 72 hours
2. severe intensity

C. Not attributed to another disorder

A general rule of thumb recommended by many Migraine specialists is:

If moderate to severe Migraine pain lasts more than 72 hours, with less than a solid four-hour pain-free period, while awake, it should be considered an emergency requiring an office call or a trip to the emergency room.

Why is it important that status Migrainous be treated?
The pain of a Migraine is from dilated blood vessels in the brain and the inflammation of tissue and nerves around those blood vessels. Extended dilation of the blood vessels puts us at increased risk of stroke. Thus, it's important to stop a Migraine attack, as opposed to simply masking the pain with pain medications, as soon as possible.

MIGRAINES - Retinal Migraine

Retinal Migraine - The Basics

by Teri Robert, MyMigraineConnection Lead Expert

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Diagnosing Migraine

One of the difficulties encountered at times when discussing Migraines occurs when a Migraineur is given a diagnosis that isn't actually accurate in diagnostic terms, but is really a descriptive term. Such terms may be used fairly frequently, but they fall short of a diagnosis and may also be used differently from one doctor to another. That's one reason why most doctors diagnose based in the International Headache Society's International Classification of Headache Disorders, 2nd Edition (ICHD-II). A "standard" diagnosis also makes communications and transitions easier when patients need to consult other doctors or change doctors.

There are several terms that are sometimes used, supposedly as Migraine diagnoses, that involve visual symptoms. Most of them aren't actually standard Migraine diagnoses. Retinal Migraine, however, is an actual Migraine diagnosis. What becomes confusing about it is that it's sometimes misused, resulting in a misdiagnosis. The term "retinal Migraine" is often misused to mean any Migraine that involves any visual symptoms or a Migraine with visual symptoms but without the headache phase of the attack. 

Retinal Migraine Symptoms:

Retinal Migraine is Migraine where there are repeated attacks of visual disturbances preceding the headache phase of the Migraine attacks.

A retinal Migraine attack begins with monocular (in one eye) visual symptoms that can include:

1.   scintillations (seeing twinkling lights)

2.   scotoma (areas of decreased or lost vision)

3.   temporary blindness.

The headache phase of a retinal Migraine begins during or within 60 minutes of the visual symptoms. The headache phase presents symptoms consistent with Migraine without aura:

·         Headache duration of 4-72 hours

·         At least two of these characteristics:

1.      unilateral (on one side) location

2.      pulsatile quality (pulsing or throbbing)

3.      moderate or severe pain intensity

4.      aggravation by or causing avoidance of routine physical activity such as walking or climbing stairs

 At least one of these characteristics:

1.      nausea and/or vomiting

2.      photophobia (increased sensitivity to light) and phonophobia (increased sensitivity to sound) 

The primary differentiating factors between retinal Migraine and Migraine with aura are:

1.   The visual symptoms of retinal Migraine are monocular.

2.   Total, but temporary, monocular blindness may occur in retinal Migraine.
 

Diagnosing Retinal Migraine:

There are no diagnostic tests to confirm retinal Migraine. Diagnosis is accomplished by reviewing the patient's personal and family medical history, studying their symptoms, and conducting an examination. Retinal Migraine is then diagnosed by ruling out other causes for the symptoms. With retinal Migraine, it is essential that other causes of transient blindness be fully investigated and ruled out. 

Retinal Migraine Treatment:

For infrequent attacks, medications used for other forms of Migraine are often employed to relieve the other symptoms. These medications can include NSAIDs, antinausea medications,Midrin, ergotamines the triptans. The choice ofmedications is somewhat affected by the age of the patient. When Migraines are frequent, the same preventive therapies used for other Migraines can be explored.

The more technical explanation: 

In the ICHD-II, retinal Migraine is described as,

Repeated attacks of monocular visual disturbance, including scintillations, scotomata or blindness, associated with Migraine headache.

The diagnostic criteria for retinal Migraine under ICHD-II are:

A.     At least 2 attacks fulfilling criteria B and C

B.      Fully reversible monocular positive and/or negative visual phenomena (e.g., scintillations, scotoma or blindness) confirmed by examination during an attack or (after proper instruction) by the patient’s drawing of a monocular field defect during an attack

B.

C.     Headache fulfilling criteria B–D for Migraine without aura begins during the visual symptoms or follows them within 60 minutes

D.     Normal ophthalmological examination between attacks

The relevant diagnostic criteria for Migraine without aura are:

B.      Headache attacks lasting 4–72 hours (untreated or unsuccessfully treated)

C.     Headache has at least two of the following characteristics:

1.      unilateral location

2.      pulsating quality

3.      moderate or severe pain intensity

4.      aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs

D.     During headache at least one of the following:

1.      nausea and/or vomiting

2.      photophobia and phonophobia

MIGRAINES - Ocular, Optical, and Ophthalmic Migraines

Ocular, Optical, and Ophthalmic Migraines

by Teri Robert, Lead Expert

Ocular, Optical, and Ophthalmic Migraines

Migraine disease is not only painful and potentially debilitating, it can be confusing. There are different types of Migraine, and some should be approached and treated differently than others. That makes it important that Migraine be properly diagnosed.

In any health field, there needs to be standardization in diagnosing. If every doctor used different diagnostic criteria and classifications, there would be total chaos. It would be impossible to communicate with patients, other doctors, researchers, etc. In the field of Migraine disease and headaches, the gold standard for diagnosis and classification is the International Headache Society's International Classification of Headache Disorders, 2nd Edition (ICHD-II).

Questions often arise about ocular, optical, and ophthalmic Migraines. These questions, however, are difficult if not impossible to answer because there are no such Migraine classifications in the ICHD-II, no such diagnosis listed there. Although there are doctors who use these diagnoses, they use them differently, making it difficult for anyone else to enter a discussion or answer questions. 
 

Examples:

Mary Jane reports having been diagnosed withocular Migraines. Her Migraines typically beginning with six to 18 hours of mood swings, excessive yawning, food cravings, and unusually frequent urination followed by tiny blind spots in her vision (scotoma) and  extreme sensitivity to light (photophobia) and sound (phonophobia). These symptoms are followed by a headache that is on one side (unilateral), throbbing with her pulse (pulsatile), and moderate to severe in intensity. Her ICHD-II diagnosis? Migraine with aura. She sometimes has the same symptoms, but without the headache. The ICHD-II diagnosis for those Migraine attacks is still Migraine with aura, but the descriptive term acephalgic (meaning without head pain) is added, acephalgic Migraine with aura.

Lou has been diagnosed as having optical Migraines. She reports having quickly developing intense headaches on the right side of her head, focused around her eye. She also reports extreme nausea and vomiting. Her optometrist diagnosed her with optical Migraines. Her ICHD-II diagnosis? Migraine without aura.

Dianna was diagnosed with ophthalmic Migraines. Her first symptom was complete blindness in one eye (monocular). This was followed by phonophobia, nausea, and a mild headache. The blindness resolved by the time the headache was over. Her ICHD-II diagnosis? Retinal Migraine.
 

If you've been diagnosed with ocular, optical, or ophthalmic Migraines, you may encounter some confusion when talking with other Migraineurs or seeing doctors other than the doctor who diagnosed your Migraines. The examples above are not meant to be applied to anyone else, but to show how differently terms are used when they're not used with any established criteria. To better educate yourself about Migraine disease, particularly how it affects you, ask your doctor if he's familiar with the International Headache Society's International Classification of Headache Disorders. If he is, he should be able to give you an ICHD-II diagnosis. If not, you may want to seek a second opinion from a doctor who is familiar with the ICHD-II.

MIGRAINE - Hemiplegic Migraine

Hemiplegic Migraine - The Basics

by Teri Robert, Lead Expert

To understand Hemiplegic Migraine, we have to understand that Migraine attacks are episodic manifestations of a genetic neurological disease. Migraine can present in a variety of ways. Hemiplegic Migraine is a rare form of Migraine, made more confusing by there being two variations: Familial Hemiplegic Migraine (FHM) and Sporadic Hemiplegic Migraine (SHM).

Diagnosing FHM and SHM can be difficult as the symptoms are also indicative of vascular disease. and can be thought to be stroke, epilepsy, or other conditions. A full neurological work up and careful review of medical history and symptoms are necessary to rule out other causes and confirm a diagnosis of FHM or SHM. Family medical history is especially helpful in diagnosing FHM.

FHM and SHM share the same symptoms, which will vary among different Migraineurs. The difference between the two is that FHM can be traced back in the family history and has been linked to mutations of specific genes on chromosomes 1 and 19. SHM is FHM without the familial connection and that particular genetic mutation.

Symptoms of FHM and SHM:

·         Episodes of prolonged aura (up to several days or weeks)

·         Hemiplegia (paralysis on one side of the body)

·         Fever

·         Meningismus (symptoms of meningitis without the actual illness and accompanying inflammation)

·         Impaired consciousness ranging from confusion to profound coma

·         Headache, which may begin before the hemiplegia or be absent

·         Ataxia (defective muscle coordination)

·         The onset of the hemiplegia may be sudden and simulate a stroke.¹

·         Nausea and/or vomiting

·         Phonophobia and/or photophobia

Treatment of FHM and SHM:
Treatment of Hemiplegic Migraine can be challenging. The symptoms are greater in number and more difficult to treat. Those who experience Hemiplegic Migraines absolutely need to educate themselves about their disease and treatment. It's very common to need to seek the care of an excellent Migraine specialist with an established track record for treatment as many other doctors have never treated a case of Hemiplegic Migraine.

·         Abortive and Pain Relief: Migraine-specific abortives, the triptans and ergotamines, are currently contraindicated in the treatment of Hemiplegic Migraine because of their vasoconstrictive properties and concerns about stroke. One small study was conducted, safely using triptans with patients with Hemiplegic Migraine, but more trials are needed before they're considered a safe option.² Since the triptans and ergotamines aren't options, other treatments such as NSAID's, antiemetics, and narcotic analgesics are generally used for relief of Hemiplegic Migraine.

·         Preventive: Given the severity of the symptoms and the contraindication of abortive medications, preventive regimens are considered especially important in the treatment of Hemiplegic Migraine. As noted above the genes for FHM are mapped on chromosomes 1 and 19, These code for the calcium channel. "The mutant calcium channel does not open and close properly and cannot regulate the amount of calcium coming into the cell, so calcium influx and efflux regulation goes awry. This in turn leads to neurons firing too easily."³ For this reason, calcium channel blockers are sometimes especially effective preventive medications for FHM.

A Word of Caution:
Migraineurs with Hemiplegic Migraine should give special consideration to wearing some kind of medical identification at all times since an attack can lead to impaired consciousness and an inability to speak. Medical identification can save valuable time in an emergency and assure that proper treatment is received far more quickly.

Diagnostic Criteria from the International Headache Society⁴:

Familial hemiplegic migraine (FHM)
Description: Migraine with aura including motor weakness and at least one first- or second-degree relative has migraine aura including motor weakness.
Diagnostic criteria:

1.    At least 2 attacks fulfilling criteria B and C

2.    Aura consisting of fully reversible motor weakness and at least one of the following:

1.    fully reversible visual symptoms including positive features (e.g., flickering lights, spots or lines) and/or negative features (i.e., loss of vision

2.    fully reversible sensory symptoms including positive features (i.e., pins and needles) and/or negative features (i.e., numbness)

3.    fully reversible dysphasic speech disturbance

3.    At least two of the following:

1.    at least one aura symptom develops gradually over ≥5 minutes and/or different aura symptoms occur in succession over ≥5 minutes

2.    each aura symptom lasts ≥5 minutes and <24 hours

3.    headache fulfilling criteria B–D for Migraine without aura begins during the aura or follows onset of aura within 60 minutes

4.    D. At least one first- or second-degree relative has had attacks fulfilling these criteria A–E

Comments:
It may be difficult to distinguish weakness from sensory loss. New genetic data have allowed a more precise definition of FHM than previously. Specific genetic subtypes of 1.2.4 Familial hemiplegic migraine have been identified: in FHM1 there are mutations in the CACNA1A gene on chromosome 19, and in FHM2 mutations occur in the ATP1A2 gene on chromosome 1.

Sporadic hemiplegic migraine
Description: Migraine with aura including motor weakness but no first- or second-degree relative has aura including motor weakness.
Diagnostic criteria:

1.    At least 2 attacks fulfilling criteria B and C

2.    Aura consisting of fully reversible motor weakness and at least one of the following:

1.    1. fully reversible visual symptoms including positive features (e.g., flickering lights, spots or lines) and/or negative features (i.e., loss of vision)

2.    2. fully reversible sensory symptoms including positive features (i.e., pins and needles) and/or negative features (ie, numbness)

3.    3. fully reversible dysphasic speech disturbance

3.    At least two of the following:

1.    1. at least one aura symptom develops gradually over ≥5 minutes and/or different aura symptoms occur in succession over ≥5 minutes

2.    2. each aura symptom lasts ≥5 minutes and <24 hours

3.    3. headache fulfilling criteria B–D for Migraine without aura begins during the aura or follows onset of aura within 60 minutes

4.    No first- or second-degree relative has attacks fulfilling these criteria A–E

Comments:
Epidemiological studies have shown that sporadic cases occur with approximately the same prevalence as familial cases. The attacks have the same clinical characteristics as those in Familial hemiplegic migraine. Sporadic cases always require neuroimaging and other tests to rule out other cause. A lumbar puncture is also necessary to rule out pseudomigraine with temporary neurological symptoms and lymphocytic pleocytosis. This condition is more prevalent in males and often associated with transient hemiparesis and aphasia.

---

Migraine without aura
Description:
Recurrent headache disorder manifesting in attacks lasting 4–72 hours. Typical characteristics of the headache are unilateral location, pulsating quality, moderate or severe intensity, aggravation by routine physical activity and association with nausea and/or photophobia and phonophobia.
Diagnostic criteria:

1.    At least 5 attacks1 fulfilling criteria B–D

2.    Headache attacks lasting 4–72 hours (untreated or unsuccessfully treated)

3.    Headache has at least two of the following characteristics:

1.    unilateral location

2.    pulsating quality

3.    moderate or severe pain intensity

4.    aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)

4.    During headache at least one of the following:

1.    nausea and/or vomiting

2.    photophobia and phonophobia