Talk:Migraine/Archive 1

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Hormonal changes

Hormonal changes may contribute to migraines. People susceptible to migraines may have very sensitive nervous and hormonal systems. Many neuropeptides serve as hormones and neurotransmitters with the characteristic differences in structure being very small. One significant example is Serotonin which in one form binds to receptors in the stomach lining and in another form binds to receptors in the brain. One form of migraine that is somewhat rare that appears in adolescents is the abdominal migraine which has classic migraine headaches along with gastric discomfort. —Preceding unsigned comment added by 12.221.185.221 (talk • contribs) 16:56, 15 February 2004 (UTC)

I think that the hormonal aspect of migraines, especially for women, is well worth documenting here. goodwillstacy 00:32, 6 December 2005 (UTC)

Is there a difference between men and women getting migraines? —Preceding unsigned comment added by 24.136.121.173 (talk • contribs) 01:11, 19 April 2006 (UTC)

Ergotamine?

Hi, I know nothing about migraine, but just wrote the ergolines page, noting that (according to my research) ergotamine, dihydroergotamine and methyergine were used in the treatment of migraine. Are they still used or have they been completely superseded by the new drugs? If not perhaps a link to ergoline is appropriate. -- Rkundalini 13:46, 27 Apr 2004 (UTC)

DHE is definitely still used, especially in chronic migraine patients and in patients who do not respond to the gold standard treatments like sumatriptan. Dihydroergotamine is used in the hospital when a patient has had migraine cycle that cannot be broken, and also to help wean migarine patients off other medications like tylenol, narcotics, etc which can cause rebound headache. For chronic migraine sufferers, DHE is commonly prescribed for injection at home. I think an addition would be appropriate. goodwillstacy 00:23, 6 December 2005 (UTC)

Dihydroergotamine is used in the form of DHE injections as Goodwillstacy noted. It's also available in a nasal spray, brand name Migranal. As with the triptans, ergotamines such as DHE are contraindicated in patients with any form of ischemic disease such as coronary artery and other heart disease or history of stroke. Teri 10:57, 24 January 2006 (UTC)

Ergotamine tartrate is still very much in use in Asia, and probably other low-income parts of the world. Egotamine has "fallen out of favour" because drug manufacturers convinced USA doctors in the 1990's that triptans were superior at 5-10 times the price per headache. Triptans require less patient management, but are not superior. Ergotamine tends to work when triptans don't — one former importer called ergotamine the "gold standard" of migraine relief. Sumitriptan most certainly is not unless one has no choice. Ergotamine oral absorption is not erratic — that sounds like a drug detailer's myth in the current article. Ergotamine is also more effective than the triptans per dose because its effect lasts more than 24 hours, whereas headache rebound followed by redosing with triptans is rather typical within 12 hours. As a result, two or more 1 mg ergotamines ($2 ea) typically cost much less than do two 10-25 mg triptans ($20 ea) per headache. (That may change as triptans go OTC.)

Despite the cardiac contraindication, ergotamine tartrate only infrequently exacerbates angina. • The down side is that frequent migraine will cause ergotamine use that leads to temporarily disabling ergotism pain in the calves — three uses per week is the limit and that may be too much in older patients. Therefore drugs must be available to alternate with ergotamine. • Ergotamine tartrate with caffeine 1/100 mg (Cafergot, Ercaf, etc.) is the most commonly available fixed ratio drug formula, but it can't be used for evening onset migraines due to caffeine interference with sleep. Pure ergotamine tartrate is highly effective for aborting migraine during sleep without rebound, but it's even more difficult to find than ergotamine/caffeine, and is completely unavailable in the USA. Cafergot is currently advertised at a USA web pharmacy for about $1.50 per 1/100 mg tablet, but it may or may not actually be available in stock. Milo 05:26, 28 August 2006 (UTC)

Capitalization

Is there a reason "Greek" isn't capitalized? —Preceding unsigned comment added by 4.16.250.66 (talk • contribs) 06:19, 6 October 2004 (UTC)

No, it is the language and not the printing style, uh? JFW | T@lk 08:25, 6 Oct 2004 (UTC)

Botox

Should add a short paragraph about the success of botox in treating severe migraines. -- Barolo 21:01, 03 Jan 2005 (UTC)

I've started with a one-liner and a reference. I get Botox treatments for migraines myself, and it works. I was skeptical about whether it would work, until the first treatment wore off after three months and I realized how much it had helped. I'll try to add more information later. --Pbfurlong 20:20, 2 December 2005 (UTC)

Caffeine?

This article says something about "Ergotamine tablets" that contained caffeine. But my doctor told me not to drink coffee and energy drinks because of the caffeine. Because caffeine could trigger an migraine attack. --Ice Cream Reaver 17:45, 19 Mar 2005 (UTC)

Caffeine helps some migraine sufferers and hurts others. IceKarma 09:08, 2005 Apr 24 (UTC)

Caffeine sure as heck helps me. Coffee and acetaminophen often do the trick. My migraine specialist reccomended it. (Of course, readers must always consult their own doctor. Never use the Internet as a substitute for competant medical advice.) RK 00:41, May 9, 2005 (UTC)

I have experimented a bit... And I have come to the conclusion that Energy drinks help me. But coffee triggers migriane. Is there something different in energy drinks that could eliminate a headache? --Ice Cream Reaver 22:38, 14 May 2005 (UTC)

Never mind that. I was wrong... Both seem to work postive. But I wonder why a docter would say it is bad for migraine sufferers while it seems to help. Are there different forms of Migraine? --Ice Cream Reaver 15:37, 17 May 2005 (UTC)

No offence but they sound like caffeine headaches, caused by overuse or withdrawal. Caffeine can cure mild headaches but not real migraines. A lot of people claim to have migraines when they just have bog standard headaches so you're not alone. --62.252.128.18 17:57, 25 August 2005 (UTC)

"No offence", but did you actually read Ice Cream Reaver's initial question which mentions a diagnosis of migraine? Nor was it claimed that caffeine cures migraines, merely that it helps them. And I suppose the large number of over-the-counter analgesics containing caffeine as an adjuvant, _targeted to migraine suffers—and even some not so _targeted—are just placebos... IceKarmaॐ 20:02, 25 August 2005 (UTC)

I know the difference between a headache through a lack of caffeine when (mildly) addicted, and migraine. The aches feel very differently somehow, something I can't really explain. Though a SEVERE migraine attack is noticable. It has been roughly five years now since I had my first migraine attack, back then, I did not even drink caffeine. (I was 12 back then) And I don't think a headache through caffeine can result in aura's, somewhat numbness, and nausea. Ice Cream Reaver 22:46, 23 September 2005 (UTC)

Scientifically explainable or not, I find the mix of acetaminophen and caffeine quite effective. If I take a little during auras or even as pain starts to develop, it can often cut the headache off completely. Once the headache progresses though, it rarely helps beyonf dulling the pain slightly. Gadriel 03:40, 25 November 2005 (UTC)

Many headache sufferers start with one headache type, then take a remedy which works for a while (caffeine, paracetamol, codeine etc) that, in the long term, merely gives them a second headache type on top of the original one. In your case there may be both migraine and caffeine withdrawal headaches involved. The two basic rules of headache are 1) take as few drugs as possible (if in doubt, stop taking it); 2) prevention is better than cure. That'll be 2 cents please. -- Dubbin 23:17, 23 September 2005 (UTC)

Regarding Ice's initial question: "Ergotamine tablets" with caffeine is endorsed as a cure for migraine not because it cures migraine per se but; Caffeine warns neurons, and ergotamine accelerates this process. So in result, you get your nerves warned, stretched so that your body must rest. After this rest is done, your body is refreshed, assumably, and in result your migreine-attack stops. But this may not always be the case, and there isn't a scientifical way to cure one's migraine attacks for good. -- Kedi the tramp 23:44, 07 July 2006

These things are highly variable from person to person and attack to attack. Caffeine acts as a vasoconstrictor, which can, at some points in a migraine attack, be therapeutic for the same reason that ergotamine can help some sufferers. Of course, any vasoactive substance can also be a trigger factor. People need to learn about their bodies and figure out what works for them. —Preceding unsigned comment added by 216.138.232.59 (talk • contribs) 28 September 2005 (UTC)

Many people claim they can distinguish between their migraines and their caffeine withdrawal headaches, but they rely on purely subjective means to distinguish between the two conditions. Also, many people report they got migraines as a child, before they ever used caffeine. They may be mistaken, however, and may have unknowingly used caffeine when children. These days most children regularly use caffeine. Caffeine often aborts genuine migraine episodes. Vascular dilation is a symptom of migraine, rather than the cause of migraine symptoms — the vascular theory is wrong — so caffeine, though it constricts blood vessels, doesn't relieve migraine by constricting blood vessels. Caffeine has only one known mechanism of action at likely doses: it occupies and blockades adenosine receptors. So caffeine must relieve migraine episodes by blocking adenosine. Caffeine often fails to effectively abort migraine episodes, though, and I think that is due to the peculiar mechanism — adenosine receptor blockade — by which caffeine works. If adenosine receptors are already saturated with adenosine, there's not much administered caffeine can do. It can block an unoccupied receptor, but can't remove receptor-bound adenosine. All a caffeine molecule can do is wait around for an adenosine receptor to become unoccupied and available, and then must compete with adenosine for access to the receptor. That would explain why caffeine is most likely to be effective if taken early during the migraine episode, before adenosine occupies all available adenosine receptors. Barry 01:32, 23 December 2005 (UTC)

Caffeine is rather paradoxical. Although it is a headache and/or Migraine trigger for some people, it's also an ingredient in many compound medications. Even for patients for whom caffeien IS a trigger, it's often helpful in medications. It potentiates the effects of meds, i.e. helps them work more quickly and sometimes more effectively. Yes, there are different forms of Migraine, but I don't think that's the issue here. IMO, it's whether caffeine is a trigger for an idividual Migraineur. Teri 11:03, 24 January 2006 (UTC)

One of the lists of triggers mentioned is "Caffeine (including decaf)." I'm assuming this is meant to read, "Coffee (including decaf)." Can somebody with access to this doc's trigger list double-check this and correct it? 151.190.254.108 19:51, 14 June 2006 (UTC)

Stomach emptying is delayed during a migraine attack. This both contributes to the nausea that many migraineurs experience and reduces the absorption of analgesics. Although caffeine on its own is unlikely to help, if you take it with a conventional analgesic it will increase its efficacy and speed of onset. I have added a sentence to this effect in the article. Jbelsey 16:32, 6 October 2006 (UTC)

My doctor said that changes in caffeine consumption can trigger migraines and thought I remember reading several articles that said the same. I can find the source of these articles if interested for this Migraine article. I just read this article and searched "change" to see if change in caffeine level can trigger a migraine is mentioned but did not find it, but is the day after a migraine for me and I may have missed it. Emailscottso 21:50, 27 May 2007 (UTC)

Narcotic Analgesics

A great deal of recent evidence indicates that the addiction potential of opioid analgesics for legitimate pain patients has been vastly overstated. They provide a valuable last resort for those migraine sufferers who have not responded well to other treatments. —Preceding unsigned comment added by 66.80.215.119 (talk • contribs) 20:30, 13 May 2005 (UTC)

Public domain site

Some text in the article was taken from http://www.ninds.nih.gov/disorders/headache/detail_headache.htm (public domain) —Preceding unsigned comment added by Wouterstomp (talk • contribs) 01:24, 13 November 2005 (UTC)

Fix?

Could someone work at fixing up some of the grammar in this article? It looks somewhat like it was written ESL. Gadriel 03:15, 25 November 2005 (UTC)

Symptoms

Is it just me, or does the symptoms category not actually list any symptoms? 24.153.226.7 05:35, 30 November 2005 (UTC)

I have a list of all known migraine symptoms, in outline form (arranged by type of symptom). I can add it as soon as I figure out how to make tables. 68.126.224.85 00:03, 23 December 2005 (UTC)

Earlier Version

An earlier version of this article stated that it's a misconception to refer to a migraine as a headache, that the migraine is actually the disorder itself, and the headaches the most commonly known symptom. This version stated that it was possible to suffer migraine attacks with no headache at all. That seemed to describe my migraines exactly, but all of that information is now either missing or directly negated (since the current version of the article says in the very first sentence that a migraine is a headache). So my question is, which version is accurate? We should get people to quote their sources more often to avoid such confusion. —Preceding unsigned comment added by 69.182.62.38 (talk • contribs) 01:09, 13 January 2006 (UTC)

Quoting the public domain site: 'Headache-free migraine is characterized by such migraine symptoms as visual problems, nausea, vomiting, constipation, or diarrhea. Patients, however, do not experience head pain.' Therefore headache is a symptom of migraine that may or may not be present in a migraine attack. In light of this I'm going to correct the opening sentence. Cheers. !mAtt™ 21:28, 18 January 2006 (UTC)

I too suffer from migraine aura without headache. I have been told by neurologists that it is quite rare. It does run in my family as my sister also has migraine without aura. I think the article should at least make the distinction since some people have atypical migraine aura which is probably more like a partial seizure condition rather than an auto-immune or vascular problem. Perhaps a sub-article is needed for this variant of 'migraine'. —Preceding unsigned comment added by 69.180.37.214 (talk • contribs) 01:01, 19 July 2006 (UTC)

Organization needed.

The article states the same thing in a couple places, such as the technical name of the condition where one suffers a migraine attack without an actual "headache". But, I ended up on this page while 'suffering' from a migraine, so I don't quite have the capacity to do it myself at the moment. Any takers? 70.92.174.251 20:31, 22 January 2006 (UTC)

Anti-inflammatory drugs

I wonder if anti-inflammatory drugs should be added under treatment, I believe they are commonly used against migraines. Any opinions?Neltah 22:46, 6 February 2006 (UTC)

Prodrome

I think the article is very helpful and informative. It is noted that some sufferers experience psychological effects after a classic migraine. I can attest to this anecdotally. During the postdrome of a migraine attack, my thinking is slow and my emotional state is flat. Reference is also made in the article to the 24-hour period preceeding an attack, but no 'prodrome' symptoms are listed. Several sources on the subject of migraine describe the sufferer as experiencing a range of symptoms including, irritable bowels, yawning, crankiness, food cravings, drowsiness, depression and euphoria the day before the onset of an attack. Euphoria appears before most of my migraines, usually presenting as an inexplicable burst of creative or physical energy, loquaciousness and a feeling of well-being. Only very recently was I able to recognize this euphoria, while I was experiencing it, as a prodrome to an attack and take action to prevent onset of the migraine. Other sufferers of classic migraine may benefit from knowing about prodrome symptoms. 72.141.26.222 05:51, 20 February 2006 (UTC) msklystron

Yeah, I'd have to agree there as well, on the topic of prodromes and post-attack symptoms. I suffered terribly from migraine as a kid, and afterwards I'd always be detatched and "daydreamy". Before an attack my vision would go wonky (things would look as if they were hundreds of meters away when they were at arms reach, and my depth perception would go out the window), I'd go pale and my eyes would "wash out" from blue to grey. Never experienced euphoria (damn shame :P ) but I'd definetly get the feeling of things "not being right". It took a while for my schoolteachers to catch on to the fact that I suffered migraines, alot of the time I'd have to bear one out for half a day because they thought I was attention-seeking. Do you know what it's like to be photo-, phono-, and smell- (didn't know the prefix, sorry) phobic and be trapped in a bright classroom filled with screaming 2nd graders and smells like food or paint? Not fun. I would like to see some more symptoms listed as well. I'm glad they've drawn a distinction between migraine and a nasty headache - too many people say "I've got a migraine" yet they're still capable of carrying out their normal day-to-day lives. Migraine typically sidelines you when it hits. And it's beyond pain, it's into uncharted territory. —Preceding unsigned comment added by 61.68.99.35 (talk • contribs) 10:32, 8 April 2006 (UTC)

The wonky vision effects you mentioned I also got as a kid, but very rarely as an adult. When I get those wonky effects while an adult it is always when I'm stressed so assumed it was an symptom of a mild panic attack. I didn't get migraines as a kid, but get about one migraine a year as adult, it's interesting thought that the wonky vision effects you mentioned may have been early migraine like symptom. Emailscottso 22:00, 27 May 2007 (UTC)

magnesium

Hi, everyone,

I have noticed that a google search of magnesium+migraine brings up lots of info [1]. My idea is to make a section called Dietary supplements, like in the Clinical depression article, and put in there the most promising, well researched, and which migraine sufferers might want to take on a daily basis. The others can remain in alternative treatments.

I can volunteer to track down the research on q10 and magnesium. --Mihai cartoaje 04:28, 22 February 2006 (UTC)

A doctor in Dallas, Texas does IV administration of Magnesium for acute migraines. It works for some people. He said that magnesium supplements may help, but the dose levels in the IV are much higher. MeekMark 14:40, 25 April 2006 (UTC)

Removed text

Okay, I cleaned up the Signs & Symptoms section by removing this text... The parts that aren't redundant belong in another section. Putting this here to keep it from getting lost. -- Taral 02:30, 12 April 2006 (UTC)

---

"Aura" refers to the non-headache features of migraine that often happen before, or in the place of, the actual headache.

It is possible to have a migraine attack marked by other symptoms and no headache at all, which is called acephalalgic migraine. The symptoms associated with these migraines are very similar to the symptoms of Chronic Fatigue Syndrome, and thus it is possible that the two may be related, or even the same.

Many migraine sufferers have headache without aura. Such headaches are commonly misdiagnosed as sinusitis or chronic sinus infections. The error can be revealed by a CT scan of the sinuses, which will show inflammation in the sinuses if a sinus infection is present.

Migraine had been thought to be caused by vasodilation in the head and neck; however, newer research suggests that vascular dilation associated with migraine is a symptom of migraine, not the cause of migraine symptoms.

Blood vessel diameter is under neurochemical control; in other words, blood vessels dilate during a migraine episode because the nervous system tells them to. The cause of the pain itself is from activation of the trigeminal nerve. This theory is still being examined though. The trigger of the migraine may be overactivity of nerve cells in certain areas of the brain (for example, the raphe nuclei). Often a migraine episode is associated with strong emotional expression or psychic tension, but those may be migraine symptoms rather than migraine triggers.

---

Cleanup

Pathophysiology reads like some foreign language in parts. The different migraine theories need clear separation.

Migraine Triggers starts with "so there needs to be some explanation for why a particular migraine episode occurs at a particular time and not at another time." Needs rewriting for tone, and possibly integration into the Pathophysiology section.

I'm done for now, hopefully someone else will give this article some attention too. :) -- Taral 02:36, 12 April 2006 (UTC)

And, like, I don't think I'm stupid or nothin', but couldn't pathophysiology just be causes? I know you lose bonus points on the 50-cent words, but I think it easily makes up for it for the average passer-by who, like myself, was looking for the section on "causes." Wiki Wikardo 05:27, 21 April 2006 (UTC)

I think that is at least a $5 word; I've got a college degree but I've never seen that word before; many (some people believe many) people could probably guess what it means, but certainly something would be clearer. Causes isn't quite the same (see http://www.m-w.com/dictionary/pathophysiology), but close enough. MeekMark 03:27, 28 April 2006 (UTC)

Alternative Approaches Section

The section Migraine#Alternative_approaches very long and unweildy - I suggest these sub-sections:

===Prism Eyeglasses===

===Exercise, Physical Therapy===

===Medical Treatments===

  (Botox®, Spinal Cord Stimulator)

===Herbal===

===Biofeedback/Visualization===

  (Can't think of a good section name that would encompass these related topics)

===Accupuncture===

I'm sure someone can come up with better sub-sections, but this is a start. MeekMark 17:41, 22 April 2006 (UTC)

Be bold and make the changes if you think it is better. —Preceding unsigned comment added by Btball (talk • contribs) 08:37, 17 June 2006 (UTC)

LSD as treatment?

What about research done into using LSD as treatment? http://www.theaustralian.news.com.au/story/0,20867,18180578-23289,00.html

I'm surprised this isn't mentioned. —Preceding unsigned comment added by 70.68.251.237 (talk • contribs) 18:50, 30 April 2006 (UTC)

I'm not surprised at all. This is something in development, which is very unlikely to ever reach the point where doctors will prescribe their migraine patients LSD rather than a triptan. If you insist, please do the readers a favor and find an academic paper that discussies the benefits of LSD rather than a somewhat sensationalist (because involves illegal drugs) newspaper article. JFW | T@lk 22:04, 30 April 2006 (UTC)

I would have thought the disadvantages of LSD somewhat outweighed the advantages... Jatos 18:40, 21 June 2006 (UTC)

In a similar vein, does anyone know if DHE has any hallucinogenic properties like its more notorious cousin? 130.36.62.139 14:29, 22 August 2006 (UTC)

LSD was originally developed as a treatment for serious psychotic illness, but its use was discontinued for obvious reasons. It has been experimented with as a last-ditch treatment for cluster headache - an extreme form of migraine that can actually make patients suicidal. Even in this circumstance, it seems highly unlikely that the FDA or EMEA will issue it with a licence, so I wouldn't hold your breath!

Regarding DHE, I can't find any reports of hallucination in the medical literature. I suspect, looking at its pharmacology, if you took a high enough dose you might get some effect but your fingers and toes would have dropped off long before that. Jbelsey 16:43, 6 October 2006 (UTC)

External Link about migraine and sex drive

Moved here for discussion

• Migraines Linked to Higher Sex Drive

An anonymous user from IP 205.188.116.73 which has received several warnings about vandalism. It is a shared IP for AOL users and I suspect this is vandalism also. Rather than cite an AOL news article, I think it would be better to cite a scientific article - if this link is appropriate at all. Brian 08:18, 17 June 2006 (UTC) btball

You could be right, but I know of at least three migraineurs (all doctors) who admit to this prodromal phenomenon. It doesn't seem to last beyond the onset of headache, though, and we're all pretty normal performers the rest of the time! Jbelsey 16:45, 6 October 2006 (UTC)

From my own experience and from what I've been able to pry out of family members who also suffer from migraines: some sufferers definitely experience an increase in sexual desire during migraine attacks, and suffer temporary but complete relief during sexual activity. DPU 22:03, 12 December 2006 (UTC)

Is there any known hypotension Link?

Is there anyone here who knows if migraines are linked to hypotension. The reason I ask is I suffer from both migraines andd hypotension, and I seem to be more prone to migraine symptons when my blood pressure is low. Jatos 18:43, 21 June 2006 (UTC)

I haven't heard anything one way or the other on that, but I experienced a dramatic reduction in migraine frquency and intensity after getting my hypertension under control. However, my doc put me on atenolol for the high BP (it's also used for migraines), so it's tough to say if there's a link between my BP & my migraines or if the atenolol's just pulling double duty. 130.36.62.139 14:35, 22 August 2006 (UTC)

Yes. Blood pressure is under control of several hormones, including adrenal cortisol[2]. Low cortisol can mean low pressure, your brain may not get enough blood flow, and may dilate your cranial vessels to compensate. (If there is still not enough blood, you would faint.) Cranial blood vessel vasoconstricting serotonin keeps the vessels' smooth muscle tone in balance with normal pressure changes (standing up, sitting down). • Under the "vascular theory", if you have migraine genes, the dilation process becomes extreme due to loss of normal serotonin, and your blood vessels expand until they stretch and hurt. Migraine by type (common or classic) is associated with different than normal lengths (alleles) of the serotonin transporter gene. I think the serotonin transporter protein (made by the gene) is mishaped and maybe it reuptakes too much serotonin. Where does the serotonin go? Spare serotonin is apparently stored in and resupplied from the platlets. When the platlets become exhausted of serotonin, then that could be one cause of a migraine headache. Cortisol levels are supposed to rise under this kind of stress and help stimulate the DNA replication of enzymes which make more serotonin from 5HTP, and it from food tryptophan. But if you don't have enough cortisol to keep your blood pressure normal, then you aren't going to make more enzymes or serotonin very fast. Milo 08:07, 28 August 2006 (UTC)

Yup, I suffer from severe migranes and I've always theorised on a link between it and the fact my blood pressure is low (I had a kidney removed when I was younger) - sometimes they seem to be caused by for example leaning on my arm or crossing my legs - that side of my body will go totally numb and then the classic symptoms of migrane will onset. I'm due to go on medication to raise my blood pressure soon so I may find out for sure. --Streaky 08:07, 20 September 2006 (UTC)

Is this a migrane?

I have recently been suffering these slightly migrane like symptoms. But they differ from the symptoms iv read on here quite a bit. Instead of a long period of Purudome i think it was called before hand, my things happen with no warning. Mine make me feel as if my head is spinning in 5th gear, I feel sick, but I never ever come close to being physically sick, its closer to extreme dizziness. And, I don't get "flashing lights" or weird crenalation like lines, I get full blown visions of events that I don't remember happening. Most often I see conversation between my self and several friends, or events involving friends at school, like kicking a football around or something. They are very intense and realistic.

Mine only last for about a minute or two at the most, i have no cravings for food, depression or anything like that.

But the strangest thing is, I seem to be able to classify these things into two distinct types, there are the heavy headaches that accompany these weird hallucinations, and then there are these small, mild ones i get where i merely feel slighty ill, and only slightly. However, during I've noticed rather worryingly, that what i was doing when these mild attacks occur is something that I realise i saw happening in a heavy attack. At least I think I do see that. I get a huge feeling of de ja vu.

However there is an explanation for this, deja vu is theorised to be communication between the "now" and "memory" area of the brain, so the "now" event mirrors itself in the memory area and you think you're experiencing something thats also in your memory at the same time, when reality its never happened before. Is it possible that that is what Im getting when I feel deja vu? And the headache I get is just there because my brain associates the headache with the heavy headaches i got where I supposedly saw the thing im now having deja vu over?

These things only happen about once or twice a month at the most, though slightly more recently at the moment as I've just finished exams.

Whats going on? I'm not particularly worried about it, being psychic would be kinda cool. --SGGH 13:04, 24 June 2006 (UTC)

If the headache is brief too (minutes instead of hours) probably not a migraine. The vivid images could be symptoms of a serious disease; I'm not a doctor, and I don't play one on TV either, but I'd find a neurologist that specializes in headaches. MeekMark 16:55, 24 June 2006 (UTC)

I've always had a VERY active and powerful imagination. Seeing as it isn't definitely a migrane (though there is family history) I'll put it down to recent exam and social stress and an over active imagination, but if persist I might head down doctor way. Probably just very lubricated synapses though. Cheers.--SGGH 17:47, 24 June 2006 (UTC)

I'm not a doctor nor do I play another one either, but like the guy says, go see a real one. Though it doesn't sound like a migrane to me either. --Streaky 08:14, 20 September 2006 (UTC)

Well I am a doctor and this is definitely not migraine. Take everyone's advice and see your doctor. Jbelsey 16:48, 6 October 2006 (UTC)

Dead-end Links

I was only interested in the "Aura" section. None of the links that I attempted to follow there actually linked to anything. —Preceding unsigned comment added by 64.40.59.79 (talk • contribs) 02:52, 26 June 2006 (UTC)

Stroke

Any truth in what I read about migraine suffers being more at risk of stroke? --Streaky 08:15, 20 September 2006 (UTC)

Yes, there is. Here are three facts for you...

1) The averaged risk of stroke for all Migraineurs was 2.16 times that of people without Migraine.

2) Migraineurs who experience Migraine with and without aura had 2.27 and 1.83 times the risk factor of that of non-Migraineurs.

3) Adding oral contraceptives resulted in increasing the risk of stroke by approximately eight times.

Reference: Etminan, Mahar; Takkouche, Bahi; Isorna, Francisco Caamaño; Samii, Ali. "Risk of ischaemic stroke in people with migraine: systematic review and meta-analysis of observational studies." BMJ, doi:10.1136/bmj.38302.504063.8F. December 13, 2004. --TeriRobert 06:18, 21 September 2006 (UTC)

Migraine from multiple genetic disorders

New topic post moved here from heading "Is there any known hypotension Link?"

User:Milo mentioned "migraine genes", but the article does not. The article is listed in the Genetic disorder category. Can anyone provide a reference for this or remove the category. --apers0n 18:25, 3 October 2006 (UTC)

The Ogilvie, 1998 reference at Pubmed is not the most recent but it neatly abstracts migraine genetic findings.

Migraine by type, classic (MA - migraine with aura) or common (MO - migraine without aura), is associated with different than normal lengths (alleles) of the serotonin transporter gene, which in turn replicates the serotonin transporter protein (STP), that reuptakes serotonin in the nerve synapses. Ogilvie, et al, 1998, (PMID 9601620) found 10 alleles for controls (no migraines), 12 for MA's, and 9 for MO's.

Cephalalgia. 1998 Jan;18(1):23-6.
Altered allelic distributions of the serotonin transporter gene in migraine without aura and migraine with aura.
Ogilvie AD, Russell MB, Dhall P, Battersby S, Ulrich V, Smith CA, Goodwin GM, Harmar AJ, Olesen J.
Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital, UK. ado20@cam.ac.uk

Since replacement serotonergics work better than any other treatment overall, there must not be enough endogenous serotonin somewhere in the migraine cycle. Serotonin is a neurotransmitter that acts inside the synapses, those gaps which are located between connecting nerve cells in the brain and elsewhere.

Maybe depending on exactly where the vessel is located, but certainly where migraine head pain is located, vasoconstriction occurs when serotonin acts in the synapses controlling smooth muscle of blood vessel walls. Less serotonin in the gap causes less nerve impulse activity, and less constriction with greater vessel diameter. If less than normal, a mild vascular headache results, but if much less, migraine pain.

The serotonin transporter protein (STP) moves serotonin out of the gap and into the nerve end (reuptake). STP is DNA replicated by the serotonin transporter gene.

Because of its importance, here is a fair-use copy of the Ogilvie, 1998 abstract:

"Allelic variation of the human serotonin transporter gene (HSERT), a highly plausible candidate gene for susceptibility to migraine, was investigated in 266 individuals with migraine, including 173 having migraine without aura (MO), 94 having migraine with aura (MA), 18 with co-occurrence of MO and MA, plus 133 unaffected controls. The distribution of a polymorphism with different forms of a variable tandem number repeat (VNTR) in intron 2 were compared. The MO group had an over-representation of genotypes with two twelve repeat alleles (STin2.12) and a reduction of genotypes containing one ten repeat (STin2.10) compared to controls. The MA group showed a similar pattern, but also a trend towards an increase in genotypes containing the nine repeat allele of the VNTR (STin2.9). Genotypes containing this allele were found in 6.4% of the MA group compared to 2.3% of controls. The group with co-occurrence of MO and MA had a significantly different pattern of overall allele frequency distribution from controls, reflecting a reduction in genotypes containing the STin2.10 allele and a shift both to STin2.9 carriers and to STin2.12 homozygosity. These results support the view that susceptibility to MO and MA has a genetic component, that these disorders are distinct, and that genetic susceptibility may in some cases be associated with a locus at or near the serotonin transporter gene."

Note the small percentages that suggest that this particular HSERT, aka STG, gene is "a" cause, not "the" cause of MA or MO migraines. In turn this hints that migraine is a symptom of several or many genetic and functional disorders. That would help explain anti-intuitive observations like "cold" versus "hot" migraine treatments, or why caffeine can both cause and treat migraine.

A possibility is that STP, made by the gene, may have a miscount number of serotonin molecular receptors corresponding to the allele miscounts on the gene (say, either 9 or 12 receptors per protein molecule instead of the normal 10). Thus, maybe, the 12-STP allele reuptakes too much serotonin in the synapse with the consequence of direct vessel dilation. Alternatively, since migraine is sometimes a short-term cyclical diameter disorder (vessel constriction followed by dilation and migraine), perhaps the 9-STP allele results in too little reuptake with a direct vessel constriction, followed by a reactive dilation rebound (via a backup mechanism to prevent brain death from excess vasoconstriction).

Spare body serotonin is apparently stored in and resupplied from the blood platelets, which are on the body side of the blood-brain barrier. When the platelets become exhausted of serotonin, then that could be one intersecting cause of a migraine headache. Blood/body and brain serotonin don't normally interchange (except in a hypothetical leak between blood and brain serotonin during migraine), so it's not understood (by me anyway) why selective serotonin reuptake inhibitors (SSRI's), antidepressants that act on the brain side, seem to help some migraineurs. There is additional research connecting STG allele variations with some chronic depressions, so the same defective genes could be acting on both sides, with the usual ifs, ands, buts. Milo 06:14, 4 October 2006 (UTC)

That's great, migraine clearly has genetic components - do you also have a reference for the STG polymorphism and depression? Could you update the article with this information, both in the intro and perhaps in the section "Triggers" (the section could be renamed "Causes")? If not, I will do it. --apers0n 18:35, 4 October 2006 (UTC)

I found the other reference here: PMID 8602004 --apers0n 18:53, 4 October 2006 (UTC)

Let's both work on it — there's a lot of issues to be covered in that clever article style that speaks to both newbs and techies. • If you are a tech writer good at summarizing (not my strength), you could compress what I've written and enter that into the article. One of my abilities is to then reorganize where needed by changing headings, moving material, maybe changing some paragraphs to lists, and filling in logical process gaps. • I made a point above of describing the basic mechanics of body serotonin's function (the "toning" of vessels — see Serotonin) because this article and most web articles on migraine don't explain it. Without knowing those mechanics the STG genetic disorders are very abstract. • There is a further task of succinctly explaining the role of serotonin receptor subtypes — such as 1B and 1D, the sumitriptan _targets of both migrainous vessels and, unfortunately, heart valves (PMID: 10772044). Milo 23:36, 4 October 2006 (UTC)

Serotonin replication and low cortisol migraine

Further investigating serotonin mechanics, I just read the serotonin article which says (body) serotonin is constructed in the intestinal tract's enterochromaffin cells. • Somehow circulating platelets get loaded up with serotonin made (replicated) in the intestinal gut. This helps explain a connection with food-caused migraines (e.g., tyramines), and a connection with the low adrenal cortisol cause of migraine. 80% of cortisol hormone recirculates through the gut daily in order to stimulate DNA replication of the disposable gut lining, surely with simultaneous DNA replication of serotonin. Low cortisol means a thin gut wall causing "leaky gut syndrome", which lets tyramines and other offending substances pass through instead of being rejected. The adrenergic drug prednisone cures migraines by replication thickening of the gut wall cells, and replicating endogenous serotonin, as well as replicating enzymes to boost every other supporting metabolic process. Milo 23:36, 4 October 2006 (UTC)

Hot/cold/warm water treatment

The statement in the intro:

• Migraine's simplest treatments such as applying hot versus cold water are illogically contradictory among different patients.

Was changed by User:Moshe Constantine Hassan Al-Silverburg to:

• ... such as applying warm water are illogically contradictory...

Neither statement really makes sense, can anyone throw any light on this or provide a reference? --apers0n 13:27, 5 October 2006 (UTC)

Yea I was kinda confused with the whole sentence. I thought they were saying "hot as opposed to cold" because they wanted to clarify that they weren't using a different meaning of the word "hot" or something, I kinda thought that "illogically contradictory" meant that it works for some people but for others it might have the opposite effect. Maybe we could track down the editor who originally added it and ask them what they meant.- Moshe Constantine Hassan Al-Silverburg | Talk 18:26, 5 October 2006 (UTC)

Or remove the sentence if a reference cannot be provided? --apers0n 19:01, 5 October 2006 (UTC)

Gzuckier improved this to "The simplest treatments, such as applying warm water or applying cold water, have contradictory results among different patients." On reflection, that plural should become singular. I worked on it some more yielding "The simplest treatment, applying warm/hot water or cold water soaked cloths to the affected area of head, is contradictory — hot or cold can either increase or decrease pain, though it is consistent in the same patient.[+reference]" • The reference is "The Essential Book of Herbal Medicine" (aka "Out of the Earth") by Simon Y. Mills, Viking Arkana, 1994(1991). Mills is former president of the UK licensed medical herbalists association. • In an age of pills, we have nearly forgotten what is probably the oldest migraine treatment, dating to the prehistory of hot water from sunlight, thermal springs, and eventually fire. The treatment reduces pain for some migraineurs as long as one can continuously keep up the activity. • Mills' point is the traditional classification of migraines into "hot" and "cold" types, meaning that one's migraine type is determined by whether one's pain is reduced by hot/warm versus cold water. This info is probably worth adding to the body of the article. Milo 19:59, 5 October 2006 (UTC)

It reads to me like.. some people get benefit from warm water, some from cold.. That's why it's 'illogically contradictory' - smacks of placebo effect to me. --Streaky 12:56, 4 November 2006 (UTC)

Phases of migraine terminology

Migraine (history page) 2006-10-08T13:23:04 Msteri (Talk | contribs) m (?Aura phase - This was NOT a typo. "Headache phase" is appropriate AND from the source cited. Please do not change this again.)

From User talk:Milomedes
When I typed "headache phase," that's exactly what I meant. It was not a typo. Headache phase is as correct as pain phase, and headache phase is the terminology used in the source that I very carefully cited. Why did you feel it necessary to make this change? It makes no sense to me to take up people's time in this fashion.
Thank you,
--TeriRobert 18:28, 8 October 2006 (UTC)

This is a community issue so I'm moving it to the talk page. Milo 18:47, 8 October 2006 (UTC)

First, I didn't think it was a typo. Both "headache phase" and "pain phase" terms are (or were) in use, though I don't know which is used more commonly. I do know that "pain phase" is a better term for three reasons: 1) abdominal migraine isn't in the head, 2) the "headache" word is recursively overused, 3) "-ache" underdescribes the sensation, and, 4) "pain" is shorter. You can argue with 2), 3),4), but 1) is technically a debate stopper.

Second, with all due respect to your professional writing expertise, just because you carefully copied the words that were used in your source, doesn't mean that I can't substitute different words that I have reason to think are better. I quote from concluding text at the bottom of every edit page:

"Please note: If you don't want your writing to be edited mercilessly or redistributed by others, do not submit it. "

Third, Wikipedia isn't about you or me. I didn't know you wrote it, and it shouldn't matter that you did. This is an interactive community process. If you think I'm taking up your time, then you probably don't have enough time to write here. Furthermore, if you assume that anything you write here is still going to be here, say, 10 years from now, then you probably don't understand the nature of Wikipedia.

As to disagreements about which terminology to use in the article, that is usually handled with a talk page poll. I respectfully suggest that we use that tool as needed. Milo 20:35, 8 October 2006 (UTC)

Milo, If you didn't think it was a typo, why did you say, "fix typo in reference; "headache" phase to "pain" phase?" I'm not referring to MY writing being "mercilessly edited." I'm talking about changing the terminology in a section that was obviously carefully sourced. My professional writing experience isn't at issue here. It isn't MY writing that you changed. It was terminology taken from several prominent experts in the field -- experts whom I can guarantee know more about migraine than you and I put together. It says clearly on all pages that "Encyclopedic content must be verifiable." That's why I sourced what I added to the content. "Headache phase" is used in other sections of the article as well.

Of course, Wikipedia isn't about you or me. I don't think this particular discussion is about you or me as the wording in question was not mine but from the cited source.

Your suggestion is well taken, but I would propose that when the terminology in question is not that of a Wikipedia editor, but of a cited source, it's irrelevant. Thanks, Milo, --TeriRobert 23:06, 8 October 2006 (UTC)

"If you didn't think it was a typo, why did you say, "fix typo in reference; "headache" phase to "pain" phase?" I made two edits, separated by a semicolon in the edit summary. Motivating the first edit, the Evans, 2005 reference was mistyped as "Hanbook of Headache". In the second edit, the word "headache" that I changed to "pain" was in the main text, not in a reference. Hmm, seems like a careful writer would read the diff[3] to avoid writing a muddied-up complaint to a fellow editor.

"It isn't MY writing that you changed." Uh, are you confessing to a copyright violation? No? Ok, it really is your writing that I changed.

"when the terminology in question is not that of a Wikipedia editor, but of a cited source, it's irrelevant." Neither terminology in question is that of a Wikipedia editor, both are from citable sources; therefore, it's relevant.

"It was terminology taken from several prominent experts in the field ..." Sure, that's the issue, dueling experts or sources as confounded by a correctness problem. If lots of other editors would check their many sources, we might come to a poll consensus. Milo 02:53, 9 October 2006 (UTC)

Milo, Such rudeness and sarcasm is unnecessary and, frankly, beneath what I have experienced in interacting with other Wikipedia editors and with Wikipedia administrators. Obviously, trying to have a civil discussion with you is futile. It's just a shame that two people with an interest in improving an article can't work together in harmony and mutual respect. --TeriRobert 03:50, 9 October 2006 (UTC)

What you have inferred, I did not imply. I don't see anything on-topic in your last response. If you want to get on with editing, where's your vote in the poll? Milo 06:26, 9 October 2006 (UTC)

Please vote in migraine phase terminology poll

Which terminology do you prefer in the article "headache phase" or "pain phase"? Please add long comments to the subsection above.

Prefer "pain phase". Milo 02:53, 9 October 2006 (UTC)

I prefer that "pain phase" and "headache phase" both be used as determined appropriate by the contributing editors. --TeriRobert 14:37, 9 October 2006 (UTC)

An expert in the field, JN Blau, cited extensively in the book by Davidoff, Robert A. (2002). Migraine: Manifestations, Pathogenesis, and Management (Second ed.). New York City, New York: Oxford University Press. p. 44. IBSN: 0-19-513705-1. lists 5 or 6 phases: 1) prodrome, 2) aura, 3), headache phase, 4) resolution, and 5) postdrome. And a "free interval" came be placed after the aura and the headache. Although headaches are often the more obvious phase, some migraine have no headaches. And it could be argued that events in the prodrome and aura phase could be painful. I vote for headache phase, as long as the info includes the possible lack of headache could still be a migraine. MeekMark 04:44, 10 October 2006 (UTC)

The International Classification of Headache Disorders [Cephalalgia 2004;24(suppl 1)1-160], which is the definitive source used by all medical profesionals in the field, uses "headache" rather than "pain". Related conditions such as abdominal migraine are seperately classified and therefore there is no contradiction here. Jbelsey 12:41, 12 October 2006 (UTC)

Comment. Can we get a more accurate reference for this source? There are 3 possibles in Pubmed: PMID 15595988 (2-7), PMID 15595989 (8-15) and PMID 15595991 (24-30) - or none of the above? --apers0n 16:01, 12 October 2006 (UTC)

Apers0n, I'm a bit confused on which source you mean sice the 3 Pubmed sources you listed are to different journal articles. Do you mean the International Classification of Headache Disorders? Should we perhaps link to the PDF version on their Web site? http://216.25.100.131/upload/CT_Clas/ihc_II_main_no_print.pdf —Preceding unsigned comment added by Msteri (talk • contribs) 16:12, 12 October 2006 (UTC)

Yes, that would be much better, ideally using Template:Cite journal, mentioning the specific page number referred to in the article, and that it's a 780 Kb PDF document with 150 pages... If someone wanted to find the exact reference online and didn't have a copy of the journal, then the current "Cephalalgia 2004;24(suppl 1)1-160" reference doesn't help much if it's not listed on PubMed :-) --apers0n 05:58, 13 October 2006 (UTC)

Sorry for the sloppy referencing. The link mentioned above is the correct one. The relevant page numbers are 24-27 which deal with the classifications for migraine with and without aura. They use the term "headache" almost exclusively, the only use of the word "pain" being in the phrase "moderate or severe pain intensity" in the diagnostic criteria for migraine without aura(page 24). In the introduction to this section (page 24) they state "...some patients also experience a premonitory phase, occurring hours or days before the headache, and a headache resolution phase..." The specific terms "headache phase" and "pain phase" are not used, but as headache is the predominant term used here, I think we can justify sticking to this. Jbelsey 11:33, 13 October 2006 (UTC)

Types of migraine

I have added new sections on "migraine without aura" and "migraine with aura" based on the International Headache Society Classification of Headache disorders. I have also edited the section on abdominal migraine, as the text that was there described a mixed abdominal/MWA picture, rather than pure abdominal migraine. When I've got time next week I will also add the epidemiology section Jbelsey 13:30, 12 October 2006 (UTC)

Hi, Jbelsey, This is great! If I can help with anything like this, please let me know. I'm fairly well versed on ICHD-II, and would be glad to help. --TeriRobert 17:42, 12 October 2006 (UTC)

I have improved the references to incorporate the specific pages and the weblink. I was wondering whether to add similar sections to the other migraine types listed here. Also, it might be useful to put in the criteria for episodic tension type headache (pages 38-39) to help people distinguish this from migraine. What do you think?

For the epidemiology section there is a really useful graph that I would like to insert, showing the variation in migraine prevalence by age and sex but I'm a newcomer to Wikipedia so I don't know how to do this. Any advice? Jbelsey 11:54, 13 October 2006 (UTC)

Do you have a reference for such a graph? I might be able to come up with something if I can see the data. --Dpryan 00:06, 14 October 2006 (UTC)

Stewart W, Linet M, Celentano D, Van Natta M, Ziegler D (1991). "Age- and sex-specific incidence rates of migraine with and without visual aura". Am J Epidemiol. 134 (10): 1111–20. PMID 1746521.{{cite journal}}: CS1 maint: multiple names: authors list (link) has a nice chart reproduced in a migraine textbook I have, but it might be hard to obtain permission for an exact copy of the chart; in theory I could copy down the data points and a chart could be generated from the data points, but that could be somewhat questionable. Here's the permissions link for the article: [4] MeekMark 00:56, 14 October 2006 (UTC)

I don't see that as questionable. The data is provided in a convenient table form and as long as we reference that said article provides the original data then all should be well. If we directly copied out the figure then, of course, it'd be an infringement but since I created it from the data they provide then I would see that as fair use. Anyway, I created one that can be found here, it might make sense to merge the two into a single graph and add color. Alternatively, perhaps it would be nice to have graphs seperated by with/without aura instead of gender...I'd personally find that more interesting. --Dpryan 01:41, 14 October 2006 (UTC)

Nice chart! That was quick. And rearranging of the charts would certainly qualify as a derivative work. I think color and combining would be good; one advantage of retaining gender, or perhaps a second chart including gender, is it shows the spike of incidence in females at the time of onset of menses. Could you post the data so I could play with some charts too? MeekMark 20:28, 14 October 2006 (UTC)

Sure, here is a single figure containing all of the data. If you want to make some others you can use this IGOR Pro file or this excel file (since you're unlikely to have IGOR Pro). --Dpryan 22:26, 14 October 2006 (UTC)

Here is a quick sample of how a chart image may look like; I tweaked Dpryan's data so the male data is shades of blue and female shades of pink. It is just a quick hack to show possible wiki markup. The main thing to do is to specify a good image width so that the scaled image in the article is legible; users can click on the Enlarge icon in the caption to see the full size image if desired. MeekMark 00:42, 17 October 2006 (UTC)

IMO, ICHD-II is a great tool for helping differentiate between types of Migraine, especially when used as you did in the MA section. This seems to be especially true with less common forms of Migraine such as hemiplegic and baislary type where the description in ICHD-II clearly speaks to motor weakness in BTM, but not FHM or SHM. While I'm sure you would arrive at the correct differential diagnosis, I see too many people with true motor weakness who are diagnosed with BTM, probably because many physicians haven't had the opportunity to treat many such cases and aren't given a very full background in medical school. (Sorry I digressed from the point, but my enthusiasm has been fueled by your contributions.) Good point also on the criteria for TTH. Dr. Dawn Marcus has a short section in a fairly recent book that has some good tips for differentiating between TTH and Migraine. Possibly the combination of the ICHD-II and a short paragrapph with a citation to that would be a good combination? As for the graph, I've not tried inserting images, but it sounds valuable, and there are several editors who have an interest in this article and would probably be quite willing to advise you on that. What do you think of adding more info on the genetic discoveries to date? Regards, --TeriRobert 14:39, 13 October 2006 (UTC)

The original graph is in Stovner LJ et al. Epidemiology of headache in Europe Eur J Neurol 2006;13:333-345. Unfortunately there is no free access to this article. I have redrawn the graph for a slide presentation that I am preparing and will be seeking permission of the authors for this - I'd be happy to ask them for permission to include in this article as well - I can't imagine the publisher would object, especially as I'll be paying them for the permission for the other project. It would complement the graph that Dpryan has prepared, as Stovner's contains prevalence rather than incidence data. I think there are several distinct points that need to be made (+illustrated) in the epidemiology section:

1. The age/sex distinction between MWA and MA.

2. The fact that sex ratio in prevalence terms changes with age, illustrating the influence of repreoductive hormones.

3. The changes in incidence over time.

4. Geographical differences in epidemiology.

It would be a mistake to try to cram all these into one graph, as we would run the danger of losing the message. I think there is enough data to support all these points, though - I will try to prepare a draft section for comments in the course of the coming week.

By the way Teri - I agree that medical school training on this subject is abysmal and the average family doctor or general neurologist is not well placed to distinguish the rarer forms of migraine. I tried to pursuade the International Headache Society to fund me to develop an interactive version of the ICHD-II to serve as a diagnostic aid for these clinicians but they weren't interested - shame. Jbelsey 10:39, 14 October 2006 (UTC)

Jb, Yes, it is a shame that the IHS wasn't interested in your idea. From attending the American Headache Society conference and their sessions on ICHD-II, I wonder if it had anything to do with the frequent discussion of tweaking it and working toward ICHD-III. There are some interesting things happening in the training of new doctors and the certification of doctors as headache and Migraine specialists. If you ever want to discuss it, feel free to post to my talk page or email me through my web site. It's probably a bit off-topic here. :-) --TeriRobert 12:50, 14 October 2006 (UTC)

Epidemiology

I've added an epidemiology section. I'm waiting for permission to arrive but hope to include a diagram or two in due course Jbelsey 14:55, 20 October 2006 (UTC)

Head/Neck Massage

I have had debilitating migraines every week for over twenty years. Other than vomitting, there is only one "treatment" that can eliminate the pain every time, even once the migraine is full-blown: head/neck massage. It does not need to be done by a professional, and it does not need to be "deep" (thereby artificially triggering a headache). Rather the massage needs to be persistent, from fifteen minutes to an hour (for example, applying pressure to the temples, blood vessels around the ears, and at the base of the skull). The problem with this cure is that you need somebody who is willing to massage your head for extended periods of time. Of course this only addresses the symptoms (migraines can be preempted in many other ways, before becoming full-blown...but drugs have almost no effect whatsoever once the migraine is full-blown).

p.s. I have a question for neurologists: why does throwing-up stop the neurons in one's head from firing? Therein, perhaps, lies a pharmaceutical treatment. —Preceding unsigned comment added by 137.82.188.80 (talk • contribs) 19:45, 24 November 2006 (UTC)

Finnish group, myGRAIN??

What is this at the top of the page? "For the Finnish melodic death metal group, see myGRAIN." It links to two different groups. Not sure the first one is even relevant. Does this belong at the top of the page anyway, or somewhere else? --TeriRobert 05:14, 30 November 2006 (UTC)

Yes, it belongs at the top of the page. Many Wikipedia articles have such disambiguation notices at the top of the page; it allows readers who have come to the wrong article by accident to find the right article quickly, instead of reading through screens of irrelevant text. Katherine Tredwell 19:53, 19 January 2007 (UTC)

Thanks, Katherine!! --TeriRobert 05:06, 21 January 2007 (UTC)

Acephalgic Migraine Information Link

This leads to a directory of other links, not information itself. It's covered with Google ads, making it a commercial site. Other links to commercial sites have been removed, even when they were content sites as opposed to link sites. I'm told that linking to commercial sites is expressly prohibited. Some editors are quite vehement about this and will call you on spamming if you keep adding this link. --TeriRobert 20:47, 1 January 2007 (UTC)

Migraines In Stomach

In the part about abdominal migraine, it sounds as though it occurs only in children and as though it is a very severe disease that includes vomiting. I am diagnosed with abdominal migraine. I have never thrown up on account of it. I just get a migraine in my head and a 'migraine' in my stomach at the same time. The migraine headache part is a real migraine and not a version of one, it just has a stomache ache addition. Daffy100 02:01, 11 January 2007 (UTC)

The worst feeling ever!!!

Hi my name is Knikki and I'm nineteen years old I was bullied in school as a child,when I was 13 I was hit in the back of the head with a 5 lbs rock....ever since then I can remember having migraines on a weekly basis My triggers are orange juice ,rainy weather and strong perfumes or sweet scents....does anyone know if in fact the rock is what started it all? my doctor has no clue ...which is weird and uncomforting. —The preceding unsigned comment was added by 207.203.80.13 (talk) 19:40, 22 January 2007 (UTC).

I wouldn't say it's out of the question. As you may have noticed from the article, the causes and pathology of Migraine are variegated and many. It could as easily be coincidental that you began having migraines after being hit as it could be that the two were linked. It's good that you've spoken to a doctor about it, but I don't think that anyone on here is in as good a position as your doctor to speculate about the subject. --HassourZain 18:46, 29 January 2007 (UTC)

I had a major concussion in 5th grade (1.5 somersault from mini-trampoline to the padded floor (i.e., head first), 12 hour blackout) and about three minor concussions in the years after and then started getting migraines. I asked my doctor the same question you did and he pretty much scoffed at the idea the concussions were linked to the migraines. I've seen several other doctors about my migraines but none that I can remember thought the concussions and migraines were linked. But I still wonder. Emailscottso 22:21, 27 May 2007 (UC)

Diagnosis

After reading this article, I have the impression that migraine is diagnosed by symptoms alone, and that no physical test (scan, blood analysis, etc.) can be used to confirm or rule out the condition. Is this correct? If so, would it be worth spelling it out? Perodicticus 12:42, 26 January 2007 (UTC)

• Yes, that is true; there are no definitive diagnostic tests; it can only be determined by a history of symptoms, which can be varied from patient to patient, and even for a particular patient. Some tests (CT and MRI scans, Electrophysiological studies such as EEG) show some abnormalities, but not for everyone, and not enough to make a blanket statement. Sometimes a CT or MRI is needed to rule out a more acute diagnosis such as intracranial bleeding. Chapter 7 of Davidoff, Robert A. (2002). Migraine: Manifestations, Pathogenesis, and Management (Second ed.). New York City, New York: Oxford University Press. pp. pp. 150-158. IBSN 0-19-513705-1. {{cite book}}: |pages= has extra text (help) goes into painstaking detail, that would take a while to summarize more succinctly than I just did here. MeekMark 01:38, 27 January 2007 (UTC)

Thus with no definitive testing method available, the statistics that 15% of the worlds population are migraine sufferers is false or unable to be proven, thus should be removed. IMHO, from my experience, 100% of self professed migraine sufferers have merely exhibited headaches or anxiety attacks. I'm not saying migraines don't exist or are an overdiagnosed fallacy like ADHD in poorly behaved teens, but it seems to also be a common factor that personal will, overall health, and weight are big factors also. Everyone I've met with an even slightly hypochondriac personality type has been a self-professed migraine sufferer. Perhaps this angles should also be addressed, as this article seems NPOV focused on the legitimacy of everyones claims that they have a migraine when they're misdiagnosed problems of other sources in most cases. It's just fuelling the fallacy so to speak and probably doing misjustice to those seeking diagnosis who actually have an inherent cause. 211.30.71.59 02:47, 20 February 2007 (UTC)

• There is specific diagnostic criteria for migraine; take some time to review the references in the article. So just because there are no definitive lab tests for migraine, the disease doesn't exist? That is beyond belief. If you cared to take the time to review the volumes of information referenced in this article, you would find it hard to refute it is a valid disease. Maybe somewhere on Wikipedia there is a list of diseases where there are no specific lab tests; the list would be long I suppose. Maybe some day you may experience one; then you'll know! MeekMark 01:30, 21 February 2007 (UTC)

I think it's a good point though; a lot of people don't understand that migraine *does* have specific criteria, and instead use the term for any bad headache (like tension headaches or cluster headaches). The differences are mentioned in the section on types, but maybe there should be a separate section explaining what isn't a migraine or what else a so-called migraine might be (differential diagnosis). (I disagree with removing the statistics though.) --Galaxiaad 02:20, 21 February 2007 (UTC)

Lactose-migraine syndrome

Coming from a migraine-susceptible family, though thankfully personally unaffected, and with twenty years of subsequent experience, I would like to add to the main page, but, being new to Wikipedia, would appreciate prior opinion.

The most common type of migraine to my personal knowledge is caused exclusively by the ingestion of lactose by people who periodically cannot produce lactase. Briefly, this enzyme normally hydrolises lactose, permitting the absorption and processing of the constituent glucose and galactose molecules. In the absence of lactase, the odd number of oxygen atoms in lactose cannot be divided, and the result is the discharge of 5HT. This substance controls the capacity of the blood vessels, and its discharge provokes dilation of - among others - the veins and arteries in the restricted space of the cranium, and the result is experienced as migraine.

The remedy is to pre-digest foods which contain lactose, or to which lactose is artificially added, this being done with lactase before or during manufacture. A patent to this effect was obtained in Spain some ten or twelve years ago, but has been allowed to lapse due to steadfast disinterest on the part of the manufacturers. The European patent was not completed due to expense and frustration.

Therefore the present alternative is to abstain totally from foods containing any milk products. - It will be noted that most if not all the food triggers mentioned in the article, including some red wines which are cleared by the use of lactose-bearing casein, will most likely contain milk products in one form or another.

This subject is dealt with at greater length - and is to be freely seen in various languages - in www.justice-publications.com and www.amazin-books.net

Comments will be welcome on the suitability of inclusion of any of this information in the Wikipedia main migraine page. Migraine sufferers are asked to try the remedy of total abstension from lactose before decrying this description, as so far it has proved a solution to this syndrome.

Kevinplumley 11:40, 3 February 2007 (UTC)

Kevin, In seven years of research, working with the world's leading experts in Migraine disease, and writing on this topic, I have seen only a handful of people whose Migraines are triggered by lactose intolerance. Weather changes, hormonal fluctuations, and other triggers are far more common. Do you have any information on this from a peer-reviewed journal? Thanks, --TeriRobert 19:23, 3 February 2007 (UTC)

Hello, TeriRobert,

No, I have no information from peer-reviewed journals, but have twenty years experience of seeing hundreds of migraine sufferers relieved of migraine when they totally abstain from foods containing lactose. When they slip and return to lactose, then they have migraine again. It is as simple as that. It was the uniformity of these results that led me to the expense and trouble of taking out a patent - now after ten or twelve years of frustration allowed to lapse. I conclude that weather changes and hormone levels etc. at any time are simply involved in the failure to produce lactase, which then means that the 0 eleven in the lactose molecule (I don't know how to write formulae on this page) cannot be hydrolised to 0 twelve. So 5HT discharge then follows, with migraine as evidence. Whatever may be the initial cause of the failure to produce lactase, it is the 0 eleven in lactose that then produces the problem.

- Think of the trouble that Africans - other than from the cattle-owning nilotic tribes - have with lactose intolerance, migraine and all - 70% or more. Not having been selected as we have been by thousands of years of dairy products, they naturally have no use for lactase after weaning, stop producing it on a regular or sporadic basis, and so have serious problems when exposed to our dairy-rich diets. See how our various traditional national susceptibilities to migraine have varied with the proportionate inclusion of African immigrants.

If you run a trial you will find the results will duplicate my findings. But abstention from lactose has to be total. Ten years ago I had Americans telling me that their doctors prescribed cheese and yoghourt as they contained no lactose! Most processed foods now have lactose artificially introduced - and almost all migraine prescriptions! And when I had the temerity to intrude my notions into their comparing of their various medicaments, I was howled down by people I have to presume to be paid agents of the medical lobby.

Kind regards,

Kevinplumley 10:32, 4 February 2007 (UTC)

One problem, namely that it's Original Reasearch, if there's real research out there, feel free to Cite Your Sources. --86.8.36.200 02:16, 11 March 2007 (UTC)

Not scientifically valid of course, but I avoided all milk products for many years - did not have migraine, although previously when I consumed milk-products I did get them particularly when under stress. I looked this article up because I'm just getting over a migrain headache, the first in many years. I had resumed eating milk-products some time ago. I recall that in the day before the headache started I had eaten much more dairy products than usual (including some "blue cheese" (brie) which I do not normally eat). I realised earlier this year that I am lactose intolerant. So my personal experiences back-up the previous comments. I always have migraine with aura. At least, if I didnt have the aura I'd just call it a headache I suppose. Looking back I have been getting more headaches recently - this might be due to a build up of the effects of milk products perhaps since I started consuming milk products again.

What I meant to write here was that in the past I found that I could stop the aura symptoms developing into a headache by immediately eating something VERY sugary such as a lot of fudge. Maybe this was just a placebo - who knows. 80.2.207.173 16:17, 27 June 2007 (UTC)

References for pathophysiology section?

Folks, the section on pathophysiology doesn't cite any references in refuting a commonly held (mis)conception re: migraines caused by vascular disorders.

Migraine was once thought to be initiated by problems with blood vessels. This theory is now largely discredited. Current thinking is that a phenomenon known as cortical spreading depression is responsible for the disorder. In cortical spreading depression, neurological activity is depressed over an area of the cortex of the brain. This results in the release of inflammatory mediators leading to irritation of cranial nerve roots, most particularly the trigeminal nerve, which conveys the sensory information for the face and much of the head.

Can these be researched/added? Cnbingham 23:05, 6 February 2007 (UTC)

I have found an article refuting cortical spreading depression to be the cause of migraines on UniSci: Current Theory About Migraine Headaches Now In Doubt. However this article was published in 2001, and every other article by that research team online cost money. Anyone else have more information regarding this? Thanks! (LeCedre 21:01, 30 June 2007 (UTC))

It is possible to cure most Migraines, according to the Fluids' Hypertension Syndromes. The E-book is available free, at WWW.izecksohn.com/leonardo .User Leonardo Izecksohn 20:57 july 8, 2007.