Alissa Caron

Migraines: The Mystery

Revealed (Or Not…)

Alissa Caron

March 26, 2012

WHAT IS A MIGRAINE, AND WHY DOES IT

HAPPEN?

!!A migraine is caused by abnormal brain activity.

!!However, the exact sequence of events leading to

a migraine remains unclear:

!! Doctors think that attacks begin in the brain and then

spreads via nerve signals to affect other pathways

throughout the body.

!!The headache itself causes intense pain (normally

on one side of the head) that lasts from 4 hours to

3 days.

!!Migraine headaches often begin to affect people in

childhood, adolescence, or early adulthood.

4 STAGES OF A MIGRAINE HEADACHE

Prodrome:

1-2 days before migraine:

subtle changes including depression, irritability, hyperactivity, constipation, diarrhea, food cravings, neck stiffness

4 STAGES OF A MIGRAINE HEADACHE

Aura:

Visual or sensory disturbances 10-15 minutes before migraine:

blurred vision, bright spots, loss of vision, pins and needles in arms and/or legs, speech

problems

4 STAGES OF A MIGRAINE HEADACHE

Attack: pulsating pain on one side of the head

sensitivity to light, sound, and/or smells

nausea and vomiting

blurred vision

diarrhea

lightheadedness, fainting

numbness, tingling

chills

sweating

increased urination

problems concentrating or speaking the right words

4 STAGES OF A MIGRAINE HEADACHE

Postdrome, aka migraine hangover:

After the attack, you will feel drained, and these symptoms may

linger:

Lack of clear thinking, weariness (need for sleep), neck pain

WHAT IT FEELS LIKE TO ME…

IN CASE YOU THINK YOU HAVE MIGRAINES…

!!Migraines normally continue undiagnosed and untreated. If you regularly experience the signs and symptoms, start to keep a journal of your attacks and visit your doctor…

!! If you have typical migraine symptoms and/or family history, your doctor can diagnose migraines based on your medical history.

!! In addition, the following tests can be done to rule out critical causes for pain:

Blood Work and Urinalysis

Computerized tomography (CT) scan

Magnetic resonance imaging (MRI)

Spinal tap

“DIAGNOSIS OF EXCLUSION”

!!The bottom line of diagnosis is that…

There is NO specific test that can be performed

to prove that your headache is actually a

migraine. Tough luck!

!!Current scientific understanding is limited.

MIGRAINE TREATMENT

!!Preventive medications: taken regularly (often daily), to

reduce the severity or frequency of migraines.

!! Beta blockers (Inderal) , calcium channel blockers (Calan)

!! Tricyclic antidepressants (amitriptyline)

!! Anti-seizure drugs (Topamax)

!!Pain-relieving medications: acute or abortive treatment,

taken during migraine attacks, designed to stop

symptoms that have already begun.

!! Modest pain relievers (ibuprofen, acetaminophen)

!! Triptans (Relpax, Imitrex, Zomig): most effective

!! Ergot (ergotamine + caffeine): less effective

COMPLICATIONS FROM TREATMENT

!!Rebound headaches: medications taken often and/or

in high doses can start to cause additional

headaches

!!Abdominal pain, bleeding, ulcers from high doses of

certain pain relievers (ex/ ibuprofen)

!!Life-threatening serotonin syndrome if taking

certain migraine medicines (triptans, ex/ Zomig,

Imitrex) and selective serotonin reuptake inhibitors

(SSRIs) or serotonin-norepinephrine reuptake

inhibitors (SNRIs) anti-depressants simultaneously

THE MYSTERY OF MIGRAINES: WHO GETS

THEM AND WHY?

!! Family history: Some sources claim that 90% of people with migraines have a family history of migraine attacks.

!! Age:!Migraine can begin at any age, though most people experience their first migraine during their teenage years.

!! Gender: Women are three times more likely to have migraines than men. During childhood, headaches tend to affect boys more than girls, but by adolescence, more girls are affected.

!! Hormonal changes: Women may experience migraines just before or after their period. During pregnancy, attacks may be more intense during the first trimester but should occur less frequently during the rest of the pregnancy.

COMMON TRIGGERS

!! Alcohol

!! Stress

!! Loud noise

!! Bright lights

!! Smoking or exposure to smoke

!! Certain strong perfumes and odors

!! Caffeine withdrawal

!! Changes in sleep patterns

!! Physical stress or intense exercise

!! Missed meals

!! Dehydration

!! Changes in women’s hormone level due to menstrual cycle or birth control

!! And….

…AND FOOD! WHO KNEW? !! More than 100 foods contain certain chemicals that

are known to set off migraines.! These chemicals include tannin, nitrates, sulfites, monosodium glutamate (MSG), tyramine, and phenylethylamine (in aspartame). The most common food triggers are:

!! Any processed, fermented, pickled, or marinated foods

!! Baked goods, chocolate, nuts, peanut butter, and dairy products

!! Foods containing tyramine: red wine, aged cheeses, smoked fish, chicken livers, figs, and certain beans

!! Some fruits: avocado, banana, citrus fruit, tomato

!! Meats containing nitrates: bacon, hot dogs, salami, cured meats

!! Onions

WITH ALL OF THESE POSSIBLE TRIGGERS AROUND

YOU, WHAT CAN YOU DO TO PREVENT MIGRAINES??

First off, don’t cry like this child….

THE BEST PREVENTION TOOL: TAKE CARE OF

YOURSELF!

Questions?

Thank you!

Easy-Reading References:

National Institutes of Health:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001728

Mayo Clinic:

http://www.mayoclinic.com/health/migraine-headache/DS00120

Alissa Caron

Thank You!