10 Highlights from the past 3 Months (October 2014 edition)

Neck pain, Topamax, Stevia, surgery, and much more!  These are the most-visited posts from the last three months.  Join the conversation!

  1. Neck Pain: A Missing Piece of the Migraine Puzzle?
  2. Topamax not working? Here’s a Possible Alternative
  3. Is it Migraine or Lupus?
  4. Complex Confusional Migraines
  5. Using Migraine as an Excuse
  6. Having Trouble Seeing “Up Close”? Just can’t focus?
  7. Standard Blood Tests for Migraine – are they on the way?
  8. Vasculitis: When Your Body Attacks Your Blood Cells
  9. Migraine Surgery – Should it be Banned?
  10. Is Stevia giving me a Migraine Attack?
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Should We Be Talking About Stem Cells as a Migraine Treatment?

Reports are beginning to emerge of patients who are seeing a major decrease in migraine symptoms from stem cell treatment.  Might this be another new frontier in migraine treatment?  And might it help with other headache disorders?

Stem cells for Migraine and Headache
Photo courtesy of Jacopo Werther

Stem cells are remarkable partly because they can become many different types of cell.  Stem cell treatment is the result of over a hundred years of research, which has become much more intense over the past thirty years.

A lot of the controversy over stem cells has come from the field of embryonic stem cell research – stem cells that come from aborted “test tube babies”.  However, the controversy has calmed down a little because there are many different stem cells that can come from other sources, and that’s where most of the medical breakthroughs are coming from.

Researchers have found that stem cells can repair the body in remarkable ways.  They can also help repair problems with immunity.  Stem cells can be introduced into a new area without a fight from the body – and yet without impairing immune responses.

And so stem cells are being researched and used for many conditions, including arthritis, colitis, and lupus.

And what about migraine?  The New York Headache Blog reports that cases are showing up where migraine is being treated with stem cells, often unintentionally (see Stem cells for headaches).  For example, a study in Australia treated women for osteoarthritis using stromal vascular fraction, a type of tissue taken from the patient’s own fat which contains stem cells.  The women found that both migraine symptoms and tension-type headaches decreased after the treatment.

Another case study found that four women with chronic headache conditions saw significant improvement with similar treatment.

What about other headache conditions?  Another study out this year showed the promise of stem cell treatment for patients with neuropathic trigeminal pain, once again using a similar type of treatment.  Another study last year looked into stem cell research for traumatic brain injury.

How exactly stem cell treatment may fight these conditions is a complex question that will take time to answer.  We do know that stem cells can repair damage to the body, help with immune responses and fight inflammation.  This type of treatment could go a long way in helping patients with chronic headache conditions of various kinds.

Because stem cell treatment is already common for many conditions, the field is wide open for serious research into how migraine patients and patients with various headache disorders could benefit.  This may be another way to actually heal the body instead of just coping with other ongoing treatments.


Sumatriptan and Cluster Headaches

Sumaptriptan has been used for cluster headache for many years, but it may not be used in the way you think.

Cluster headaches are not only known for the very severe pain which is the most well known symptom, but also for their predictable cycle.  Lasting from a few minutes to a few hours, they come during a “cluster period” lasting weeks or months, most often followed by a remission of months or even years.  Some patients, however, do not experience remission, but continue to have attacks up to eight times a day.

Sumatriptan Cluster Headache treatment

One of the most common abortive treatments is a sumatriptan injection.  Cluster patients often have injection kits, so that they can inject themselves right when an attack hits.  It is usually effective within a few minutes, and can be repeated once in the day if the pain continues or returns.

But here are a few other facts you might not have known about sumatriptan and cluster headaches:

  • A sumaptriptan injection does not always involve a needle.  For example, Sumaval DosePro pushes the sumatriptan through the skin in a tenth of a second without a needle.
  • Sumatriptan works better for men than women.  Women with cluster respond better to inhaled lidocaine.
  • Some cluster patients take a sumatriptan nasal spray, or even oral sumatriptan.  These approaches work, but take longer, which limits their usefulness in a headache like cluster which doesn’t usually last long to start with.
  • Usually patients experience very few side effects, and they don’t last long.  Typical temporary side effects include nausea, fatigue, and dizziness.  However, if you get hives or experience chest pain or pressure, you should call your doctor immediately.
  • Because cluster is rare and studies are limited, there have been very few studies into various other triptans.  Zolmitriptan is most commonly used next to sumatriptan, but it does not tend to be as effective.  However, for some patients it may have fewer side effects.
  • Dosages vary depending on how you’re taking sumatriptan, from a small dose of 6mg for an injection to a large dose of 100mg when taken orally.

Have you used sumatriptan for cluster headache?  How well did it work for you?

Also see:  Cluster vs. Migraine (Infographic)

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Stabbing Headache – Could it be MS?

Although most autoimmune disorders are chronic, patients have a number of reasons for wanting to diagnose them early.  First and most importantly, there is the concern that these disorders are degenerative – they get worse as time goes by, in a way which may not be reversible.

Of course there’s also the matter of the symptoms themselves.  The sooner you can get them under control, the sooner the patient can have a life with less disability.

And this is what makes some recent research into primary stabbing headache particularly interesting.

Stabbing headache is characterized as jolts of headache pain (often in the face or around they eye) that usually last for two or three seconds.  It may just happen once, or it could happen many times a day.

Many migraine patients have the occasional stabbing headache.  Treatment often involves a non-steroidal anti-inflammatory drug, such as indomethacin.

Primary stabbing headache is not caused by a known underlying disorder (by definition).  However, a study published in 2012 following 26 patients with stabbing headache found that over half of the patients also had an autoimmune disorder (Stabbing headache in patients with autoimmune disorders.).

This would include not only multiple sclerosis but also lupus, autoimmune vasculitis, and Sjogren’s syndrome.

Could the damage done by these diseases actually bring on the stabbing pain?

A more recent study found that a flare-up of multiple sclerosis (MS) could bring on the stabbing pain, and that treating the MS would also alleviate the head pain (Stabbing headache as a sign of relapses in multiple sclerosis.).

Could this type of pain be an early sign of an autoimmune disease?  At the very least, it could be a sign that a flare-up needs to be treated.  If doctors are aware of the connection between stabbing headache and autoimmune disorders, they may be able to ask the right questions to get patients treatment faster.


Sleep Apnea and Migraine – Comments from You!

The connection between sleep apnea (sleep apnoea) and migraine is a topic that we’ve covered here more than once.  The September issue of HeadWay (the free headache and migraine ezine) also looked into this link in more depth.

I’ve heard from some of you regarding your experiences…

My 65 year old husband has had migraines since he was a child.  He has never really snored much unless he had a cold.  The symptom that caught the doctors attention 3 years ago was jerking muscles at night.  Sometimes jerking muscles can indicate a lack of oxygen.  An at home oximetry test showed his oxygen level was dropping to 65 at night.  Following a sleep study, CPAP treatment, and oxygen at night his migraine are manageable with Botox and occasional meds now.

To learn more about the oximetry test (pulse oximetry), read What is pulse oximetry? from John Hopkins Medicine.

Sleep Apnea - your comments!

My 40 year old daughter was suffering from debilitating migraines when I subscribed [to HeadWay].  After 2 years and 12 doctors, she was diagnosed with severe sleep apnea and uses a CPap machine and has not had a migraine since then – 7 months. Thanks.

No, it’s not that simple for everyone.  But once again – worth checking out!

I had my first migraine aura w/out pain when I was 30.  Between 30 and 55 I may have had 5 or 6 more episodes.  In my 50’s I gained a great deal of weight and also started having the aura’s 6 to 7 times a year.  I went to a neurologist who did all the testing and again diagnosed migraine aura w/out headache.  Finally I discovered I have sleep apnea.  Since using the CPAP machine I have not had even one aura attack.  My blood pressure has also dropped to 118/78.  I think that I have had sleep apnea all my life (even before I gained the weight).  My aura’s occurred less often before I gained the weight, but my apnea was probably not as severe.  I just hope that everyone knows that sleep apnea can cause these aura’s and the neurologist nor the Optholmologist will necessarily know this.  As a side note one time I even went blind in 1/2 of one eye.  No one should have to be so terrified when the remedy was so simple.

Of course the remedy isn’t simple for everyone.  However, the evidence does suggest that sleep issues are a major factor for many people when it comes to migraine symptoms.

I have had migraines since my teens.  I am 39.  I have had about 2-7 migraines a month since I can remember.  I took every type of medications for them with no relief.  I was diagnosed with severe sleep apnea last November.  Since having my CPAP machine which I use every night I have had only 3 migraines in total this year.  Those three I must say were due to stress and perhaps knocking off the head gear of the CPAP machine.  I never thought I would get relieve from my migraines.  Also I am not a zombie anymore…I actually have energy and can last a day without falling asleep in mid sentence!.  It took some getting use to but if I would have known years ago….I would have saved so many wasted days throwing up and in the worst pain of my life with those migraines!  I haven’t lost any weight using the CPAP nor has my blood pressure dropped….but no migraines….that’s worth millions in my book! (Stacy)

Thanks for all your comments!  It’s great to hear some success stories.  Let’s keep the conversation going! :)

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