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

As usual, here we have the posts that have been most popular over the past 3 months, most popular first. But I’m doing something a little different this month. The articles in bold are the ones that had the most “likes” on Facebook. :)

  1. The “Revolution” in Migraine Treatment (Dr. Peter Goadsby)
  2. A Migraine Mystery (You’ll never guess this one…)
  3. Why this Essential Oil may help, but won’t ever be popular…
  4. What is Retinal Migraine?
  5. Is Your Brain “Slower” During A Migraine Attack?
  6. TRPV4 and “Switching Off” Headache Pain
  7. Topiramate + Nortriptyline (and another reason why treatment is not simple)
  8. The Battle.
  9. 18 Reasons to Suspect Migraine in Your Child
  10. Do You *Hear Voices* during a Migraine Attack?

Amerge for Cluster Headaches

Is Amerge for cluster headaches an overlooked treatment?

Amerge or Naramig are brand names for naratriptan, another in the triptan class of medications which include sumatriptan and zolmitriptan. Triptans are commonly used for both cluster and migraine.

Triptan optionsTriptans were gradually introduced into the market starting in 1991 with sumatriptan. But this gradual release has perhaps caused some problems which are true for migraine patients but magnified when it comes to cluster.

Naturally, the first triptan to arrive has been studied the most. Maybe it’s more because of this and less because of its effectiveness that sumatriptan has become the go-to triptan for cluster.

Because cluster is so rare, and because of challenges in running clinical trials, it will be a long time, if ever, before we have good data on whether Amerge for cluster headaches, or another triptan, is the best option – and for what type of patient.

The other challenge is that the newer triptans are less likely to have better (faster) delivery methods – such as nasal sprays and injections.

Naratriptan has been used as an add-on to high dose verapamil treatment (Naratriptan in the preventive treatment of cluster headache.). This cluster case study in 2002 showed a 2.5 mg twice daily dose of naratriptan completely stopping cluster headache in a 36 year old male. And naratriptan is being used, though maybe not as much as it should be.

The best advice for doctors and patients is probably the advice that’s often given in the case of migraine. If one triptan doesn’t work at all, or not as well as you hoped, you may have much better success with another. Talk to your doctor about trying another option. Amerge may be one to try next.

For more on triptans, check out:


Why this Essential Oil may help, but won’t ever be popular…

There is an essential oil that is sometimes used to treat migraine and headache, and yet I don’t think we’ve ever talked about it here.

The Mystery Headache OilI was recently reminded of this essential oil because of a report from The American Society of Anesthesiologists (ASA). They reported that this oil was actually effective in easing menstrual pain.

If menstrual pain – could it be used for headache?

Indeed it could – and has been. This oil has been used for a number of conditions related to headache and migraine as well, including anxiety and depression. It can also be used on the skin (many essential oils can’t be used directly on the skin, or must be diluted with other oils. However, it is still wise to either dilute or carefully test rose oil first). It’s used to moisten skin and prevent acne, among other things.

So what could possibly be better than an essential oil that could be massaged into the temples, that would help relax you and improve your mood and help your skin, and even fight headache?

And it gets better before it gets worse. This is not an obscure scent – it’s one that has been used for a very long time – in the art of romance. Yes, it may actually be an aphrodisiac.

So what is this amazing treatment we’ve never talked about?

It’s a form of rose oil. In particular, it’s rosa damascena (the Damascus Rose). It’s sold as “100% pure rose otto”.

So why won’t this become a popular migraine treatment? Go and look for yourself – click the link: rose otto essential oil. Go ahead, just take a look.

Yes, that’s 0.12oz – a little over 3.5ml.

For those who didn’t click the link, the key point here is that rose otto oil may be great, but it’s expensive. Very.

Now you do have other options, but the benefit may or may not be there. You can get a diluted version, or a type called rose absolute which is not considered a therapeutic essential oil because of the way it’s extracted. However, these are obviously much cheaper options, so if there’s no way you’re going with rose otto, you could try one of the others (and then ask for rose otto for Valentine’s day).

There are other oils, made from other parts of the rose or other varieties, but they’re a whole different thing.

On the bright side, you obviously don’t need to use a lot of rose otto at a time. Remember, one single drop of this oil was made with about 60 roses!

Though this will never be the next big treatment, some are using it and claiming success. If you’ve tried rose otto (or another rose oil), let us know!

Read more about The Benefits of Rose Essential Oil
Also see Aromatherapy headache solutions and Peppermint Oil for Headache?


The Migraine Patient Registry

If knowledge is power, will knowledge of migraine patients be power to find a cure?

The Migraine Patient RegistryThat’s what the American Migraine Foundation is hoping. The announcement was recently made that the foundation wants to make a database with information on every migraine patient. This would include genetic materials (such as saliva), blood and other fluid samples, and brain images.

These types of registries actually aren’t unusual for other diseases. Take for example the Canadian Epilepsy Database and Registry (CEDAR), the Colorado Pediatric Partners Asthma Registry, and the Australian Lupus Registry.

Once information is collected, research is done to find out more about the diseases and treat them more effectively.

Foundation chair Dr. David W. Dodick puts it this way:

The goal of the American Migraine Foundation is to develop a multicenter patient registry and biorepository that will transform migraine research and lead to substantial treatment breakthroughs. We hope to be able to assemble a treasure trove of data that researchers can access to find powerful clues to migraine causes and treatments. The data collected in the registry will also help treatment providers tailor existing therapies to specific types of migraine.

This kind of research is already being done, of course. But with more information comes better research.

In case the collection of all this intimate information sounds a little creepy, it should be noted that the registry will not be collecting personal information along with you saliva sample.

Money is currently being raised for what is being called the “Migraine Patient Registry and Biorepository“. For more information about the initiative, read about the American Migraine Patient Registry here.

See the original press release here.


New Insights Into Trigeminal Neuralgia

Researchers in Denmark are providing new insights into the painful condition known as trigeminal neuralgia (TN).

Have you ever had a stabbing pain on one side of your face – almost like an electric shock? Maybe it just happens, or maybe it seems to come when you’re brushing your teeth, or even putting on makeup.

Trigeminal neuralgia is not a common disease, and so it hasn’t been studied nearly as much as many other pain disorders. But this study of 158 patients gives us a clearer picture.

  1. TN seems to strike later in life than conditions like migraine. The average age when symptoms appeared was about 53 years.
  2. Although both men and women get TN, it is somewhat more likely to affect women.
  3. Almost 50% of patients had persistent pain in addition to the stabbing pain. Sometime TN with persistent pain has been called “atypical”, but it doesn’t seem to be as atypical as some think (the more proper name, by the way, is classical trigeminal neuralgia with concomitant persistent facial pain. Has a ring to it, wouldn’t you say?).
  4. The pain is more often on the right side.
  5. A little less than a third had “autonomic symptoms”, such as dizziness, and a little less than a third had “sensory abnormalities”, even if they hadn’t had surgery.

Researchers also investigated the nerve that TN affects. TN can affect different branches of the trigeminal nerve in the face. They discovered that the first branch alone was rarely the problem. Usually the culprits were the second and/or third branches.

TN is usually treated with medications such as anticonvulsants and muscle relaxants. Botox has also been used successfully for TN, and in much smaller doses than are used for migraine.

In rare cases, surgery is recommended. However, surgery is not always a guarantee that the pain is gone for good.

A clinical trial is beginning in the USA also, in Philadelphia, to investigate the use of Botox for TN. If you would like to be a part of the study, you can find more information by clicking the last link below.

For more information: