migraine symptoms

21 August 2020

Is it Migraine or COVID-19? The surprising similarities

You might think it’s easy to tell the difference between migraine symptoms and COVID-19 symptoms. And if you’ve had migraine for a while, and your symptoms are generally the same every time, you may be right – it might be easy for you.

But that’s not the case with everyone. Some people’s migraine symptoms change significantly and regularly. And of course if this is your first migraine attack, or you haven’t had migraine for very long, it’s easy to wonder if it’s migraine or something else.

So today we’re going to look at some symptoms that both migraine and COVID-19 may have in common, and how to tell the difference.

Headache

Headache is, of course, the most common symptom of migraine (although you can have a migraine attack with no headache). But headache can also be a symptom of COVID-19.

Migraine headache tends to be throbbing, and one-sided. It’s often accompanied by photophobia and/or phonophobia, that is, sensitivity to light or noise. The pain is usually made worse by activity (for example, climbing stairs).

Though migraine may last from a few hours to a few days, there is usually a progression. The pain may peak, and then diminish, and you may experience a day or two of “migraine hangover”.

From what we know so far, a COVID-19 headache is more often a “tight” kind of headache, that specifically appears along with coughing and/or fever (more on those in a moment). It may get progressively worse over time, instead of “peaking and diminishing”.

The tricky thing is that conditions like COVID-19 may also trigger migraine symptoms – so just because the headache appears to be a migraine headache doesn’t mean that you don’t have COVID-19 as well.

If the pain is moderate to severe, and it’s different than any headache you’ve had before, you need to see a doctor, whether you’re experiencing “COVID-19 symptoms” or not. There are a variety of very serious conditions – some urgently serious and extremely dangerous – that send out a “headache warning”.

A severe headache with COVID-19 can be a very serious sign. Don’t delay that doctor’s visit.

Coughing

Some people do cough during a migraine attack, but it’s most often a “warning sign”. So in migraine, coughing may precede the headache. In COVID-19, the cough may get worse as the headache gets worse.

Congestion/Runny Nose

A runny nose, or feeling congested, is a very common symptom of migraine. Red eyes, watery eyes, feeling “stuffed up” – all these may go along with a migraine attack. If you’re an experienced migraine sufferer, you may be able to tell the difference.

But some people are surprised how common this is. And it can be tricky if you try to go to work with a runny nose that you know is caused by migraine!

These symptoms may go along with your migraine headache, but if it’s COVID-19 they may get progressively worse, and be accompanied by other common symptoms such as fever and coughing.

Fever

Yes, fever may be a symptom of migraine, although it is rare (see some of the experiences of people with fever here). But feeling feverish is much more common! Feeling hot and sweaty, having the chills – this is not uncommon at all during a migraine attack.

Again, you need to look at the big picture (check out – Coronavirus Symptoms: Frequently Asked Questions). If you have progressing symptoms of sore throat, fever, coughing, etc., it’s much more likely to be something other than migraine (or accompanied by migraine).

Nausea

Nausea is a very common (though not universal) symptom of migraine, often experienced along with the headache. Experience will help you know the difference here, but nausea along with migraine headache symptoms (see above) is a big hint that it’s a migraine attack, especially if it comes fairly suddenly and disappears after a few hours.

More information

For a very helpful article featuring Dr. Merle Diamond from the Diamond Headache Clinic, check out COVID-19 or migraine? Here’s how to tell and what to do about it.

5 April 2019

Your Symptoms/Special Abilities (poll results)

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Our most recently completed poll question was: Which of the following symptoms (or special abilities!) have you experienced?

In this case, you were able to choose up to three answers. It’s interesting that some symptoms are indeed “special abilities”, such as being able to smell things before anyone else does. So – let’s look at the results.

The Three Winners

These three were almost tied (all about 18%), but here they are in order, starting with the top answer:

Trouble speaking or writing or understanding words – this one is both a common symptom of migraine and also a symptom of some medications. A very big concern among migraine patients.
Ringing in the ears – Tinnitus. Here’s a quick overview of tinnitus. There are medications that can cause tinnitus as well – talk to your doctor.
Smelling things that no one else can smell – yes, surprisingly common. This does not necessarily mean the smell is a “hallucination” (although it could be). You could just be smelling something others don’t notice or can’t smell yet.

The Next Five

These didn’t make the top three, but were also very common.

Very sensitive/painful skin (for no apparent reason) – technically called cutaneous allodynia, this is another one that can be a symptom and also made worse by medication. 13% reported this symptom.
Numbness in part of your body – 10%. May be a symptom indicating a certain type of migraine.
Feeling like things are out of proportion – such as Alice in Wonderland syndrome. Feeling like your arm is too long, or that objects are much farther away than they are, for example. 8% reported this symptom.
Hearing things that no one else can hear – again, could be an auditory hallucination, or a actually specially sensitive hearing. 6% reported this one.
Temporary partial or full blindness – this again may indicate a certain type of migraine (a type of migraine with aura). 5% experienced this.

Just Two More

Of course there are many symptoms that we could have mentioned, but here are two more that, although less common, do still affect many migraine patients.

Out of body experiences – Another one that we’ve talked about before – join the discussion at Migraine and Out of Body Experiences. 3% of respondents.
Hearing voices – a type of audio hallucination. 1% reported this, and you can discuss it here: Do You *Hear Voices* during a Migraine Attack?

An interesting list of experiences! What about you? Have you experienced any of the above, or do you have something to add? Leave a comment and keep the discussion going!

25 February 2019

What is it really like to have a Migraine Attack?

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The answer won’t be the same for everyone – in fact, it won’t even be the same for every attack. But what if someone asks you this question? Are you ready to give an answer that will help them really understand?

“Me with a migraine” (courtesy Prairie Kittin)

It is very helpful to have a bit of an “elevator speech” to use if someone asks you about your condition. That will be a little explanation – about 30 seconds long – that gives them an idea not only what migraine is, but what it is for you.

We’ve talked many times about the strange and varied symptoms of migraine. Why not take a look and think about which symptoms affect you most? Which are most “disabling” or disturbing? How does migraine change your life on a day to day basis, what emotional impact does it have?

You might find this recent article to be helpful – 13 People Explain What It’s Really Like to Have a Migraine. Do you relate to any of these symptoms or stories?

You might want to leave a comment here – how do you explain migraine to people who don’t understand (but who are willing to listen)?

28 January 2019

Hard to Talk During a Migraine Attack? You’re not alone!

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If you have trouble talking during a migraine attack – or even before it fully hits you – you’re not alone. Speech problems are a well known, but complex, part of migraine.

Journalist Lindsay Patton-Carson recently wrote about her migrainous struggle with words – and it’s not just speaking them, it’s writing them. She began to connect the dots, she writes, “I did notice that as my migraine frequency increased, my word recollection decreased.”

A recent study set out to look at various specific types of speech disturbances in migraine patients. These were people with “episodic” migraine (not chronic). Using a mobile app, everyone provided three speech samples per day, while tracking their migraine attacks.

This research was not so much studying whether or not people could remember words, but things like pitch of voice, how fast you speak, and how clearly you enunciate (clear pronunciation).

There were, as expected, speech differences in patients with migraine. Not just when they were in the middle of an attack, but all the time (as compared to the control group).

However, the main focus was on changes during the pre-attack phase (prodrome) and the main (normally headache) phase. About half of the patients had significant speech changes during an attack, and about a quarter experienced changes during the pre-attack.

The most significant changes were in how fast and clearly the patient spoke, and “phonatory duration”, an ability to hold a vowel sound (which tends to decrease with age).

Language difficulties (such as slurred speech) are common in migraine – and a common way to diagnose migraine with aura. In an online poll, 90% of our visitors had experienced some kind of language problem related to migraine. It’s well known that there are brain changes during an attack (see Is Your Brain “Slower” During A Migraine Attack?). Interestingly, none of the patients who experienced pre-attack speech issues knew it was happening – it was only found through research of the recordings they made.

This study, though very preliminary, may start to help us understand what types of speech changes are most common and why.

One of the study authors explains

Changes in speech patterns during migraine attacks might be expected given the relatively widespread alterations in brain function and functional connectivity that occur during migraine attacks. The ability to share our thoughts and ideas through spoken communication is a complex and fragile process . . .
Dr. Todd J. Schwedt [source]

Remember, changes in speech and language are not just one thing, and they are complicated. But they’re also common. Yet another reason to fight back against migraine.

Read more here: Migraines can cause altered speech

7 January 2019

Migraine and Suicide: Not What You Think

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A health professional once told me,”I don’t know how you couldn’t be depressed, with all your headaches.” I think the statement was well intended, to remind me that there’s no shame in being depressed.

The truth is that not all migraine patients – even patients with chronic migraine – are depressed. Many are not. But that being said, there is a clear link between migraine and depression.

Surprisingly, researchers aren’t sure why. It’s not a clear-cut case of “pain=depression”. Instead, there seem to be underlying biological/genetic issues that make a person with depression more likely to have migraine, and vice versa.

A recent study on migraine and depression has confirmed some previous studies, but may come as a surprise to many.

The study focused on patients that were hospitalized – obviously a specific subgroup. And yes, patients with migraine were more likely to suffer from anxiety, depression, or PTSD. They were also more likely to have 2 or more co-morbid conditions – migraine usually doesn’t arrive alone.

And yes, patients with migraine were more than twice as likely to demonstrate suicide behaviour. Previous studies have found an increased risk in migraine patients, such as this meta study from 2009, and this study from Ethiopia.

So where’s the surprise? Well, the researchers went on to look at the risk for patients with migraine and anxiety, depression, or PTSD. Of course, you would expect suicide risk to skyrocket in patients with migraine + one of these conditions.

Except, it didn’t. It dropped. Patients without anxiety, depression, or PTSD were significantly more likely to demonstrate suicidal behaviour! The Ethiopian study found the same thing specifically with depression – when a migraine patient did not have depression, they were more likely to be suicidal.

Why? Does this mean that non-depressed people are more suicidal? Not necessarily.

The study explains:

Friedman and colleagues did not detect a link between specific psychiatric conditions and suicidal behavior among patients with migraine. They speculated this might be because patients with migraine with comorbid psychiatric disorders are receiving treatment that reduces their risk for suicidal behaviors.
Study Summary: Link Between Migraine and Suicidal Behaviors

It could also be that patients had not been diagnosed properly with depression (and hence weren’t receiving treatment), or that they failed to report these conditions.

This study and others should remind us of some important things. So let’s summarize:

Migraine patients are not automatically depressed.
Many are.
Sometimes it’s hard to see the visible signs of depression, or suicidal thoughts.

We need to recognize, again, that migraine is serious. If someone you love is suffering from migraine, they may rarely mention it. But when they do, listen. Take it seriously. If appropriate, help them find treatment, and encourage them not to ignore it.

Read more about the study here: Study Summary: Link Between Migraine and Suicidal Behaviors