Menu

James

About James

http://relieve-migraine-headache.com

Posts by James Cottrill:

Nausea / Vomiting and Migraine: 10 Facts

2

Nausea / Vomiting and Migraine

  1. N/V: one of the most common symptoms of migraine.
  2. Childhood N/V disorders may be migraine or indicate future migraine.
  3. Nausea could be an early sign of migraine – hours before headache (if there is headache).
  4. There’s no nausea in occasional tension-type headache (TTH), but could be in more constant or chronic TTH.
  5. Typical treatment of migraine often fights N/V also (ie triptans, biofeedback).
  6. Many patients take suppositories, transdermal meds, etc. to avoid problems with pills that go through the digestive system.
  7. Some medications specifically fight N/V, such as metoclopramide, dimenhydrinate, and promethazine.
  8. Some supplements may treat/prevent N/V,such as feverfew and ginger.
  9. Talk to your doctor.  It can be dangerous to take multiple medications/supplements at the same time.
  10. Common sense: Stay hydrated, relax, and eat bland foods when you can.

For more, check out Migraine nausea, Nausea – still a Major Migraine Problem, and for specific general information on the headache disorders mentioned above, the 2nd Edition of The International Headache Classification.

Helping Doctors to Change

0

This is a brief podcast from Dr. Michael Wilkes from the University of California.  It’s not about headache or migraine, but it’s very relevant.  In the podcast, Dr. Wilkes asks some important questions.  When new scientific information comes out that shows that an old method is wrong, or that shows a new treatment is right, why don’t doctors change?

Listen to the podcast, and then I’d like to make a few comments.

Change Doesn’t Come Easily

First, I would like to question one thing that Dr. Wilkes says.  He describes a common attitude that doctors have as,“— but — I’ve always done it this way!”

Maybe a doctor would like to comment, but I think that reasons for not changing can often be more complex.  For example, there’s the impression that the “facts” we have today were different yesterday, and will change again tomorrow.  There’s the realization that treatment is often more complex than a single study on a single aspect shows.  Also, there’s the impression that what we’re doing “works” – and so why change?

Finally, there’s so much information out there – how do you keep educated?

I would like to ask both doctors and patients these questions.  If you’re a doctor, how do you keep up to date?  How do you think you or other doctors could do better?

As a patient, can you help your doctor keep up with information relevant to your situation?

These questions are very important when it comes to migraine, cluster, and other related disorders.  At this time in history, we’re learning a lot, and we’re learning it fast.  That means we can jump to the wrong conclusions in our impatience.  But it also means that there’s a lot of good information available, and it’s difficult for both doctor and patient to keep up with.

Remember, your doctor has to not only treat patients, but keep learning, and take all those facts – some more “true” than others – and integrate them into a wide sea of knowledge she already has.  It’s not easy.  How can we help make it easier?

Is Migraine Different if Your Income is Low?

4

Just how much do economic problems impact migraine?  A new study is providing some fascinating answers…

We do know that economic status is a part of a complex web of factors that relate to migraine.  There is some evidence that children in lower income families are more likely to get migraine, for example (read Lower income = more migraine?.  You might also remember a poll we ran here back in 2010 showing that headache conditions had a large impact on job/career choices (read: Impact of Migraine/Cluster/Headache on Job Decisions

One of the most challenging questions is this:  Why are people with lower income more likely to have migraine?  Is it because migraine leads to a lower income?  Or does the lower income lead to migraine?  Or both?

A study of 162,705 people is providing some major clues.  Each person shared information such as: do you have migraine?  when did the symptoms appear?  what is your household income?

Is there more Migraine among lower income people?

Yes.  You can see the differences in the charts below:

Women with Migraine, by income

Men with Migraine, by income

The study also found that those with low incomes were likely to have more pain and more disability.

But some things are the same…

Now, here’s the interesting bit.  Remission rates were the same, no matter what the income.  In other words, more people had migraine disease among the lower income brackets.  But, once anyone had migraine, they were just as likely as anyone else to stop having symptoms (remission).  People with lower incomes do not seem to have migraine for a longer period of time.

Now, maybe you wondered if people with lower income were less likely to get treatment that works.  That still could be the case, especially considering that symptoms seem to be more severe for this group.  But when migraine went away, whether “naturally” or through treatment, it didn’t go away faster for those with higher incomes.

Researchers suggested that maybe different factors were involved at the start of migraine than at the remission of migraine.  At least, when it comes to economic factors.

This also questions just how much influence “low income stress” really has.  The author of the study, Dr. Walter F. Stewart, put it this way:

If the stresses of low income were the sole determinant, we would expect low-income people to be less likely to stop having migraines.  It’s possible that the start of the disease may have a different cause than the stopping of the disease.

For more, check out the study abstract here:  Migraine prevalence, socioeconomic status, and social causation, and this article from Science Daily:  Does Migraine Affect Income or Income Affect Migraine?

What is Persistent Migraine Aura?

3

Persistent Migraine Aura

Persistent Migraine Aura (PMA)

persistent aura without infarction

Migraine aura (ie visual) which hangs around for more than a week (and could last for years).

Proper diagnosis:

To be diagnosed, it must occur in a patient who has had previous migraine attacks with aura.  Death of brain cells (infarction), and other related disorders must be ruled out.

Symptoms

Aura symptoms, and especially visual aura symptoms such as:

  • Visual snow
  • Flashing lights
  • Patterns

Treatments

Drugs such as acetazolamide, valproic acid, furosemide, verapamil, and lamotrigine

Nothing has been found that works for everyone.
PMA can be very difficult to treat.

For more information, read Persistent Migraine Aura and Visual Snow? and Visual Snow and Persistent Migraine Aura – tests and treatments

Selected References:  The visual aura rating scale as an outcome predictor for persistent visual aura without infarction. Cephalalgia 2008; The International Classification of Headache Disorders 2nd edition 2003; Is ‘visual snow’ a symptom of migraine? Dr Paul Shanahan; Is Visual Snow a Migraine Aura?; Migraine with Persistent Visual Aura: Response to Furosemide Clinics 2009; It’s snowing! Seven cases of persistent migrainous visual aura Saint Louis University; The visual aura rating scale as an outcome predictor for persistent visual aura without infarction. Cephalalgia 2008

Triptans for Children and Adolescents

, 1

Triptans, drugs developed specifically as migraine abortives, have long been used by adults.  And children too, actually.  But the adults have benefited from much better information – trials, studies … but things are improving for children.

Studies on triptans for children have suffered because of various factors.  Obviously, experimenting on children is rightly frowned upon.  Also, there’s a very high placebo effect when it comes to children.  Finally, the data is going to be, by nature, short-term.

Two drugs are approved in the USA for use with children/adolescents of various ages – rizatriptan (Maxalt) and almotriptan (Axert).

Reading through some of the study reviews, it seems that besides these, sumatriptan (Imitrex) and zolmitriptan (Zomig) have the greatest potential for treating children.

Two more important notes.  Triptans have generally been safe for children, when taken carefully under the supervision of a doctor.  A child should never be given someone else’s prescription.

Second, some triptans work in one form and not in another.  It’s very common to prescribe a nasal spray for a child, for example.  Wafer medications may also be effective.  Read more here.

Sometimes children don’t like the “aftertaste” of a nasal spray.  Try giving them a hard candy after taking the medication.

There is one more thing that is unique when it comes to child migraine.  The attack tends to pass quicker than it does in adults.  If you find that the symptoms go away just as fast without the triptan, skip the medication and try a simple home remedy.  This will avoid issues that can come with medications, and still give the child a feeling of “control” over their symptoms.

More information:

Load More

Back To Top
The articles on Headache and Migraine News are © 2004-2026 J. Cottrill.
Every effort is made to ensure the accuracy of each article, and to point you to further sources of information. However, this site is for informational purposes only and should never replace a visit to your doctor.