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1 November 2013

How many headaches are too many in a week?

It’s a common question – just how many headaches are too many in a week?

We’ll get into the details in a moment, but first let’s give the simple answer and explain why.

The answer is – 1.

Yes, one headache a week is too many. You knew I was going to say that, didn’t you?

Why is 1 too many? Because, contrary to popular belief, headache are neither “normal” nor “benign”. They should not happen, in many cases can be treated, and can cause long-term damage.

That being said, here are some tips if you’re wondering just when you should be concerned.

First, if you’re getting 1 or more headaches a week, and this is new, you need to see a doctor right away. In fact, any new symptoms, or a “worst ever” headache, could be a sign of something very dangerous.

If you’re getting one or two headaches a week, it’s probably having a significant impact on your life – your relationships, productivity, and enjoyment. You should be cautious about jumping into a preventative medication, however you do need to have a serious talk with your doctor about treatment. At 1-2 a week, headache is becoming something serious.

If you’re having more than 2 attacks a week, you’re at increased risk of developing other conditions that could be related to the headaches. This is “high frequency”. It’s time to find a specialist, and it’s time to seriously consider preventative medication and other treatments that are especially for your type of headache. Not all headache treatments are the same.

If you have more than three headaches a week, you may have a chronic condition. And without proper treatment, things could get worse. You’ll need proper ongoing treatment from a specialist to avoid more serious disability in the future.

One thing to remember is that one headache a week (which is already too many) can very easily lead to many more if not properly treated in the beginning.

How many headaches are too many in a week? Are you really getting one or more headaches every week? It’s time to take action, and fight back.

For an examination of migraine frequency in particular, check out this issue of HeadWay. If you’re not already subscribed to HeadWay, you can subscribe for free here.

28 October 2013

6 Key Stomach/Gut Terms related to Migraine

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Abdominal Migraine Common in children, but also seen in adults. A type of migraine that could include stomach pain and nausea, and may not include headache.
Cyclic Vomiting Syndrome (CVS) Particularly in children, this could be related to migraine or could actually be a type of migraine.
Gastric Stasis A common condition in migraine patients – a delayed emptying of the stomach – which can keep medications from working properly.
Gut-Brain Connection The enteric nervous system or “second brain” in the gut may explain why diet and treatment of stomach issues are closely connected to migraine.
Irritable Bowel Syndrome (IBS) A common disorder comorbid with migraine.
Nausea One of the most common symptoms of migraine (including vomiting).

21 October 2013

Migrainous Infarction – A Stroke from Migraine?

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Migrainous Infarction - Stroke from Migraine?

She has migraine with aura. But this time, aura symptoms last more than an hour. Tests (neuroimaging) show that she has had “cerebral infarction”. This is a disturbance of blood vessels supplying the brain. This causes a type of stroke.

The result may be a variety of stroke symptoms.

Although migraine with aura may increase your risk of stroke, migrainous infarction is much more rare, because it occurs during the aura phase of migraine.

Migrainous infarction is VERY rare.

If your aura symptoms unusually last over an hour, get to a doctor immediately!

Additional notes: In answer to the question above – is this a stroke from migraine? We actually don’t fully understand the connection. Migrainous infarction is not a stroke which happens to occur during a migraine attack, or the migraine-like symptoms that may accompany a stroke. In migrainous infarction, the aura symptom or symptoms are actually related to the infarction. In other words, the blood vessels and part of the brain which is affected is related to the type of aura symptoms you have.

Again, it is extremely rare, and people have been mistakenly diagnosed when they actually have a different condition.

For more information: Migrainous infarction from the International Headache Society; Clinical and MRI characteristics of acute migrainous infarction.

19 October 2013

Vagus Nerve Stimulation For Cluster Headache and Migraine – without surgery?

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Vagus nerve stimulation is not new in cluster headache treatment, or even in migraine treatment. But it has commonly been accomplished through surgery. Is there a better way?

The vagus nerve is a very important nerve that extends from the head through the neck all the way down to the abdomen, connecting to important systems along the way. It runs down each side of the body. When there’s a disfunction in this nerve, common symptoms could include pain, muscle cramps, and even problems with various key organs.

Though we’re not sure why stimulation of this nerve can fight cluster headache and migraine, we do know that it sometimes works – even in chronic cases.

Commonly a device is implanted through surgery. But today, there is increased interest in non-invasive vagus nerve stimulation.

One device being studied is known as gammaCore, developed by the neuroscience company electroCore.

The gammaCore device is a small hand-held unit, about the size of an electric razor. It’s placed on the neck and turned on for about 90 seconds.

So far, the results have been positive. Patients have found pain to decrease with a minimum of side effects.

As with any treatment, it doesn’t work for everyone. But since it involves no surgery and no medications, it’s worth further study.

And further study is what it’s going to get. Patients with chronic or episodic cluster headache may be eligible for a study in the UK and Ireland. Researchers want to complete the study early next year.

You can read more about gammaCore here. Read more about traditional vagus nerve stimulation here.

11 October 2013

Can ID Migraine diagnose Migraine Fast?

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ID Migraine is a tool that was developed about 10 years ago by Dr. Richard Lipton and a team of researchers. At the time, there was so much misdiagnosis that few people were getting good, targeted treatment. (Sadly, there is still a lot of misdiagnosis, but things are improving.)

Knowing that doctors often have limited time with patients, a tool was needed to point them in the right direction early on.

ID Migraine consists of three simple questions. The test has been modified and reinvented at times, but basically it goes something like this:

Has a headache limited your activities for a day or more in the last three months?

Are you nauseated or sick to your stomach when you have a headache?

Does light bother you when you have a headache?

If you answer “yes” to at least two of these questions, you probably have migraine.

Cautions and Limitations

Research seems to support the idea – yes, if you answer in the affirmative to at least two of these questions, you probably do have migraine.

But could you answer “yes” and still not have migraine? It’s possible. You could also have migraine symptoms that are caused or triggered by other diseases or conditions. There is always a danger that a doctor (or patient) will say “it’s just migraine” and miss out on something else that could be treated if caught in time. That’s another reason why continued dialogue with your doctor and ongoing treatment is critical.

Could you answer “no” and still have migraine? I’m afraid so. It should be noted that this tool does work best for someone who goes to the doctor complaining of headache. There are types of migraine where headache is not the predominant symptoms, or where it isn’t present at all.

But assuming there is headache, it is possible to have symptoms other than nausea and photophobia (sensitivity to light).

Of course, diagnosing anything with three questions is a challenge, and only the first step. This tool does an excellent job of getting things right the majority of the time.

But it is still very important to see a doctor who knows your medical history, and to look for good, well researched treatment for migraine.

Again, diagnosing migraine is only the first step. Knowing what type of migraine you have is the next step toward good treatment. Get a specific diagnosis and keep an eye on your symptoms over time. If things change for the worse, or don’t improve, you’ll need to be more aggressive in your fight against migraine.

Still, ID Migraine is a useful tool that can point a doctor in the right direction and hopefully help many get proper treatment faster. It’s still being used today to help both doctors and patients.