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25 March 2019

Is My Vertigo Related to Migraine? (video)

Migraine and vertigo or dizziness (two different symptoms) are a common combination. We saw this confirmed again in a poll several years ago (see: Do you experience vertigo or dizziness during a migraine attack?).

Migraine and vertigo - what's the cause?

Here’s a quick video describing the basics of migraine and vertigo, from the Mayo Clinic. We’ve talked about these things in more detail before, so if you’d like to learn more about your dizziness or vertigo symptoms after watching the video, check out Vestibular Migraine: What’s New.

11 March 2019

Pregnancy and Breastfeeding with Migraine – Assessing Risk

James Information, Tips 0

A study from Norway, published last month in BMJ Open, raised some interesting questions about women with migraine who are pregnant and breastfeeding. In this case, though, it wasn’t a study about treatment options, but a general investigation about what women think about treatments.

Here’s a quote from the study abstract that says it all: “Women with migraine severely overestimated the risk associated with migraine pharmacotherapy in pregnancy.”

In other words, in the opinion of the authors, women are overestimating just how potentially dangerous pharmaceutical drugs are for the baby.

First of all – I think it’s actually good that mothers “overestimate” the risk, because doctors and researchers may often “underestimate” the risk. We should all be thankful for picky, “paranoid” mothers who have saved us from a lot of troubles in life.

Philosophy aside, however, it’s not necessarily a good thing that women “severely” overestimate the risk. Why?

First, because overestimating the risk of medications probably means you’re also underestimating the risk of migraine. Yes, migraine itself carried a risk. It’s not simply a matter of “enduring pain for the sake of the baby”. That pain may do damage beyond the momentary, and may lead to other health issues, not to mention impacting your ability to mother. Migraine treatment is important, both in the short term and in the long term, for both you and your baby.

Second, you may be suffering through the pain needlessly. There may be good treatments available to you that you are avoiding based on outdated information.

Also, we need to recognize that prescription migraine drugs are not necessarily riskier for the baby than over-the-counter painkillers. So don’t run to the local drugstore assuming that will be safer than your doctor’s prescription. Talk to your doctor – and then weigh the risks. If possible, talk to a migraine specialist.

It’s wise to be extra-cautious for the sake of your baby. But be sure you’re not making assumptions that are going to make your health worse, when you can actually get some good treatment. And don’t stop taking preventative medication without talking to your doctor.

For more on migraine and pregnancy, check out The Myth-Busting Guide to Migraines and Pregnancy.

The study abstract is here (with a link to the full text): Risk perception, beliefs about medicines and medical adherence among pregnant and breastfeeding women with migraine

28 January 2019

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

James Discoveries & Stats, Information 0

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

9 January 2019

Barometric Pressure Headache – Experiencing Bad Weather?

James Information 0

Headaches and the weather have been a subject of controversy for a long time. Not because people don’t experience barometric pressure headaches, but because the relationship between atmospheric pressure and headache is hard to measure.

Why? First, because weather is complex. Was the change in pressure accompanied by lightning? Wind? Heat? There are many things that may work together with pressure to give us a headache.

Second, because we are complex. There can be a number of reasons why atmospheric pressure may trigger a headache or migraine attack.

This is actually an important area of study called – consider this your word of the day – biometeorology. “The study of the relationship between living organisms and weather”, according to Oxford.

So what actually changes in your body that could cause a barometric pressure headache?

The biggest change is blood pressure. Lower atmospheric pressure means lower blood pressure. But not only that, low pressure can affect your joints (remember grandpa’s knee, which always knew when rain was coming?), and your sinuses. Both of these could have to do with changes in fluid pressure. Blood thickness also increases, which can cause problems with blood sugar levels – a special concern for diabetics.

Any of these things could be related to headache or migraine pain. But scientists still wonder if there’s more to it – a neurological reason why your brain may respond differently when pressure changes, thus triggering a barometric pressure headache.

Whatever the case may be, it’s wise to keep a headache diary, which can help narrow down the triggers that bring on headache in your case. For more tips on dealing with barometric pressure headache, check here.

For more interesting information on weather and health, check out How changes in barometric pressure affect the human body, this brief New York Times article on barometric pressure headaches, and more quick tidbits from The Weather Channel – 13 Ways Weather Affects Your Health — Without You Knowing.

5 January 2019

MSG and Headache – A Myth?

James Discoveries & Stats, Information, News 1

Late last year, an article in Lifehacker caught my attention – Stop Being Afraid of MSG. People with headaches and migraine may either be relieved or shocked by the claims that follow:

If you’re still afraid of the seasoning MSG giving you headaches, you should know you’ve bought into a decades-old myth.

Words like “afraid”, “bought into” and “myth” certainly make one feel like they should change their opinion immediately, and order a bottle of MSG (affiliate link conveniently provided in the above article).

But on the other hand, many headache sufferers swear that, every time they eat MSG, they get a headache.

So what’s the truth? First, in spite of the fact that MSG has sometimes pretty much been blamed for the imminent fall of civilization, it doesn’t seem to have an obvious, immediate effect on most people. And long term effects of that kind are extremely difficult to measure.

So the real question is, does it bother some people, perhaps those predisposed to migraine?

Almost anything bothers somebody, so we’re actually looking for something more widespread than 6 people in Berlin who get sick if they eat MSG.

So here’s what many of you really want to know. Yes, there are many people who feel that MSG gives them headaches. You will hear lots of stories. That doesn’t make it a fact, but it’s widespread enough that it seems to be more than a coincidence.

However, the clinical trials have not been conclusive. So why is that? Are the “right” people simply not in the trial?

Part of the challenge is that MSG is noticeable. That means placebo effect. So a well designed study is difficult to do with MSG, and trials in the past have often been poorly designed from a scientific point of view.

In 2016, a useful review of the studies of MSG was published in the Journal of Headache and Pain (Does monosodium glutamate really cause headache? : a systematic review of human studies). The study pointed out some of the problems with previous studies.

Falling short of claiming that MSG headaches are “myth”, the researchers concluded that the evidence was not strong enough from clinical trials to prove a direct causal relationship:

Because of the absence of proper blinding, and the inconsistency of the findings, we conclude that further studies are required to evaluate whether or not a causal relationship exists between MSG ingestion and headache.

Interestingly, the study actually interacted with the beta edition of the International Classification of Headache Disorders 3rd edition (ICHD-3 beta), which listed monosodium glutamate (MSG)-induced headache as one type of “Headache attributed to a substance or its withdrawal”. The cited studies were investigated more closely, and again, the studies did not seem robust enough to prove the relationship between MSG and headache.

The editors of ICHD-3 seemed to agree, dropping the mention of MSG altogether when the document came out of beta.

If someone gets a headache after eating foods with MSG, what does that mean? Is it possible that other issues (such as high salt content in general) could be causing the headache? In some cases, yet. It is easy for individuals to assume that one thing is causing their headache, when it’s something else altogether – and that’s something that happens frequently.

On the other hand, it would seem difficult to use these studies to “prove” that there is no causal relationship. So that leaves us with two practical issues.

First, you are the only one who is going to “test” the relationship on yourself. Keep an open mind, and if you’re convinced that MSG is a problem for you, stay away from it. If you’ve read the evidence and would like to give it another try, go ahead.

We should probably be a little cautious before we start labelling the MSG headache as a con or myth. And laughing at the silly woman who still lives in the bronze age and thinks that MSG causes her headache would seem to be counter-productive. We really don’t have the evidence to know if MSG bothers her or not. And when new research comes out, who knows if our minds will change.