But that doesn’t mean we know everything about migraine, and it doesn’t mean that we can explain simply what exactly is causing the pain. In fact, pain is incredibly complex.
For example, we also know that the way we think about pain influences how much pain we feel, and how persistent it is (see, for example, Pain Catastrophizing and Your Headache).
Recently TED-ed posted a little introduction to some of the complexities of pain. Take the time to watch it below. It’s critical that we start thinking about these things, so that we don’t over-simplify either our condition or our treatment.
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.
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 There may be good treatments available to you that you are avoiding based on outdated information.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.
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.
Mouth/Brain disconnect?
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 . . .
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.
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.
