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Cefaly: Now Available in the USA (for less)

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Last year we introduced you to the Cefaly anti-migraine device, a convenient non-drug migraine treatment device.

Cefaly Site USA

Now Cefaly has a direct US website, with a currently less expensive option than amazon.  This is after the FDA approval of the device earlier this month.

In order to purchase from the new website, you will need to email a copy of your prescription.  At this point, it’s unlikely that your insurance will cover the cost of the device.

However, the savings to US customers at the new site will no doubt allow many more to try the device.

Visit the new site at Migraine Prevention Cefaly

via:  The Daily Headache

Vitamin D: An important Migraine Treatment?

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The truth is that a shocking number of migraine patients have “vitamin D deficiency”.  This could mean cardiovascular disease, bone pain, and even depression and allergies.  But will more vitamin D mean fewer migraine attacks?

Vitamin D - a migraine treatment?

Dr. Steve D. Wheeler is one of those who has advocated for investigation of vitamin D and migraine.  In 2008, Dr. Wheeler was involved in a study which showed 41% of people with migraine also had a deficiency or insufficiency.  Although the study did not investigate vitamin D as a migraine treatment, it does seem to help some patients.  Dr. Wheeler suggests some reasons why this might be the case:

  1. Anti-inflammatory effects mediated through reductions in matrix metalloproteinases, C-reactive protein, tumor necrosis factor-alpha and other inflammatory mediators
  2. Analgesic effects
  3. Nitric oxide reduction
  4. Magnesium absorption increased

Read the rest of the article at Vitamin D, Migraine, and Health – Medical Complications: Optimize Therapy!

Another specialist in the use of vitamin D is Dr. Michael F. Holick.  Dr. Holick navigates the recent research and presents guidelines for vitamin D dosages, sun exposure, and treatments of specific symptoms in his book The Vitamin D Solution: A 3-Step Strategy to Cure Our Most Common Health Problems.  In his book he discusses migraine, along with other diseases and symptoms such as fatigue and pain.

More recently, researchers in Iran compared migraine patients and healthy patients to check vitamin D levels.  They found that there really was no difference – the non-migraine patients were just as prone to vitamin D deficiency as migraine patients.  In fact, a more severe deficiency did not seem to worsen headache symptoms.  The 2014 study can be found here:  Vitamin D Status in Migraine Patients: A Case-Control Study

Does this prove that there’s no relationship between migraine and vitamin D?  Not at all.  It’s still entirely possible that improving our intake of vitamin D may help many with migraine.  A deficiency may show itself in different ways – for someone with migraine, might it make their symptoms worse?

Many still think so.  Although the clinical trials so far haven’t been targeted enough to give us a definitive answer, some migraine patients have found relief after increasing their vitamin D intake.  Again, the suggestion is not that vitamin D is the ultimate cure of migraine.  More likely it’s part of the complex web of issues that are making the problem worse.

For more information, check out:

Patent foramen ovale closure – for children?

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Patent foramen ovale closure is still being used as a treatment for migraine and other headaches in children.  But is it worth the risk?

Patent foramen ovale (PFO) closure is the closing of a common “hole in the heart” that once was hoped to be a great new migraine treatment.  So far, however, the surgery has not lived up to the original hype.  Trials have failed to put this anywhere close to the top of the list when it comes to migraine treatment.

In spite of the general let-down, the treatment is still being used, even among children.

It has been estimated that one in four people have PFO, but most people have no symptoms at all.  But in some people this does seem to contribute to migraine.

Pediatric Neurology recently published a study from the USA on PFO treatment for children in general.  Children with both migraine and non-migraine headache usually reported an improvement after the surgery.

So far so good.  However, the researchers have some concerns, and rightly so.

First, this study was not designed to see how effective PFO closure was in patients, and so it had a number of shortcomings which we won’t get into here.  But there are some things that would be helpful to know.  For example, did these patients have other symptoms besides headache or migraine that prompted them to see a cardiologist (in most cases, the procedure was recommended by a cardiologist)?  If so, could it be that treating other conditions are actually helping with migraine symptoms?

Researchers are also concerned about long term effects of this surgery (it’s a generally safe surgery, but it’s still surgery), and the cost.  If there are less-invasive treatments that work just as well or better, doctors should be cautious about recommending PFO closure.

This study highlights the need for further well-designed studies of PFO closure for migraine and headache.  For example, I would like to see further study into type of migraine or headache vs type of PFO.

We’re still getting mixed answers about how helpful it is, and we need to be especially cautious before we recommend it for children.

For more information:

Does the Smell of an Onion Trigger Migraine?

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Could the smell of an onion – or garlic – actually trigger a migraine attack?  If so, what can we do to keep it from happening?

There’s no doubt that certain smells bother people who are having a migraine attack, even in the early stages before there’s a headache.  And many people have reported that smells actually trigger attacks – perfumes and household cleaners are common culprits.  It has been estimated that odours can trigger attacks in 70% of migraineurs.

Does smelling onions trigger a migraine attack?

We also know that eating onion can trigger migraine attacks in some people.

In the spring, in the journal Headache, a report was published on a woman who experienced some pretty significant symptoms after just smelling raw onion.

She first had some allergy-type symptoms in her late 20s after eating an onion dip.  Over the next few years she started experiencing a variety of symptoms after just smelling an onion – severe headache, visual symptoms, sore throat, feeling faint, and so on.

The woman was testing for allergies, and in this case the test was positive for garlic and onion.  It’s nice to get a positive result in an allergy test – many migraineurs will test normal for their triggers.

Obviously this was a bit of a severe case, more of an allergic response than just a trigger.  However, to varying degrees many migraineurs do experience symptoms after exposure to odours including cigarette smoke, car air fresheners, aerosols, and even the smell of foods cooking (particularly fatty foods).

The treatment that this woman was given actually worked.  In her case, medication was tried first without success.

The treatment was two-fold.  First, a nose plug (she had been covering her nose and mouth when going out previously).  Next, “counter-stimulation” using peppermint.  These two simple solutions kept the headaches from coming.

Are there certain smells that trigger migraine attacks for you?  Have you ever tried a nose plug, or a counter-smell such as peppermint oil?

For more information:

What is Triptan-Overuse Headache?

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What is triptan-overuse headache?

  • Patient takes one or more meds containing a triptan 10+ days per month for 3+ months.
  • As more triptans are taken, headaches have increased to 10+ days per month.
  • Typically these attacks are not just headache but include other migraine symptoms.
  • Patients will have an underlying condition (a type of migraine) as well as the diagnosis of TOH.

Usually attacks decrease within 2 months after patient stops using triptans.

A patient taking triptans AND other abortives may be diagnosed with combination-analgesic-overuse headache, a condition which may be harder to treat.

Even if a patient technically doesn’t have TOH, they may still be taking too many triptans.  Talk to a specialist who knows your medical history.

For more information:

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