Headache and Migraine News

19 November 2018

Changing Treatments in Emergency

Treating migraine in the emergency room of a hospital is a challenge, and opinions and methods are changing rapidly. Narcotics were once common, but researchers began to discover that patients taking narcotics in emergency (instead of other treatments – more on that in a moment) actually tended to be in the hospital longer and come back more often. This isn’t to suggest that they were “drug seekers”, but simply that the narcotics were less effective than was once believed – and side effects were more common.

Changes in the emergency department — Photo credit: bidgee

As our knowledge of migraine treatment has expanded, many other treatments have become commonly available. More and more, treatments are being given such as – hydration with magnesium (intravenous), sumatriptan, NSAIDS (such as ketorolac or diclofenac), and dopamine antagonists such as metoclopramide (for nausea and other gastric problems).

And older medication, dihydroergotamine, has been persistently used as well.

A meta study published this month in the American Journal of Emergency Medicine highlighted some of these changed (see link at bottom of this article). Comparing how things were at the turn of the millennium, the study found:

Dopamine antagonists are now used 3-4 times more often
intravenous fluids used over 6x more often
Dexamethasone (a corticosteroid) used 22% more (this one is quite new – and it seems to help keep migraine from returning in the short term)
Ketorolac used 7-8x more often (also somewhat new in emergency)

Narcotics are only give 1/3 as often as they were. Not only that, “discharge prescriptions” are down to a third or less or what they were.

An obvious question is – are the new procedures helping? That may be a complex question, but the same study did find that return-to-emergency rates were also down, to a third of what they were back in 1999-2000.

That return rate may not be quite as great as it sounds – only 12% returned before, now only 4%. Still, a significant difference.

For more on emergency room procedures, see:

16 November 2018

The Heroes at Boon Elementary School

James News 0

This is actually old news, but it’s news that’s worth highlighting.

Boon Elementary School in Allen, Texas, was planning for their October “ribbon week”. Inspired by one of their own students who had migraine, they decided that one of their special causes of the week would be migraine and migraine research.

Students wore bracelets with yellow and orange – representing the Migraine Research Foundation. Students gave of their own money to support the causes of the week (with the 4th graders leading the charge with the most donations! — and winning the coveted “popcorn party”!).

By the end of the week, $231.29 had been raised for migraine research!

Local passion and creativity can make a difference! Working together, these elementary students have had a part in migraine research that will help migraine patients for many years to come.

So what are you waiting for? Is there something creative you can do? Big or small, if we all work together, we can fight back!

For ideas, visit the Migraine Research Foundation.

And thanks again to the heroes at Boon Elementary!

via: The Students of Boon Elementary School and Boon Patriot Post

13 November 2018

Are Vitamin Labels Wrong?

James Information, Resources, Tips, Treatments 0

Vitamin supplements are a hot and controversial topic. Many times the supplements simply don’t contain what the label says they do. And even if they do, a big question is whether various supplements are actually helping us – or just wasting our money – or actually harming us.

Vitamin Labels Regular visitors to Headache and Migraine News know that many supplements have helped many people, particularly with migraine. But we do have to be careful to use products from quality brands, and to be sure that we know how to read and understand labels.

Today, we’re talking about something a little different. Many labels simply have outdated information when it comes to “Recommended Dietary Allowances” – and probably will for many more months, even years.

This is because we have learned a lot more since these recommendations were first introduced, decades ago.

The video below, from ConsumerLab.com, provides a helpful overview. Although specifically referring to the USA, it will be helpful for everyone, and you can investigate the latest information in your own country. The helpful page that Dr. Cooperman refers to can be found here: Recommended Daily Intakes and Upper Limits for Vitamins and Minerals

Bookmark this page and use it. Remember that even these updated amounts are very controversial. Also remember that you should be getting most of your vitamins from real food! However, pay special attention to multivitamins and other supplements that go well over the recommended amount, and especially those that may get near the upper limit. Getting too little may not make much of an impact. But getting too much can cause health problems – sometimes serious ones.

10 November 2018

The Traffic Light System for Headache

James Tips 0

In the past, we’ve discussed systems for rating headache pain and disability, but today we’re highlighting one system in particular that people have found to be very helpful. It’s called the Traffic Light System

There are actually some variations of this system – not surprising, because it’s a very simple set of 3. As mentioned in the post linked to above, you could simply say “mild” “moderate” or “severe”.

But a recent report from the University of Toronto described it in perhaps a more helpful way, as shown below.

Traffic Light System The advantages of this system? It’s simple – only three options. No more trying to decide if you’re headache is a “4/10” or a “5/10”. It’s colourful – easy to see at a glance if you use these colours on a chart, or a calendar.

But maybe most helpful of all is that it describes disability more than pain.

Many people who have migraine – in particular chronic migraine – know that pain may be low one day, and yet you still feel very disabled. It could be dizziness, nausea, or other related symptoms. Other days, the pain may be higher, but you’re still able to “push through” and get some things done.

So it is very important to know not only pain levels, but just how disabled you may be over the course of a month.

Other people are finding this helpful. The Chicago Dizziness and Hearing Clinic has used a similar system. Here’s someone who incorporated a similar system into a diary (except eventually using 4 colours), and her explanation of why she likes it.

This won’t satisfy those who want a more precise measurement, but it will be useful to those who want a simple, understand-at-a-glance system.

8 November 2018

Is Migraine an early Sign of MS?

James Information, Tips 0

If you’re familiar at all with multiple sclerosis, you know that early diagnosis is considered to be very important to slow the progress of the disease and improve quality of life. We also know that migraine symptoms often accompany MS. So the obvious question is – could it be that my migraine attacks are actually an early sign of MS?

Researchers in Germany recently made that argument. But their study actually focused on the progression of headache attacks in the first few months of MS. And the results are not what you would expect.

We’ve noted before that migraine symptoms are actually especially common among women who have had MS for a long time. But according to the recent study, symptoms may actually improve over the first few months.

In the study, 50 patients were screened when symptoms of MS began, and then again 6 months later. Based on this small amount of information, headache symptoms did seem to decrease.

The authors of the study felt that the treatment of MS – specifically immunomodulatory therapy (therapy involving the immune system) may explain why headache symptoms decreased.

But of course, this means that early on in MS headache symptoms are worse. Cases have been reported of patients who have experienced migraine or cluster headache symptoms as their only or primary first warning of MS. We talked about a patient who had long lasting migraine symptoms who did indeed have MS.

An MRI for MS?

These researchers recommended that young patients who have migraine-like symptoms should automatically be given an MRI, a test which helps rule out diseases other than MS and that may show signs of MS.

There are, however, good reasons why every headache patient should not be running to get their head scanned. But then again, patients already at risk for a certain disease who are experiencing new headache symptoms should take them seriously.

Who, then, is at risk for MS? MS most often is first diagnosed in young adults. But risk is a controversial subject. Some possible risk factors include:

type 1 diabetes
thyroid disease
inflammatory bowel disease
you smoke
you’re female
you’re related to someone with MS
you live far from the equator

So a patient with some of these risk factors, who is experiencing new headache symptoms, or especially symptoms which won’t go away and are getting worse, should see a doctor at the very least. Headaches can be a warning sign for many conditions, and MS is likely one of them.

This is not a reason to worry and panic. It is a reason to take headache symptoms seriously, early on, rather than to just consider it “normal” because you’re “stressed”.

Read more about MS here.

The study abstract: Headache at the Time of First Symptom Manifestation of Multiple Sclerosis: A Prospective, Longitudinal Study.