Botox and Migraines – What Are The Risks?

botox

Botox and its role in preventing migraines has been the subject of many studies and, following positive findings, was approved by the Medicines and Healthcare Products Regulatory Agency in 2010 for the treatment of chronic migraines.

Botox is probably more commonly associated with being a way to reduce the appearance of wrinkles. Botox injections work by blocking chemical neurotransmitters that tell your muscles to contract and this is how it can diminish the appearance of wrinkles. Happily for migraine sufferers, Botox also blocks the release of these chemicals from reaching your nerve endings and causing pain.

Normally Botox is a well-tolerated preventative migraine treatment, and one which comes without the risk of a rebound headache – something which can come with many oral migraine medications. There are a few side effects which are still possible however, and it’s important to know what these are before making a decision about whether Botox injections are the right treatment for you.

Neck pain is the most common side effect of Botox. Though the term “most common” does not mean that it is something which many Botox users experience.

A 2014 study found that just 4.3% of study participants experienced neck pain, and that other side effects included drooping eyelids (1.9%), muscular weakness (1.6%), and pain at the injection site (2.1%). These symptoms, along with fatigue, dry mouth, bruising, chills, and redness or swelling at the injection site usually go away after a day or two though. If some minor side effects occur after Botox, this may not seem so bad when weighed against the fact that the positive effect of the Botox injections on reducing migraine frequency and intensity lasts for about three months.

As for potential longer-term side effects, these are eyebrows that seem to droop or be uneven, and muscle weakness. These effects also subside but they can take a few weeks to do so rather than a few days. When it comes to serious side effects, these are uncommon, but the symptoms to look out for that may point to there having been a serious complication are; blurry vision, a swelling of the tongue or throat, and difficulty speaking or swallowing.

Screen Time Migraines and How To Guard Against Them

screen time

With working from home being the new normal for many, and large-scale socialising in public banned and being replaced with online meet-ups using the likes of Zoom and Skype, it’s hardly surprising that our daily screen time has hugely increased.

This is bad news for migraine sufferers as too much screen time is one trigger of migraines. In one study from 2015, over two hours of screen time per day resulted in an increased likelihood of reporting a migraine episode.

 A great many of us are far exceeding just two hours of screen time a day now, so it’s also hardly surprising that a number of migraine sufferers have found that the frequency and intensity of their migraines has gone up. 

Unfortunately, unless we want to become even more cut off from friends and family, and with a continued need to work, we may not be able to get away from our screens as much as we would ideally like to in order to help reduce the impact on our migraines. There are other things we can do to help lessen the triggering effect of all that screen time though.

Adjust the light levels

To keep eye strain to a minimum – eye strain being something which can trigger a migraine – keep the lighting in the room balanced with the brightness of your screen.

Increase your font size

That or zoom in on pages so that you don’t have to squint to read text.

Use the 20-20-20 rules

Every twenty minutes look up from your screen for twenty seconds at something which is twenty feet away (six metres). These frequent breaks can help to reduce eye fatigue and so reduce the chances of a migraine.

Keep your distance

Position yourself at least 50cm away from the screen.

Use a filter

Using an antiglare screen on your computer monitor could help to further reduce eye strain.  

Turn off your screen

When you’re on a conference call or video chat, when it’s possible and appropriate, try turning off your screen and just listening so your eyes get a break.

Adjust your refresh rate

When the refresh rate on a screen is set too low the image can subtly flicker and this can cause more eye strain than necessary. Adjusting your refresh rate so that it’s as high as it will go should help.

Child Feeling Sick? It Could Be Migraines

child sickness migraine

If you were to ask a lot of people what a migraine is, odds are that most people would say it’s a kind of headache. If you’re lucky, they might say that it’s a really bad headache. What they probably wouldn’t say is that it’s an attack of nausea, but for some who experience migraines, and especially for children, that is exactly what the main symptom of their migraines is – their attack might even be completely without head pain.

Studies suggest that approximately 60% of children between the ages of 7 and 15 experience migraine but, as the symptom of head pain which is experienced in most adult attacks is not always involved and the symptom of nausea is more common, diagnosis can be delayed and nearly half of children with migraine never receive a diagnosis.

For children, migraine attacks often manifest themselves as abdominal pain and/or vomiting. Recurring bouts of headache or abdominal pain accompanied with nausea and/or vomiting (while between bouts there are no symptoms and the child is perfectly healthy) are probably migraines.

Other symptom variations which make migraine attacks in children different from those in adults are that the head pain usually affects the forehead and temples rather than being felt in one side of the head; that the head pain may be a minor symptom of the attack or absent entirely; and that attacks in children are usually shorter in length – sometimes lasting less than an hour.

Diagnosing migraine early on is important as otherwise inappropriate medications may be used to manage symptoms, anxiety around the attacks may occur, and there could be a resulting negative impact on home life, school life and social life. With this in mind, if a child is often feeling nauseous for no obvious reason, consulting a doctor on the possibility that it may be migraines is a key thing to do.

Migraines, Work Productivity and Education Programmes

work

When you have a migraine, doing even small tasks like having a shower can be a seemingly insurmountable challenge, let alone getting any work done.

For those who suffer with migraines personally, and also those who employ people who suffer with them, the issue of how best to manage migraine attacks is a knotty one. You want to be boosting productivity, but also making sure that you’re looking after migraine sufferer(s) and doing all you can to help them.

There are ways both of these aims – of caring and of boosting productivity – can be done.

It’s been found that putting in place migraine education programmes can be hugely beneficial. One study found that by organising educational events such as lunch conferences and webinars, sending out email newsletters, and making available online materials covering topics like ‘communicating with your colleagues about migraine’ and ‘lifestyle changes that can mitigate symptoms’, resulted in an increase in productivity of between 29-36%. This was thanks to fewer days missed because of migraine attacks, fewer days worked with migraine attacks, and increased effectiveness on days which employees worked with migraine attacks. 

Naturally these education programs can be useful for employees and employers who are directly affected by migraines, but they can also help by working to dispel the myth that migraines are “just a bad headache” and in so doing dispel the stigma around migraines. This certainly needs doing as, according to one survey which involved almost 200,000 U.S. workers, only 22% thought that migraine is a serious enough condition to warrant staying home from work.

How to Relieve Migraine Nausea Without Medication

migraine nausea

Not everyone is able to, or happy to, take prescription medications or over-the-counter pharmaceutical remedies for migraine nausea. Some migraine sufferers also find that while it may take the edge off, the medications they have to relieve their migraine nausea isn’t effective enough on its own.

If this sounds relatable then the following nausea remedies may be of use.

Ginger

Doubtless you’ve heard of this one, but with good reason. Ginger has been used by people to help digestion and calm the stomach for hundreds of years.

It can be taken as supplements if you don’t like the taste, or else eaten or drunk in a variety of ways such as ginger tea or ginger beer (though when you’re feeling sick carbonated drinks aren’t so great), or eaten in biscuits. Dry ginger biscuits can be good to nibble on while you’re feeling queasy because they’re quite plain and they’ll help ensure that your blood sugar levels don’t drop too low thereby making your migraine attack worse.

Peppermint (or menthol)

Peppermint is another good one. Peppermint tea, whether hot or cold, could be good to sip throughout your bout of nausea. Alternatively, you might find that peppermint oil applied to the temples and forehead could help, or inhaling peppermint oil via an oil diffuser is another option.

Acupressure or acupuncture

Acupressure uses the same principles of acupuncture – stimulating key points across the body to bring pain relief – only without the needles and using pressure instead, which could make it more tempting if you’re not a fan of needles.

One small study involving 40 patients showed that those who received acupressure had notably less nausea with their migraines and less of a need for migraine anti-nausea medications than those who didn’t have the treatment.

All three of these treatments could be worth exploring if you suffer from migraine nausea because they have few to no side effects and can be used in conjunction with other medications. 

Spring, Hay Fever, and Migraines

hay fever and migraine

The coming of spring is much needed after the chill and dark days of winter, but despite the warmer weather and brighter days, for migraine sufferers it’s not all good news.

The arrival of spring can mean the coming of more migraine attacks. This is especially the case for migraine sufferers who suffer from pollen allergies. People who suffer from allergies are more likely to suffer from migraine attacks, and to experience them more frequently, than those who don’t have allergies.

Hay fever season starts in spring, and runs from late March through to September. Tree pollen is the first type released – from late March to mid-May, then grass – from mid-May through to July, and finally weed pollen – from the end of June through to September.

If you suffer from migraines and have an allergy to one of these types of pollen, you may well find your attacks are more intense and/or frequent during these peak times. Although how bad and how long the pollen season and ensuing migraines triggered by it are will be dependent on average temperature and rainfall. For example, a drier season reduces the amount of pollen produced. 

Doctors aren’t sure why allergy sufferers are more susceptible to migraines, but they do know that the nervous system, hormonal system, and immune system all play a part. One part of the problem may be that when you’re exposed to allergens and your immune system is triggered, certain chemicals are released which can fuel inflammation throughout the body, and in doing so trigger a migraine attack.

With this in mind, now is the time to make sure that you have enough of your anti-histamine hay fever medication ready to use. While anti-histamines won’t help with reducing migraine pain or symptoms, they can help by easing your allergy symptoms and so reduce the migraine-triggering impact of hay fever.

Migraine and Alice In Wonderland Syndrome

alice in wonderland syndrome

Alice in Wonderland syndrome (AIWS for short) is where objects, and even parts of the body, can appear to be much smaller or much bigger than they really are. These impressions of distorted size can last for many minutes, and sometimes longer. This is much as Alice found herself to be in Lewis Carroll’s books – hence the name. In fact, based on his diary entries, it has been hypothesized that Carroll himself suffered from migraines and may have experienced the sensory distortions which characterise the syndrome.

Although not actually a migraine syndrome, it’s worth talking about Alice in Wonderland syndrome here because so many of its symptoms are like those of a migraine aura. AIWS can also accompany migraines as one part of a migraine aura, or it can happen during the headache phase of a migraine attack, or even both. In a situation where no head pain is experienced, but other migraine symptoms and AIWS are, it may be part of what is commonly referred to as a “silent” migraine.

Although it was first described in 1952, and named in 1955 by the English psychiatrist John Todd, not that much is known about what causes AIWS, but it may stem from disruption to the parieto-occipital part of the brain. The parietal part of the brain is what deals with perception of space and the body, while the occipital area is what deals with vision.

This would tie in with why migraine auras might involve AIWS – since cortical spreading depression (CSD), which has been thought to cause migraine aura symptoms, moves through the brain during a migraine aura and disrupts different senses in turn and so resulting in symptoms such as seeing flashing lights and having difficulty speaking.

Migraines, Magnesium, and Pregnancy

magnesium and pregnancy

Pregnancies are rarely an easy walk-in-the-park kind of an affair whoever you may be, but when you suffer from migraines being pregnant can get even more complicated. Many of the migraine medications you normally take may suddenly become off limits as they’re not recommended for use during pregnancy. This is where things start to get complicated.

Well the good news is that many migraine sufferers find that their migraines decrease in frequency and intensity during pregnancy. Research has shown that between 50%-80% of women who had migraines before they were pregnant noticed a reduction in their migraine attacks during pregnancy, and especially so during the second and third trimesters.

That’s not all migraine sufferers though, and if you are one of the unlucky few who doesn’t see a positive change; or not enough of a reduction; or (please no!) a worsening of their migraines during pregnancy, what do you do? What can you do to manage your migraines without causing potential harm to your baby?

As well as discussing with your doctor which medications are suitable to take during pregnancy (paracetamol and, for the first 24 weeks of pregnancy, ibuprofen are common recommendations), you might find taking magnesium supplements to be beneficial.

There has been lots of research which has shown that people with migraines often have lower levels of magnesium than those who don’t have migraines and, linked to this, one study found that giving participants a regular intake of magnesium reduced the frequency of migraine attacks by an average of 41.6%.

Aside from migraine-related benefits, in terms of pregnancy-related benefits, research suggests that magnesium supplements may reduce some risk of additional complications such as foetal growth restriction.

It may not eliminate your migraine attacks completely, but even so given the research results, magnesium supplements could be beneficial for both mother and baby.

How to Find Migraine Triggers With An Elimination Diet

elimination diet

We all know the saying you are what you eat. Well, while it might not be quite that simple (thankfully!), there is an element of truth to it.

This link between your diet and your health is one which some migraine sufferers know only too well. Certain foods such as chocolate, cured meats, and caffeinated drinks are all commonly cited as migraine triggers, but it can be even more complicated than that.

As all migraine sufferers are different, so are their triggers, and identifying what could be helping to trigger a migraine attack is not easy for this reason. It’s an important thing to do however, as prevention in the case of migraines is far better than trying to relieve the pain of a migraine once one has struck.

Perhaps the most effective way to identify which food(s) may be triggering your attacks is to do an elimination diet. This is where you remove any foods which you suspect may be triggering your attacks or worsening your symptoms, and then reintroduce these foods at a later date, one food group at a time, to see if your attacks are worse following the introduction. If they are, it’s a fair assumption that the food you reintroduced is a trigger.

The first part of an elimination diet is the 2-3 weeks during which you cut out all possible trigger foods. If your migraine symptoms improve, it’s a safe assumption to make that one or more of those foods was helping to trigger your migraines.

The next phase is to reintroduce a food or food group (citrus fruits may be an example of a food group which is reintroduced as opposed to an individual food). This reintroduction should be done over 2-3 days, and any attacks or symptoms which are experienced during this time carefully recorded. If reintroducing a food doesn’t trigger an attack, it’s likely that that food will be safe for you to eat. If it triggers an attack, you may need to cut it out of your diet.

Normally an elimination diet lasts a total of between 5 and 6 weeks, and should only be done under the supervision of a health professional such as a doctor or dietitian – since such diets increase the risk of a nutritional deficiency if the diet is not followed correctly.

Motion Sickness and Migraine Nausea

motion sickness

Nausea and vomiting are both common symptoms of migraine. In fact, between 50% to 60% of migraine sufferers vomit during an attack, and between 60% and 95% of migraine sufferers experience nausea. Although this statistic does vary depending on which study you read, it is certainly generally accepted that nausea and vomiting are common migraine symptoms, and a symptom which you are more likely to suffer from if you also experience motion sickness.

Motion sickness happens when messages from the inner ear and from the eyes are in conflict with one another. If the inner ear detects one degree of motion, and the eyes detect an even slightly different degree of motion, then motion sickness can occur. Often this happens when travelling on a boat, in a car, or while in other forms of transport. However, it can also occur when there is motion in your visual surroundings while you’re stood still.

Scientists aren’t clear exactly why there is a link between suffering from migraines and from motion sickness, but there is a theory.

Many drugs which are used to treat motion sickness work by increasing levels of the hormone serotonin in the brain. Research has also suggested that having low levels of serotonin may make you more likely to suffer from migraines. Perhaps this low level of serotonin is one reason why migraine sufferers often suffer with nausea.

If you find that you suffer from motion sickness, from migraines, and also from nausea during migraine attacks, then that combination will make a difference to what kind of medication you might want to take in order to treat the nausea. Motion sickness medications are generally more effective for treating migraine nausea than over-the-counter treatments which are used for gastrointestinal issues.