Migraine Matters - Migraine discussion, news and views

Breastfeeding and Migraine Attacks

Posted on December 31 2021 by admin

There is some data to suggest that migraine severity and frequency may reduce during the time in which women are breastfeeding. For example, there is a 2013 article in ‘Headache: The Journal of Head and Face Pain’ with data that suggests migraine may improve during breastfeeding. However, more than half of female migraine sufferers experience migraine recurrence within one month of giving birth. Why?

Well, there are many things which new parents will be experiencing which may be contributing factors in the resumption of migraine attacks.

Tiredness and disturbed sleep have to be the first factors of note. These are both common migraine triggers, and since newborn babies don’t sleep through the night and need feeding every few hours, getting unbroken sleep is almost impossible.

Missed meals is another trigger. A drop in blood-sugar levels is a trigger for migraine attacks, but remembering to eat at regular times isn’t easy when you have a new baby around.

Dehydration is a trigger of migraines too, and one which is all too easy to get if you’re breastfeeding. You’re losing far more fluid than usual, so you need to drink more. Easier said than done when you’ve already got so much to think about and you’re running on so little sleep. All of these environmental factors around breastfeeding, rather than the act of breastfeeding itself, could be reasons why so many women see a return of their migraine attacks so soon. There is little evidence to suggest that postpartum migraine attacks are a result of breastfeeding.

Morning Migraines – What Causes Them?

Posted on December 29 2021 by admin

Waking up to find that you’re suffering from a migraine attack is one of the worst ways to start the day. Sadly it’s not uncommon for migraine sufferers. Many of us are regularly greeted in the morning by an attack already underway, with early morning between 4-9 a.m. being the most common time for migraine headaches to occur.

There are a few reasons why “morning migraines”, as they’re sometimes called, happen. Dehydration is one. The American Migraine Foundation have found that up to a third of migraine sufferers say that dehydration, even mild dehydration, is a trigger. Countering this by drinking lots before bed isn’t necessarily the best idea though, since going to sleep only to wake up an hour or two later needing the loo can contribute to another morning migraine trigger – disturbed sleep.

There is an established relationship between sleep disorders and migraines. For example; studies have shown that people with insomnia have an increased risk of suffering from migraine headaches compared to people who don’t have insomnia. Poor sleep quality can also be a migraine trigger – snoring, teeth grinding, and a failure to reach REM sleep as a result of waking up too often can all be migraine triggers. So too can a general lack of sleep, or even too much sleep. Small wonder then that migraine attacks beginning in the morning are common.

Another trigger for morning migraines is medication withdrawal. Medications which treat pain (both over-the-counter and prescription pain medications) usually wear off within 4-8 hours of taking them, so by the time we wake up after a good many hours of sleep, the pain can easily be back. For anyone who takes a lot of pain medication, this is the ideal time for the effects of rebound headaches to take hold.

Hormonal changes may also help to trigger morning migraines. Between 4-8 a.m. our bodies produce fewer endorphins, and as these are natural pain-reducing compounds it makes sense that migraines can feel particularly awful first thing in the morning. Adrenaline is also released in greater quantities during the hours of early morning, and as this hormone affects blood pressure and blood vessel contraction and dilation, this could be another contributing hormonal factor in morning migraine attacks.

Finally, caffeine withdrawal may be a morning migraine trigger. If drinking a caffeinated drink usually helps to relieve your migraine attacks, this could be a sign that caffeine withdrawal is a big contributing factor of your morning migraines. In which case, a cup of coffee could be a short-term solution, while gradually weaning yourself off caffeine could be a big help in the long-term.

Migraines and Massage Treatment – Effective?

Posted on December 8 2021 by admin

Not everyone who suffers from migraines is able to, or necessarily wants to, treat them using medicinal drugs. Pharmaceuticals are not for everyone.

Massage is one potential therapy which may be considered by those migraine sufferers who, for whatever reason, are looking for alternative migraine treatments.

Massage can help to relieve muscle spasms, relieve tension, promote relaxation (stress is an incredibly common migraine trigger!), and improve blood flow and circulation. In past studies it has been shown to help effectively relieve vascular and tension-type headaches, but few studies have looked specifically at the efficacy of massage in treating migraines.

One small-scale study conducted by the University of Miami School of Medicine found that massage therapy subjects who had two half-hour massages per week for five consecutive weeks had fewer distress symptoms, less pain, more headache-free days, better sleep, and an increase in serotonin levels.

Dawn Buse, Associate Professor of Neurology at Albert Einstein College of Medicine and the Director of Behavioral Medicine at the Montefiore Headache Center in New York has commented in the past about this lack of date; “data on the efficacy of massage for migraine are somewhat limited. This does not mean that massage is not helpful for migraine, but rather that there have been few studies, and they have had smaller samples and less rigorous designs, so we do not have the scientific evidence necessary to make a conclusive statement about its efficacy.”

So, although research studies on using massage to treat migraines are limited, it could be worth doing. Certainly it helps to counteract known migraine attack triggers such as poor sleep, muscle tension, and circulatory issues.

Adolescents With Migraines More At Risk of Pain Disorders

Posted on September 30 2021 by admin

According to a new 2021 study which examines the development of psychiatric and pain disorders in the transition from adolescence to adulthood, adolescents who have a diagnosis of migraine are far more likely to develop additional psychiatric or pain disorders than adolescents who don’t suffer from migraines.

The study looked at the 2006 and following ten years of health insurance data from 56,597 German 15 year-olds to find out whether adolescents with a migraine diagnosis were more at risk of developing comorbid pain or psychiatric conditions.

The comorbid conditions which were looked for included; mood disorders, stress-related disorders, back pain, irritable bowel syndrome, and behavioural syndromes associated with physiological disturbances. Any patients who had headaches which were not variations of migraine, and patients who had already been diagnosed with one of the comorbid conditions, were excluded from the final study.

The research showed that 88.4% of the patients with migraine developed at least one of the comorbid conditions during the ten-year period.

The likelihood of migraine patients developing a comorbid condition, when compared with non-migraine suffering adolescents was; a 2.1 times higher likelihood for affective or mood disorders, 1.8 times higher for stress-related disorders and also 1.8 times for behavioural syndromes, 1.6 times higher for back pain, and 1.5 times higher for irritable bowel syndrome. Overall, the migraine patients were 1.3 times more likely to develop one or more of the evaluated additional disorders.

The authors of the study suggested that the increased risk may also increase the impact which migraine had on a sufferer’s well-being, and they emphasized that early evaluation of risks for additional disorders was vital in the care of these patients, and might improve the long-term outcome significantly.

A Dislike of Strong Smells – A Childhood Migraine Indicator

Posted on September 29 2021 by admin

Identifying migraines in childhood is a lot harder than diagnosing migraines in adults – and that can be hard enough as it is! In fact, nearly half of children with migraine never receive a diagnosis.

What makes childhood migraines so hard to recognise is that they don’t necessarily resemble your ‘typical’ (after all, all migraines are different so ‘typical’ is a slight misnomer) migraine.

For adults the most common migraine symptom is head pain on one side of the head, but for children the main symptom is not always head pain. If head pain is experienced, it typically affects the forehead and temple areas or whole head, rather than just one side of the head.

To make diagnosis even harder, some children don’t experience any head pain at all as part of their migraine attacks – hence why so many children with migraines go undiagnosed. Instead the main symptoms of migraine in children tend to be abdominal pain, cyclical vomiting, limb pain, and episodic dizziness. What may be one marker of migraine that could help to signal if a child is suffering from migraines though is osmophobia.

Osmophobia is an aversion to or dislike of strong smells. Many adult migraine sufferers report strong smells as being a migraine trigger – with the likes of perfumes and aftershaves, cigarette smoke, and some cleaning products all being particularly triggering.

However, since what is the case for adults with migraine is not necessarily the case for children with migraine, a study looking specifically at children’s reaction to smells in relation to migraines was needed.

A 2020 study involving 300 child/adolescent patients, of whom 253 had migraine and 47 had a tension-type headache, found that 137 had osmophobia during their attacks. Those who did also had longer attacks which were more intense.

So, although not all of the patients had osmophobia or found strong smells to be a trigger for their attacks, it was concluded that osmophobia could be useful in diagnosing migraines in children. Especially as younger children may not be able to communicate exactly what symptoms they are feeling – making diagnosis of migraine that much more difficult.

Migraines and Chills – Why Do Sufferers Get Cold?

Posted on September 28 2021 by admin

There are many different symptoms which can be part of a migraine attack. Nausea and an aversion to bright lights are two, but for some migraine sufferers chills can be another – and one which can happen days before the main headache phase of a migraine attack takes place.

Why is this?

Essentially it is down to the fact that when a migraine attack is experienced, the brain undergoes both structural and functional changes. One of the areas of the brain which experiences neurological changes during a migraine attack is the hypothalamus, and it’s this part of the brain that controls our body temperature.

If the hypothalamus is affected by unusual activity, it’s not surprising that that is experienced in some perceptible way in our bodies.

Another part of the brain which is affected during a migraine attack is the brain’s cortex. The cerebral cortex part of our brain is involved in muscle movement, and chills are the result of involuntary muscle tightening and relaxing.

These two areas of the brain both being subject to neurological changes during a migraine attack, and in the prodrome phase before an attack, is why chills can be a symptom of a migraine – as can sweating and shivering.

Linked to these temperature migraine symptoms are the findings of one 2020 study, which found that women who experience chronic migraines were more likely to report having cold hands or feet – it is thought this is a result of blood vessel changes which occur with migraine.

So, although not the most common migraine symptom, experiencing chills is certainly one symptom to watch out for as a sign of an oncoming migraine attack.

A Roller Coaster Ride Leads To Better Migraine Understanding

Posted on September 24 2021 by admin

Not everyone enjoys roller coaster rides. For some people they just induce nausea and dizziness, and for those who suffer from migraines there’s a good reason for this – one which a new study from a team of university researchers in Germany can help to explain, and one which may prove to be helpful in developing new migraine treatments.

The team put twenty participants who experienced migraines, and twenty participants who didn’t, on a virtual roller coaster, and then monitored their brain activity using functional magnetic resonance imaging (fMRI) while they watched the videos to track their neurological activity. After the virtual rides the participants were also surveyed about their dizziness, motion sickness, and other symptom levels. No migraines were experienced during the virtual roller coaster rides.

The researchers found that 65% of the participants with migraines experienced dizziness, while only 30% of the participants without migraines did. For motion sickness, the questionnaires revealed that participants with migraines had an average score of 47 on the intensity scale of 1-180, while the non-migraine participants had an average score of 24. The feelings of nausea were also longer lasting for the migraine participants.

Using the fMRI scans, the researchers were able to see changes in nerve cell activity based on blood flow to different areas of the brain. Participants with migraines had increased activity in five areas of the brain, and decreased activity in two other areas – all of which could relate to abnormal transmission of visual, auditory and sensory information within the brain.

While interesting to see the difference in experiences between migraine sufferers and non-sufferers, the main point of interest is why this study may be useful for helping to treat migraines.

Neurologist Arne May from the University of Hamburg had this to say: “People with migraine often complain of dizziness, balance problems and misperception of their body’s place in space during migraine. By simulating a virtual roller coaster ride, our study found that some of these problems are not only magnified in people who experience migraine, but they are also associated with changes in various areas of the brain. By identifying and pinpointing these changes, our research could lead to a better understanding of migraine which could in turn lead to the development of better treatments.”

Migraines and Seizures – Telling The Difference

Posted on August 26 2021 by admin

The connection between migraines and seizures is by no means a simple one, but what can be said is that there is some kind of connection. The number of children with epilepsy (which causes seizures) who also have migraine is estimated to be between 8% and 24%, which is approximately double the normal prevalence of migraine found in non-epileptic members of the population. Added to this is the fact that people who have migraine with aura are at a mildly increased risk of stroke.

Even with the increased risk, experiencing either migraine or seizures does not necessarily mean that you will have the other, but for those who do experience both it can be very complicated as it’s not always clear at first which has occurred – a migraine or a seizure. After all, both conditions are related to brain function, and both have similar symptoms. There are some things that help to diagnose which is being experienced however.

In seizures something called automatism occurs – this is essentially involuntary movements. Typically these are things like chewing movements or fidgety movements. This is not something which happens with migraines, so if automatism is present along with head pain it’s most likely a seizure-related headache.

Memory loss is another thing which is usually a seizure symptom rather than a migraine symptom. Confusion may occur with a migraine, but not being able to recall the headache having taken place suggests a seizure.

Visual disturbances are something which can occur with both a seizure or a migraine, but with a migraine these disturbances emerge gradually over the course of a few minutes. With a seizure the visual disturbance will be of short duration and occur suddenly.

The time it takes to occur is another way you can differentiate between migraines and seizures more generally too – not just with the visual disturbances. Migraine pain usually increases gradually, while a headache which is related to seizure will come on very suddenly.

Having an electroencephalogram (EEG) is the best way to distinguish between migraine and seizure, but in more general terms if a person is having migraine symptoms along with neurological symptoms, and the person isn’t responding to any migraine treatments, then it’s worth asking whether it’s definitely migraines which the person is having.

Why Does Throwing Up Relieve Migraines?

Posted on August 20 2021 by admin

There are many migraine sufferers who find that feeling nauseous forms part of their migraine attacks. In fact 90% of people with migraine have reported feeling nausea as part of their migraine attacks. Not all migraine sufferers who feel nauseous during their migraine attacks then go on to throw up, but many who do find that once they have thrown up their migraine attack becomes less severe, and for some, stops completely.

There has been plenty of research into migraines and their symptoms, but even so experts still aren’t sure why throwing up can help to relieve migraine symptoms. There are theories though.

The first theory is that vomiting may happen at the end of a migraine attack because the attack has slowed down the gastrointestinal tract. With the slowed or even paused function of your stomach comes food which can have sat in your stomach for too long. Throwing up occurs as the gastrointestinal tract begins to function normally again and the normal stomach function returns.

Another theory is that the act of throwing up relieves some of the neurotransmitter imbalance that is part of a migraine episode. To get more technical – the chemoreceptor trigger zone (CTZ) in the brain works with the vomiting centre to trigger vomiting. The CTZ also releases the neurotransmitters dopamine and serotonin, which are both endorphins that can help you to feel better.

Next comes the theory that vomiting stimulates the vagus nerve, and this can help to calm the migraine. After all, the FDA has approved a migraine treatment that involves stimulating the vagus nerve electrically – so it’s certainly the case that vagus nerve stimulation in some form helps to bring relief.

Essentially, there are plausible theories as to why vomiting can signal the end of a migraine attack, but there’s no one definite reason that can be pointed to as the reason why. More than that – doctors aren’t sure if vomiting triggers the bodily responses that bring migraine relief, or if vomiting is something that occurs naturally when the migraine is ending anyway and is a symptom of the end of the attack rather than the cause of the end.