Thursday 1 July 2021

Medical myths: 11 migraine misunderstandings

 Migraine is a common condition, affecting more than 37 million people in the United States and up to 148 million worldwide. And some evidence suggests that migraine prevalence might be increasing globally.

According to the World Health Organization (WHO), migraine is around twice as commonTrusted Source in women than men.

Often, the primary migraine symptom is a moderate to severe headache, and 85% of people with migraine headaches experience throbbing pain. However, for around 60% of people, the pain is one-sided, and about 80% of people experience nausea and 30% vomiting. In addition, almost everyone with migraine has increased sensitivity to light (90%) and sound (80%).

Below, we tackle 11 myths associated with migraine. We cover medications, caffeine, nutrition, and more. To help dispel these myths, we enlisted the help of three experts:

  • Dr. Vernon Williams is a board-certified neurologist/sports neurologist and director of the Center for Sports Neurology and Pain Medicine at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, CA.
  • Dr. Medhat Mikhael is a pain management specialist and medical director of the non-operative program at the Spine Health Center at Memorial Care Orange Coast Medical Center in Fountain Valley, CA.
  • Dr. Jennifer McVige, who is board-certified in pediatric neurology, adult and pediatric headache, and neuroimaging. She is the director of the Concussion Center at DENT Neurologic Institute, Amherst, NY.

“Most types of migraine are not serious; however, they can be chronic and sometimes debilitating and disabling if not adequately treated,” explained Dr. Mikhael.

The authors of one review, which investigated the impact of migraine on quality of life, write that many people with migraine “also experience reduced productivity while at work and disruption of their family, social, and leisure activities.”

It is also worth noting that not all types of migraine are equal. “There is a kind of migraine called hemiplegic migraine that tends to be familial, associated with neurological symptoms, aura symptoms proceeding the migraine, and can lead to stroke,” Dr. Mikhael explained.

However, he is quick to point out that hemiplegic migraine that causes significant weakness or paralysis on one side of the body is rare, affecting around 0.01%Trusted Source of the population. In most cases, the paralysis resolves within hours or days; rarely, it can take 4 weeks. However, in some very rare cases, hemiplegic migraine can cause lasting paralysis.

This is not true, and it is worth noting that not all migraines involve a headache. As Dr. McVige explained, “Migraine is actually a primary headache disorder and is much more than just a headache. In fact, headaches are only one symptom of migraine, and some migraines don’t have a headache at all.”

According to Dr. Williams, “a migraine is clinically defined as a specific type of headache that [a person feels] more intensely, and usually has accompanying symptoms in addition to the pain felt in the head.”

According to Dr. Williams, a person with migraine rather than a headache will experience a combination of the following symptoms:

  • Moderate to severe pounding or throbbing pain that feels as if it engulfs the entire head or shifts from one side of the head to the other.
  • Heightened sensitivity to sounds, smells, or light.
  • Vision troubles, including blurriness, bright or flashing dots, or wavy or jagged lines.
  • Abdominal problems, which can include loss of appetite, nausea, vomiting, or an unsettled stomach.

Dr. Williams also outlined other differences between migraine and a headache. For example, he explained that some people might experience a so-called prodrome stage.

He told MNT that some people with migraine “might notice subtle changes in their daily routine up to a day or 2 before a migraine sets in — a sort of warning period.”

Although these changes vary between individuals, he said that a few of the most common prodromal signs are “excessive yawning, depression, irritability, and a stiff neck.”

Some people with migraine may also experience migraine aura. Dr. Williams said:

“Migraine aura is a neurological symptom that immediately precedes the headache. It may consist of visual disturbances (seeing flashing lights or experiencing partial loss of vision that gradually spreads across the visual field), or other sensory phenomena (numbness or tingling gradually spreading across the face or down the arm).”

Although the symptoms are an ominous sign that a migraine headache may be on the way, according to Dr. Williams, there is an upside:

“These warning signs provide an opportunity to initiate treatment very early in the course of the migraine episode, which significantly improves the likelihood that the treatment will be successful.”

Rather than waiting for the pain to come, Dr. Williams told us that taking the medication as soon as possible has the most effect.

This is a myth; caffeine does not cause migraine, but it can be a trigger for some people. Coffee and migraine have a complex relationship.

As Dr. Mikhael told us, “excessive use of caffeine can trigger migraine. However, caffeine, in general, can help alleviate headaches, including migraine headache.”

According to Dr. McVige, “some people find drinking caffeine at the onset of an attack lowers the intensity and can help alleviate some of the pain, but regular use of caffeine as a treatment is not advised.”

To add an extra level of complexity, Dr. McVige told us MNT that drinking caffeinated beverages can start a migraine attack, but that “caffeine withdrawalTrusted Source is an even more frequent migraine trigger.”

In a recent review of the interaction between caffeine and migraine, the authors concluded:

“Overall, based on our review of the current literature, there is insufficient evidence to recommend caffeine cessation to all migraine patients. However, it [is important to highlight] that caffeine overuse may lead to migraine chronification, and sudden caffeine withdrawal may trigger migraine attacks.”

Currently, there is no cure for migraine, but medicines certainly can help.

“Cure is not the word, symptom control, and prevention of migraine is the more correct term,” Dr. Mikhael told MNT, “Migraine medications [aim] toward prevention of migraine episodes and use of ‘abortive medications’ if an episode breaks through.”

Put bluntly, Dr. Mikhael told MNT, “That is a false statement; several medications are available now to help and control migraine significantly.”

Dr. McVige listed some medications that can ease migraine, including over-the-counter (OTC) analgesics, triptansTrusted Sourcecalcitonin gene receptor peptide (CGRP) antagonistsTrusted SourcegepantsTrusted Source, antidepressant medicines, anti-seizure medicines, and beta-blockers.

Effective nonpharmaceutical options are also available.

Source: Medical News Today

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