June is Migraine and Headache Awareness Month, but those who suffer from it are certainly already aware of it.
Migraines can be debilitating, but doctors say there are new ways to help, and many are hoping the headaches can be controlled.
Ideopathic, used as a medical term, means that there is no clear reason for a condition to occur. Dr Geoffrey Starr said migraines fall into this category because there are so many probable causes.
“We know that some people are susceptible to migraines, about 6% of men and 18% of women in adults,” Starr said. “Oddly, in young people boys tend to have more than girls. We know there is a hormonal link and probably a genetic link.”
“Migraines refer to the classic debilitating type of headache, not your usual support and becomes confused with the type of headache,” said Dr Matt Robertson, neurologist at Portsmouth Regional Hospital. “Migraines are lights out, don’t talk to me, dark room, throbbing headaches. They can be serious and can last for hours or even days. Most people are out of work when they have one without good treatment. “
Dr Alexandra Filippakis, neurologist at Wentworth-Douglass Hospital, said migraines are caused by abnormal brain activity that affects nerve and blood signals in the brain.
“It’s a really bad headache,” she said. “People can have nausea. They vomit. There are light and sound impacts. They may have dizziness, lightheadedness. Some see an aura, a passing attack. They have blurred vision, see lines, or even a kaleidoscope effect. They may have numbness, weakness, slurred speech, or confusion. It is not pretty. This is one of the most common reasons people see a neurologist. Over a billion people around the world suffer from migraines. “
There are good treatments. Robertson said there are preventative treatments and treatments to use when you experience a migraine.
People prone to migraines show signs warning them that the disease is imminent.
“Some people see a shimmer or a halo effect and they know it’s happening,” he said. “Over time, many people can identify the triggers that can cause a headache. These could be red wine, aged cheese or chocolate, or diets like soy, gluten or MSG. Sleep deprivation is a big trigger for some. Menstrual cycles, even changes in barometric pressure can be triggers. The reason can be multiple and people cannot live in a bubble. “
Starr said the difficult part is identifying the trigger.
“It can be anything,” he said. “Scent, stress, certain smells or lack of sleep can be the cause. It’s like solving a little medical mystery. You look for the trigger, or what the person is hurting, like taking Excedrin that can cause pain. rebound headache. “
Filippakis said she liked a phased approach to treatment.
“I start with behavior / lifestyle changes,” she said. “Sometimes a good night’s sleep can make all the difference. By that I mean restful, uninterrupted sleep. Staying hydrated is important because not doing it can be a trigger. Stress / mood disorders can trigger it. migraine, so I want to deal with the underlying one Keeping a journal of what they eat and drink can help figure out what’s going on.
Filippakis said there is good evidence to support regular aerobic exercise as a way to prevent migraines.
“Are they on medications that trigger migraines,” Filippakis said. “We’re going through what they’re on, and maybe they don’t need to be.
Robertson said the field of medication surrounding migraines has changed dramatically in recent years.
“If a person suffers from frequent migraines, we tend to look at prevention rather than treatment when they occur,” said Robertson. “There is the use of blood pressure medication, Botox, or anti-seizure drugs. Botox, used to reduce wrinkles, is also effective on migraines.”
The latest line of migraine medications is based on the CGRP (calcitonin gene-linked peptide) pathway in the brain.
“We have known about the pathway involved in migraines for quite some time,” said Robertson. “If we stop it quickly, the headache is less severe. Think of it as a forest fire. A spark can light a tree (causing a visual aura or shimmer), but it can cascade from there and as the fire spreads the pain becomes greater, more debilitating, and more difficult to put out. It is better to stop a fire with a tree and a bucket of water, than to put out a forest fire.
Previously, triptans like Imitrex were used for migraines. Robertson said they work, but the side effects are often not desirable. The new group of CGRP drugs like Ajovy, Aimovig, and Emgality work better, with fewer side effects.
Filippakis said CGRP drugs are usually self-injections once a month as a preventative measure.
“As long as you can pass the needle part, these are generally well tolerated,” she said.
Starr said the good news is that this is a whole new era for migraine sufferers. He said advancements are making a difference.
“The waste of time, the loss of productivity with migraines is real,” said Robertson. “The good news is that we have drugs that can help.”