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| | From:  Loretta12 (Original Message) | Sent: 2/22/2003 5:19 AM |
The symptoms of migraine have been recognized for more than 2500 years. The ancient Greek physician Galen called these one-sided headaches "hemicrania".
In 1600, British physician Thomas Willis coined the term "migrum".
Many famous and accomplished people have suffered from migraine. They include Sigmund Freud, Thomas Jefferson, Charles Darwin, Frederic Chopin, Madame de Pompadour, Catherine the Great, Leo Tolstoy and Virginia Woolf. Some say Lewis Carroll found his inspiration for "Alice in Wonderland" through his migraine aura.
Throughout history there have been many theories, causes and treatments for migraine. Neolithic surgeons were known to drill holes in their patients' skulls. In 400 BC, Hippocrates prescribed various herbs for those he found suffering.
By the 1940's physicians began working with ergotamine -- a substance found to constrict pulsating blood vessels in the head.
Today we know that migraine is an inherited, multi-system disturbance set off by a variety of chemical triggers. Research and developments on new treatment are ongoing in hopes of helping the more than 3.2 million Canadians who suffer from migraine.
In July of 1974, migraine sufferer Rosemary Dudley founded The Migraine Association of Canada. The Association is a national resource for sufferers whose membership provides them with up-to-date migraine information and education. Membership in The Migraine Association has many benefits, and is open to all who suffer and to those who care about the health and well being of those who suffer.
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Twice as many women suffer from migraine as men. This is because of the influence of female hormones. In one study, 25% of female migraine sufferers had one or more attacks per week, and 35% had one to three severe attacks per month. A second study showed that 77% of migraine sufferers had their normal routine affected during their last attack.
Today more and more women work outside the home. More than $500 million dollars are lost in the workplace due to migraine each year. Migraine hits women between the ages of 25 and 44 the hardest. Many women who suffer migraine in this age group are mothers, often balancing a combination of family life, home duties, a social life, a marriage and a career. Difficult even without the incredible burden of migraine!
It is believed that the reason migraine is more common in women is the influence of female hormones on the delicately balanced system of the migraine sufferer. Internal influences (such as hormones) and external influences (such as certain foods) that the brain interprets as threats are known as triggers. These triggers act to provoke an attack in those who have the tendency to have migraine attacks. You must therefore have the disorder of migraine for fluctuations in female hormones to ever trigger a migraine attack for you. Triggers are very individualized, and not all women will find that hormonal fluctuations act as a trigger for them. If they are a trigger for you, it is likely you noticed at least one of the following commonly experienced facts:
- Many women with hormonally related attacks noticed an onset of their migraine either at puberty or in their early 20's.
- Migraine associated with the menstrual period tends to occur at the same time each month, be it mid-cycle with ovulation, or at the beginning, middle or end of the period.
- Hormone triggered migraine is often worse in the first trimester of pregnancy, but thankfully tends to ease off during the second and third. Since the safety of most medications and herbal therapies during pregnancy and while breast-feeding is not known, it is particularly important for women to research and employ non-drug strategies for controlling attacks during this time.
- While going through menopause (before the periods actually stop), many women notice an increase in attacks. For many, but not all, migraines will ease up after they are completely through menopause.
Medications that contain hormones (such as the birth control pill, oestrogen replacement therapy, or medications used to treat endometriosis) can worsen migraine, bring migraine on for the first time, not affect migraine at all, and in some instances are prescribed to treat migraine. For this reason, their use must be carefully evaluated. If the attacks worsen while on any of these therapies, report this to your doctor without delay.
When a woman is ill, it has an impact on her family life, her social life, and her career. It is particularly important for migraine sufferers and their caregivers to recognize and treat migraine with the wide variety of pharmacological and non-pharmacological treatments available. It is important for women to take an active role in their care while working with their physicians by: - identifying and controlling exposure to controllable triggers
- adopting regular schedules for sleeping and meal times
- limiting intake of pain relievers in order to avoid rebound headache
- exercising regularly, and taking time for themselves in their often demanding schedules
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Cluster headache and migraine are both the result of a biological disorder in the body's central nervous system. Unlike migraine, cluster headache is not hereditary, however, migraine sufferers are quite often found in the family of the cluster sufferer. Cluster headache affects less than one percent of the population. Eighty-five per cent of all cluster headache sufferers are men, and although it can occur at any age, it is most common between ages 20 and 40.
The cluster headache gets its name from the fact that it arrives in groups or clusters, often occurring a couple of times a day for up to several weeks. Many people experience their attacks at the same time each year.
Each attack usually lasts from 30 to 45 minutes and rarely longer than four hours. The pain is sharp, piercing and debilitating. It is concentrated on one side of the head, and is often described as a hot poker going through one eye. On that side, the eyelid may droop, the eye may become red and tear, and the nose may be stuffy and running on one side. The severity of the pain often causes a sufferer to pace, rock or bang their head against a wall. A cluster headache tends to occur at the same time each day, most often during sleep. During the susceptible cluster period, anything affecting the blood vessels may intensify attacks. These can include alcohol, smoking and the food additive MSG. Some sufferers try to avoid strong sunlight, changes in sleep patterns and air travel during their cluster period. Post-stress relaxation also affects some cluster sufferers.
To remedy a cluster headache, some sufferers have found relief by breathing pure oxygen. Your doctor may also recommend medications that constrict swollen blood vessels such as ergotamine. The trouble with painkillers is that the cluster attack is usually easing off on its own by the time they take effect. Since attacks occur frequently during the cluster period, it is usually not advisable to take narcotic painkillers. Other non-narcotic prescription medications can be taken as preventatives during the cluster period. These include calcium channel blockers such as verapamil, lithium compounds, methysergide or Sansert, steroids and non-steroidal anti-inflammatory medications are also used.
Consult with your doctor. Together, you can chart and anticipate your cluster periods. Knowing when and why you suffer cluster headaches is one of the most important steps in combating the pain |
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Over the last several years, a phenomenon known as Medication Induced Headache or MIH has become widely recognized as a significant problem amongst migraine sufferers.
MIH headache occurs when the frequent and indiscriminate use of pain killers or ergotamine containing preparations leads to an increase in the number of headache experienced. If you have been having periodic migraine attacks you could be prone to medication-induced headaches. Out of fear for the next attack you may start to take pain relievers at the first sign of an oncoming headache in hopes of staving it off. However, once the medication effect wears off more medication is needed to control the rebound headache that develops, and it becomes a vicious cycle to control the pain with daily medication. Often sufferers of this type of headache report a daily or almost daily underlying headache that is usually mild to moderate in intensity and is usually present upon waking in the morning. Although it makes you feel unwell, you generally manage to get through the day. Nothing seems to work for these headaches, including the pain relievers that you keep on taking daily. The situation becomes worse when you compound the daily headaches with true migraine attacks that will continue to appear.
Most over the counter preparations can cause MIH. Prescription ergotamines and pain relievers must be used with particular care and discretion.
To treat this problem it is essential to break the cycle of habituation by stopping the medication under a doctor's supervision. Sometimes hospital admission is necessary to discontinue some of the narcotics or barbiturate-laden products. Milder medications can be stocked at home with the help of a physician. Remember, they are making you worse! One study showed that stopping the offending medication reduced the number of attacks experienced by 43%! While you are initially withdrawing from the medication, a severe rebound headache will likely result. It's helpful to think of this as a short term pain for long term gain. Physicians often prescribe short term medication during this phase. Withdrawal symptoms can last from 2 to 7 weeks. More effective and appropriate treatments may include lifestyle changes and specific medication to manage your migraine, once you have cleared your system of the pain relievers. It is important to use non-drug strategies in controlling your migraine, and not to revert back to the cycle of medication induced headache.
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Although research cannot yet pinpoint the precise cause of migraine, it is recognized that certain "triggers" can set off an attack. As a diabetic who learns to monitor sugar intake, gets regular exercise and pays particular attention to their health, the migraine sufferer must learn to avoid the triggers that can bring on an attack.
Some migraine sufferers have more than one "trigger". Others will find that it takes a combination of triggers to bring on a migraine. No two people share the same triggers, so it is essential that you become a good detective when attempting to discover your triggers. One of the most straightforward ways to isolate your trigger is to look back to the 24 - 48 hours before an attack. Do this for several attacks and see if there is a pattern. Remember, your triggers can change throughout life, so always be on the lookout for new ones and be open to the possibility that you may "outgrow" some triggers.
The Migraine Association of Canada has compiled a list of the most commonly reported migraine triggers. Many fall under a migraine sufferer's diet and include chocolate, aged cheese, alcohol (especially coloured alcohol and red wine), the artificial sweetener aspartame, home made bread, food additives, and for some, dairy products. Withdrawal from caffeine can trigger attacks, as can fasting or delaying meals. Some migraine attacks are triggered by fluctuations in female hormones associated with the menstrual period, puberty, menopause, birth control pills, hormone replacement therapy, the first trimester of pregnancy and immediately following the delivery of a baby.
Weather has an effect on many aspects of our health. The Migraine Association of Canada issued a statement to Environment Canada encouraging further studies of the effect of weather on migraine. Many sufferers feel that rapid changes in barometric pressure triggers attacks - others are bothered by driving winds and humidity especially if combined with heat, intense sunlight and glare from the sun's reflection.
Many other things that add stress to the body system can act to set off the chemical chain of events that result in a migraine attack. For example, the stress of fatigue and of a change in sleeping habits like oversleeping creates problems. This is known as the weekend migraine. Prolonged stress, be it good or bad, and often the release of it can cause a migraine attack during the relief period after stress. Some complain of attacks from intense physical exertion.
This list is not complete, but may help you become a successful trigger detective. Not all triggers are removable (such as the weather) but by being aware of any "uncontrollable" triggers, you can limit your exposure to the controllable ones and stop combinations of triggers from setting off a war in your skull.
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All symptoms should be checked out by a physician -- however, many people experience symptoms that are of concern, not realizing that they could be part of migraine. In addition to some of migraine's more easily recognized symptoms such as pain, nausea, sensitivity to light or sound, many people experience more subtle symptoms with their attacks. These may be experienced prior to as well as during an attack, and can include:
dizziness
general discomfort in the stomach and/or abdominal area
depression, irritability, tension and/or other alteration in mood and outlook, sometimes with a feeling of detachment
inability to concentrate
feelings of extreme well being with uncommon energy, vigour, and a feeling of excitement preceding the attack
yawning
unusual hunger: desire for snacks, especially sweets
talking: there may be over talkativeness or difficulties in forming words, in speaking, in recalling words, incidents, etc.
pain or numbness in neck and shoulder areas
trembling
patches or blotchy areas on skin - what looks like a rash
unusual paleness or pallor (especially true with children)
increase in weight -- perhaps along with swelling in fingers and hands, waist, breasts, ankles or legs, or an increase in frequency and volume of urination
These are the warning signs and symptoms that are most frequently noted by physicians and those who suffer from migraine, and are sometimes called symptoms of the "prodrome." Individuals have suggested others which are peculiar to them. As with the more easily recognized symptoms of migraine, not everyone experiences all of these symptoms. When you are discussing your migraine with your physician it may help if you are to write down and present the list of those (if any) which refer specifically to you.
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