by admin | Aug 19, 2021 | Children & Headaches
If you have a child with migraine headaches, you know how alarming it can be to have a child with aura symptoms. These symptoms can be helpful, though, as they do indicate when to treat the migraine attack. Early treatment can get a headache under control more easily.
But what about the child who has migraine without aura? Do you know what warning signs to look for to tell that an attack is on its way?
Warning signs of impending migraine
Many migraine sufferers experience vague warning symptoms before the headache pain of a migraine begins. In fact, in adults, this type of warning occurs in more cases than auras do. A French study (Cuvellier, Mars, & Vallée; Cephalalgia, 2009) of children with migraine found that two-thirds of the children who had migraine with or without aura had at least one early warning sign, and over half had two signs. These early warning signs are called a prodrome.
The three most common warning signs were irritablilty, fatigue, and face changes. Face changes meant shadows under the eyes or pallor (paleness). The next three most common early warning signs were sensitivity to sound, anxiety or feeling stressed, and yawning. Sensitivity to light, nausea, and food cravings were also reported. Because this was a study asking about symptoms previously occurring, the length of time the warning signs lasted was not measured.
If you have a child with migraines, paying attention to these early symptoms that occur before the head pain does can pay off. Treating early can bring migraine relief and keep your child happy and active.
by admin | Aug 5, 2021 | Migraine Survival
The Oregon Headache Clinic
15259 SE 82nd Drive, #201B
Clackamas, OR 97015
503-656-9844 | fax 503-656-3120
noheadaches@migrainesurvival.com
The Oregon Headache Clinic, located at 15259 SE 82nd Dr, #201B, Clackamas, OR 97015, and founded by Christina Peterson M.D., was established to help patients identify and treat headache disorders, including migraine and chronic head pain.
The Oregon Headache Clinic will be closing at the end of September, 2021.
If you have been a patient of the Oregon Headache Clinic, please contact us to discuss a referral and transfer of care and records. Dr. K.W. David Ho has agreed to accept our patients in transfer. Dr. Ho is a neurologist with additional training in pain medicine. He can be reached at 503-987-3707 or at www.nerveandpain.com.
It has been a privilege and an honor to be a partner in your headache care.
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by admin | Aug 1, 2021 | Migraine Survival
Migraine Survival
Migraine Survival was started by Dr. Christina Peterson to bring about more awareness of migraine and other headache types, including awareness about all the associated health conditions that exist for headache sufferers. The purpose of this site is for both headache patients and the health professionals who care for them to learn more about headaches in order to achieve better control of their headaches, so that they can live their lives with less pain and with better quality of life. All content is written by experts, and is verified by one of our Board of Experts before publication. Revised content will be periodically updated. Need to contact Migraine Survival? Write to us at noheadaches@migrainesurival.com
Our Board of Experts
Medical Director of the Oregon Headache Clinic, and owner of Migraine Survival, focusing on a wellness-based approach to headache.
read more about Dr. Peterson…
read more about Dr. Spies…
Director of the São Paulo Headache Center, and Professor of Neurology at ABC Medical School. He also serves on the Board of Trustees of the International Headache Society.
Director of Clinical Research, Harley Street consultant, Honorary Senior Clinical Lecturer at the Research Centre for Neuroscience within the Institute of Cell and Molecular Science, Barts and the London School of Medicine and Dentistry, University of London. She is also an Instructing Doctor and examiner for the Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists. Dr. MacGregor was previously Research Director at The City of London Migraine Clinic. She has served as Treasurer of the International Headache Society (IHS) and was General Secretary 1999 to 2005, and has served as a Trustee of the Migraine Trust and member of the Medical Advisory Board of Migraine Action Association, both lay organizations. Dr MacGregor has served as an ad hoc reviewer for the British Medical Journal, The Lancet, The Lancet Neurology, Neurology, Drugs and Therapeutics Bulletin, Headache, Cephalalgia, Climacteric and Maturitas. Dr. MacGregor has over 150 publications and 5 single-author books to her credit. She lectures extensively.
Dr. Ingo Anderle is an Optometrist with over 20 years private practice experience. He practiced in Germany and New Zealand, before relocating 10 years ago to work in Spain and Gibraltar. He speaks Spanish, English and German fluently and has run his own practice in La Linea, Spain.
Dr. Anderle is passionate about exceeding patient expectations. He has broad experience in working with children, people with disabilities, low vision patients, headache and migraine sufferers, and those with cataracts.
by admin | Jul 31, 2021 | Triggers
Is chocolate a major migraine trigger?
Chocolate gets a lot of bad press as a headache trigger. Is it really as bad as it’s made out to be? Actually, it’s not.
A 1995 study found that 22% of chronic headache sufferers reported chocolate to be a headache trigger. In an interview, one of the researchers, Dr. Lisa Scharff, indicated that many of the women who responded positively on a trigger questionnaire to chocolate did so because they had heard about other people getting headaches from chocolate, or discovered that their personal experience with chocolate as a headache trigger occurred premenstrually, casting some doubt on whether the chocolate was the actual trigger.
Dr. Scharff, Dr. Dawn Marcus, and others studied sixty women with chronic headache in 1997. The women were asked to follow a restricted diet, and were then tested with four candy bars, two of which were chocolate, and two of which were carob. All four bars were flavored with mint to prevent identification. Even the women who believed their headaches were triggered by chocolate did not develop headaches, regardless of whether they had eaten the carob or the chocolate.
Wöber and colleagues at the Medical University of Vienna recently reported similar findings—that headache sufferers theoretical understanding of headache triggers differed from their actual experience.
Chocolate has been blamed as a migraine trigger in the past because it was thought to contain tyramine, but more recent chemical analyses have found it to contain minimal levels of tyramine. It does, however, contain things that are good for you: flavonoids and stearic acid. The stearic acid is part of the fat in chocolate, and most of the studies done to date suggest that it is “cholesterol-neutral.” In other words, it doesn’t affect your cholesterol in a negative way. And the flavonoids act as anti-oxidants, and may have anti-platelet (anti-clotting) effects.
Studies of cocoa and dark chocolate found evidence that chemicals in cocoa reduced inflammation, and that chemicals in chocolate lowered blood pressure, increased HDL (good cholesterol), lowered LDL (bad cholesterol), prevented platelets from clumping together (like aspirin does, only not as strongly as aspiring does), improved endothelial function (the inside of blood vessels), and improved insulin sensitivity.
Dark chocolate has five times the amount for flavonoids of blueberries. Finally, chocolate is high in magnesium. And there is some evidence that chocolate results in a release of serotonin and endorphins.
I’d say chocolate is your friend. Unless, of course, it really is one of your migraine triggers. It is for some people.
References:
- Marcus, DA, Scharff, L, Turk, L, Gourley, M. A double-blind provocative study of chocolate as a trigger of headache. Cephalalgia. 1997 Dec; 17(8):855-62, discussion 800.
- Lippi, G, Mattiuzzi, C, Cervellin, G. Chocolate and migraine: the history of an ambiguous association. Acta Biomed. 2014 Dec 17; 85(3):216-21.
- Moffet, AM, Swash, M, Scott, DF. Effects of chocolate in migraine: A double-blind study. Journal of Neurology, Neurosurgery, and Psychiatry. 1974, 37, 445-448.
by admin | Jul 11, 2021 | Medication
CGRP (Calcitonin Gene-Related Peptide) and Migraine
CGRP (calcitonin gene-related peptide) has been found to play a role in causing migraine. CGRP is released from cells in the trigeminal ganglia, and migraineurs have an increased level of CGRP in blood serum. In the brain, CGRP levels are increased in inflammatory conditions. There is some evidence that at least some migraine sufferers may have inflammatory markers (such as TNF-α) present in their nervous systems during migraine attacks. CGRP is thought to increase the sensitivity of migraine pain receptors (trigeminal nociceptors). There is also some evidence that CGRP is implicated in paroxysmal hemicranias. CGRP may even play a role in hypertension.
Drug development for CGRP blockers has been a long road. Telcagepant was found to be effective in Phase III trials, but was abandoned after the discovery of concerns about liver toxicity. Olcegepant, which had undergone Phase II trials, is intravenous, and was not developed further due to adverse effects as well as an intravenous therapy for an acute medication not being the most practical option for many. Other CGRP antagonist drugs in the gepant class have emerged and more are in development (rimegepant, ubrogepant, atogepant, and vazegepant). Some gepants are used as acute medications, while others have utility for prevention of migraine.
Another form of CGRP blockade is in the form of monoclonal antibody drugs that either block the CGRP receptor or the CGRP ligand. There are currently four injectable monoclonal antibody CGRP blockers for migraine prevention: erenumab, galcanezumab, fremenezumab, and eptinezumab.
References:
1. Durham PL. Calcitonin Gene-Related Peptide (CGRP) and Migraine. Headache. 2006;46(Suppl 1):S3–S8.
2. Hoffmann J, Goadsby PJ. New Agents for Acute Treatment of Migraine: CGRP Receptor Antagonists, iNOS Inhibitors. Curr Treat Options Neurol. 2012;14(1):50–59. doi:10.1007/s11940-011-0155-4.
3. Durham PL, Vause CV. CGRP Receptor Antagonists in the Treatment of Migraine. CNS Drugs. 2010;24(7):539–548. doi:10.2165/11534920-000000000-00000.
4. Goadsby PJ, Edvinsson L. Neuropeptide changes in a case of chronic paroxysmal hemicrania-evidence for trigemino-parasympathetic activation. Cephalalgia. 1996;16:448-450.
5. Tepper, S. J. and Stillman, M. J. (2008), Clinical and Preclinical Rationale for CGRP-Receptor Antagonists in the Treatment of Migraine. Headache: The Journal of Head and Face Pain, 48: 1259–1268. doi: 10.1111/j.1526-4610.2008.01214.
6. Rafaelli, B. Neeb, L. Reuter, U. Monoclonal Antibodies for the Prevention of Migraine. Expert Opin. Biol. Ther. 2019 Dec; 19(12):1307-1317.
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