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Migraine and other diseases
More than 51 000 adults in North Trøndelag in Norway were asked about their general health.People with asthma were found to have a 50% greater chance of having migraine then non-asthmatics.
People who smoke, and especially smokers over 40 years of age, have an increased chance of headache. People who drink moderate amounts of alcohol have less chance of migraine than tee-totallers, but people who drink a lot of alcohol have more migraine than the general population.
Women who take estrogen supplements (birth-control pills and supplements after menopause) have more migraine than other women.
People with high blood pressure have less headache than others, and people with overactive thyroids (measured as a low TSH value, i.e. their thyroid was a little more active than normal) had more headache than others. Overweight people (with a BMI over 35) also had more chronic headache than others.
Women with anemia (low hemoglobin count) had less migraine than others.
Since all the information comes from questionnaires, there is no necessary causative connection between headache/migraine and the other factors mentioned.
K. Hagen, L. J. Stovner and J. A. Zwart, 2007. Potentials and pitfalls in analytical headache epidemiological studies – lessons learned from the head-HUNT study. Cephalalgia 27, 403 – 413.
Uploaded 28-8-2008
Migraine with and without aura may be entirely different diseases
Glutamate is a chemical that connects together nerve cells including those in the brain. If glutamate from one nerve cell is not removed from the receiving cell, a series of enzyme processes start that can kill the nerve cells. This can happen, for example, after a stroke (bleeding within the brain) or as a result of an epilepsy attack.Some migraineurs get a migraine attack if they eat food contain monosodium glutamate (E620 to E625) which is a glutamate. There are also reports that migraineurs have more glutamate in their blood than other people, especially during a migraine attack.
25 migraineurs with aura, 25 migraineurs without aura and 20 healthy control persons took part in the study. During the periods between attacks, both types of migraineur had more glutamate in their blood than the control people. The glutamate content was particularly high in the blood of migraineurs with aura. Glutamate is also found in the blood platelets and can be released or absorbed by them. Both release and absorption by the blood platelets was higher in migraineurs with aura, but the blood platelets in migraineurs without aura did not absorb as much glutamate as those of the control persons and aura-migraineurs.
The scientists now speculate that there may be different mechanisms involved in migraine with and without aura.
M. Vaccaro, C. Riva, l. Tremolizzo, M. Longoni, A. Aliprandi, E. Agostoni, A. Rigamonti, M. leone, B. Bussone and C. Ferrarese, 2007. Platelet glutamate uptake and release in migraine with and without aura. Cephalalgia 27, 35-40.
Uploaded 28-8-2008
High blood pressure, narrowing of blood vessels and increased cholesterol in migraineurs
An American dabase containing information about the medicine (triptans and ergotamines) prescribed for 130,411 migraineurs and a corresponding number of non-migraineurs was consulted. It also contained information about whether they had had problems with heart or circulation during the period 1994-1999 and about their use of estrogens. Since every individual prescription was registered, the scientists could divide the migraineurs into groups depending on their use of medicines. The database also held information about people in it who had died.Migraineurs were found to have had a slightly greater number of blood clots in their hearts - especially the users of ergotamines and people who did not take triptans. Migraineurs with higher than normal blood pressure were clearly over-represented, regardless of the medicine they used. Migraineurs also had a tendency to have more cholesterol than normal. Contraceptive pills were used by more female migraineurs than expected, although not by users of ergotamines.
There was no difference between migraineurs´ and non-migraineurs´ mortality, but there was a 67% increased risk that a migraineur would have had a stroke with short- or long-term effects, e.g. paralysis. The scientists were surprised to see that there was an incresed probability that migraineurs would die while they were under the influence of ergotamine (current or recent use of the drug). There was also a small increased risk of death from cancer among ergotamine users. On the other hand, there were fewer deaths than expected from heart disease among ergotamine users. The greatest risk of stroke among ergotamine users was among those migraineurs who took the drug between 11 and 28 days in 6 months.
P. Velentgas, J. A. Cole, J. Mo, C. R. Sikes and A. M. Walker, 2004. Severe vascular events in migraine patients. Headache 44, 642-651.
The study was partly finansed by Pfizer Inc.
The Danish Migraine Association recommends that all migraineurs should keep a careful eye on their blood pressure. High blood pressure should not be combined with the use of triptans or ergotamines.
30-10-2005
Strokes, blood platelets and migraine
Women with migraine between the ages of 19 and 64 have about a 2.5 times greater risk of having a stroke than non-migraineurs (1). A possible explanation has now emerged. A team of German doctors studied 72 migraineurs attending a migraine clinic in Kiel and found that they had a greater aggregation between blood platelets and white blood cells between attacks, compared with 72 controls. This tendency was especially evident in migraineurs without aura (2).The greater tendency for platelets to aggregate to white blood cells can also be seen in patients who have had strokes and those who have had diseases involving inflammation (reaction of tissue to damage or the like).
(1) A. L. Nightingale and R. D. T. Farmer, 2004. Ischemic Stroke in Young Women: A Nested Case-Control Study Using the UK General Practice Research Database. Journal of the American Heart Association 35, 1574-1578.
(2) J. A. Zeller, K. Frahm, R. Baron, R. Stingele and G. Deuschl 2004. Platelet-leukocyte interaction and platelet activation in migraine: a link to ischemic stroke? J. Neurol. Neurosurg. Psychiatry 75, 984-987.
30-10-2005
The three most important types of headache
The word ‘Headache’ is used to describe the effects of several different diseases. But the diseases ARE different and require different treatment. Some of us have ‘only’ one of them – others may have two or three different types of headache.The three most important ones are
• Migraine (with or without aura)
• Tension headache
• Cluster headache (also called Hortons headache)
Each of these three are serious diseases and if a person has more than one, it is important to be able to discriminate between them and treat them appropriately.
Migraine is characterised by
• Pain on one side only of the head. The pain may always be on the same side or it may change sides. A few migraineurs have pain on both sides at the same time
• The pain is pulsating – it follows the pulsing of the blood
• There is often nausea and vomiting
• There is often extra sensitivity to light, sound and scents
• The pain is worsened by physical activity (like walking up or down stairs)
• The attack lasts between 4 and 72 hours.
Migraine patients most often prefer to be in a quiet, dark room. Around half of all migraineurs have a close relative with migraine.
Migraine can be treated with triptans, pain killers or with beta blockers (preventive medicine).
Tension headache is characterised by
• Pain in the entire head (often like a tight band around the head)
• No pulsation of the pain
• Pain is not worsened by physical activity
• No nausea or vomiting
• Usually no problems with sensitivity to light, sounds or scents.
The pain is not as severe as for migraine and may be alleviated by a short walk or some fresh air.
Tension headache is treated with pain killers and may also be treated with physiotherapy (massage of muscle tension in the neck and shoulders).
Cluster headache is characterised by
• Very severe pain on one side of the head (as for migraine but the pain is more severe) and often located around one eye
• Short attacks (15 minutes to 3 hours)
• The eye on the painful side will produce tears and the nose may be filled
• The pupil in the painful side may be contracted
• There may be sweat on the forehead and on the face
• The eyelid may be swollen or may hang.
Attacks arrive in clusters – there may be 1 to 8 attacks during a day. Next day may be free of attacks and after some time they no longer appear. After some months the pattern repeats itself.
Cluster headache patients often wander around and may want to bang their head against a wall due to the pain.
Cluster headache is treated with triptan injections and bottled oxygen may also reduce the severity of the attacks.
Remember to talk to the doctor if your migraine or headaches have changed characteristics!
Uploaded 02-03-2005
Chronic headache and migraine - an increased risk
Migraineurs are more disposed than others to develop chronic headache When migraineurs are compared with other users of large amounts of painkillers, it tends to be the migraineurs who develop chronic headache, while folk with e.g. rheumatism don´t get this ´side- effect´. This happens whether or not the medicine contains opiates (e.g. codeine), NSAID (used against rheumatism) or paracetamol.A. Bahra, M. Walsh, S. Menon and P. J. Goadsby, 2000. Does chronic daily headache arise de novo in association with regular analgesic use? Cephalalgia 20, 294.
Uploaded 03-03-2005
Continuous headache in 4% of all Americans
Continuous headache (i.e. headache at least every second day) is the daily reality for 5% of American women and 2.8% of American men. Those with the lowest education are especially afflicted. Nearly a third of the people with continuous headache have migraine. Continuous headache is a little more frequent among white than among non-white people.Reuters, 8. August 1998.
Uploaded 03-03-2005
Sinus-headache is often migraine
Patients who visit their doctor with headaches caused by sinus infections are often found to have migraine. That was shown by a review of 2991 patients who attended their doctor because of pressure or pain in their sinuses, or because of a blocked nose. During the review, 88% of these patients were found to also suffer from migraine.C. P. Schreiber, S. Hutchinson, C. J. Webster, M. Ames, M. S. Richardson and C. Powers 2004. Prevalence of Migraine in Patients With a History of Self-reported or Physician-Diagnosed ´Sinus´ Headache. Arch Intern Med. 164,1769-1772.
Uploaded 06-04-2006
Allergy and migraine
Allergy and asthma, diabetes and stomach upsets were more common among Finnish boys with migraine, while sleep disturbances and psychiatric problems were more common among girls with migraine than with non-migraineurs (1). A comprehensive study in Holland that included all age-groups of adults (2) found the same tendencies - that migraineurs have more asthma than non-migraineurs.The connection between asthma and migraine is thought to be partly inheritable. A Turkish study showed that children have an increased risk of having asthma, eczema and allergy if their parents have (have had) migraine (3).
We therefore have to conclude that there is some kind of connection between allergy generally and migraine. Unfortunately, the studies have not shown whether or not those who have both an allergy and migraine tend to have their migraine attacks at the same time as they have an allergic reaction. Neither do the studies show whether there is an increased risk of developing an allergy if you first have migraine or whether you typically get migraine because you already have an allergy.
Maybe in the future controlled experiments will show whether or not it is physical blockage of the nose or sinuses that causes migraine, or whether there is an underlying chemical reason that makes migraineurs develop an allergy or those with allergy develop migraine.
(1) M. Sillanpaa and H. Aro, 2000. Headache in teenagers: comorbidity and prognosis. Funct Neurol 15 Suppl 3, 116-121.
(2) G. M. Terwindt, M. D. Ferrari, M. Tijhuis, S. M. Groenen, H. S. Picavet and L. J. Launer, 2000. The impact of migraine on quality of life in the general population: the GEM study. Neurology 55, 624-629. (3) F. Gurkan, A. Ece, K. Haspolat and B. Dikici, 2000. Parental history of migraine and bronchial asthma in children. Allergol Immunopathol (Madr) 28, 15-17.
Uploaded 03-03-2005
Asthma and migraine – a connection
All citizens in North Trøndelag, Norway, were asked if they had some of a number of symptoms – i.e. migraine and asthma, hay-fever and bronchitis. A significant connection was found as there were more than the expected number of migraineurs who had asthma, hay fever and chronic bronchitis (coughing). The same connection was found for those with tension headache.The more days with migraine (or headache) per month, the greater was the tendency to suffer from asthma etc. (1).
Other studies have shown that overweight gives an increased risk of having migraine (2) and there is a corresponding connection between overweight and asthma (3).
(1) H. Aamodt, L. J. Stovner, A. Langhammer, K. Hagen and J.-A. Zwart, 2007. Is headache related to asthma, hay fever, and chronic bronchitis? The head-HUNT study. Headache 47, 204-212.
(2) M. E. Bigal and R. B., Lipton, 2006. Obesity is a risk factor for transformed migraine but not chronic tension-type headache. Neurology 67, 252-7.
(3) D. A. Beuther and E. R. Sutherland, 2007. Overweight, Obesity, and Incident Asthma: A Meta-analysis of Prospective Epidemiologic Studies. Am J Respir Crit Care Med. 175, 661-6.
The risk of getting migraine and asthma is doubled for people with a BMI over 30. Even more reason for maintaining a reasonable weight.
Uploaded 28-8-2008
Cholesterol is high in aura migraineurs
A study of 240 Dutch migraineurs, who were compared with 5135 non-migraineurs between the ages of 18 and 65 (half were men), showed that migraineurs with aura had an increased risk of high cholesterol in their blood, had high blood pressure and had a substantially higher risk of dying from coronary thrombosis.The female aura migraineurs used oral contraceptives more often than women in the general population.
A. I. Scher, G. M. Terwindt, H. S. Picavet, W. M. Verschuren, M. D. Ferrari and L. J. Launer, 2005. Cardiovascular risk factors and migraine: the GEM population-based study. Neurology, 64, 614-20.
About 25 000 Danes die every year from coronary thrombosis, more or less every third death. A significant increase in risk of developing heart disease is therefore not something that can be ignored. Exercise and heatlthy eating are recommened to prevent coronary thrombosis.
Uploaded 06-04-2006
Coeliac disease (gluten allergy) and migraine - a connection
90 migraineurs were studied to see if they had sub-clinical gluten allergy (one that wasn´t strong enough to have been recognised). 4 migraineurs (equivalent to 4.5% of those studied) were discovered to have this allergy, while only 0.4% of the general population have gluten allergy. The four who were allergic were given gluten-free food for 6 months and one of them had no migraine attacks during this period while the other three had a significant reduction compared what they expewrienced while on their normal diet (1).Another study of 86 gluten-allergic people showed that 16 (19%) suffered from migraine (10 with aura, 6 without). There were substantially more migraineurs than expected from the general population and very many more aura-migraineurs than expected (2).
It is consequently suggested that there is a connection between gluten-allergy and migraine and, if you have both, you are advised to keep your diet gluten free.
(1) M. Gabrielli, F. Cremonini, G. Fiore, G. Addolorato, C. Padalino, N. Candelli, M. E. De Leo, L. Santarelli, M. Giacovazzo, A. Gasbarrini, P. Pola and A. Gasbarrini, 2003. Association between migraine and Celiac disease: results from a preliminary case-control and therapeutic study. Am J Gastroenterol. 98, 625-9.
(2) M. C. Roche Herrero, J. Arcas Martinez, A. Martinez-Bermejo, V. Lopez Martin, I. Polanco, A. Tendero Gormaz and A. Fernandez Jaen, 2001. The prevalence of headache in a population of patients with coeliac disease. Rev Neurol. 32, 301-9.
Uploaded 06-04-2006
Depression and migraine
It has been known for a long time that there is a small increased chance of being depressed if you suffer from migraine. Correspondingly, there is a strongly increased chance of having migraine if you are depressed.Migraine and depression in women between the ages of 50 and 59.
A connection has been shown in Sweden among women between the ages of 40–74 between having migraine and previously having had one or more major depressions, a high degree of stress and general anxiety (1). The depressions happened particularly between the ages of 50 and 59.
There is also thought to be a connection between migraine and feelings of panic. The authors conclude that certain neurotic aspects have something in common with the ability to withstand migraine pain, i.e. that people with migraine and these features experience pain worse than other people. Migraineurs have five times more risk of panic, anxiety and feelings of threat.
A literature survey from the USA (2) has also recently suggested that there is some connection between migraine and depression or anxiety. The authors point out that migraineurs have about 5 times as much risk as non-migraineurs of having feelings of panic, anxiety or being threatened. They recommend that migraine patients should be educated in looking after their own migraine attacks, so that they become their own ´care-givers´, take their medicine themselves and use all the various daily routines that can make migraine less troubling (such as avoiding foods that trigger migraine, hormonal treatment, light, sound and smell-disturbances and stress).
Angry patients are treated (in the USA) for psychiatric problems.
The last publication during recent months about migraine and psychiatric problems is about ´borderline personality disorder´ and chronic headache. Patients with ´borderline personality disorder´ are recognised clinically (say the authors) when they come to the doctor full of optimism and say something like ´It´s good that I have finally found you´, but after a short time, they come to the conclusion that this particular doctor cannot cure their headaches either, so the patient becomes destructive about their treatment. (3)
We think it is frighteningly easy to come to this conclusion if the doctor isn´t particularly knowledgeable about migraine and if the patient has already tried a number of other doctors without luck. But the authors are convinced that it is the patient who has a problem. As treatment for this condition, the authors recommend that MAO inhibitors should be given, a drug that stops the breakdown of biogenic amines. The drug should be taken together with a diet that excludes tyramine and phenylethylamine, the two chemicals that are normally thought to be responsible for triggering migraines. The authors aver that this treatment often gives good results, because the headaches/migraines disappear and the difficult patients become tractable.
As a migraineur, it´s good to know that doctors are on the watch for other diseases that might accompany migraine. But after using triptans for 10 years it is very easy to think that any psychological reactions might be the fault of the medicine rather than that of the migraine. It is only a step forward if doctors can distinguish between the effects of our disease and of our medicine that have affected our minds in any given case. Psychological tests need to be done on migraineurs who haven´t yet taken very much medicine; either children or adults who, for some reason or other, haven´t yet wished to use migraine medicine that needs a prescription.
It´s not easy - neither to be a migraine patient nor a migraine doctor.
(1) P. Mattson and L. Ekselius 2002. Migraine, major depression, panic disorder, and personality traits in women aged 40-74 years: a population-based study. Cephalalgia 22, 543-551.
(2) F. D. Sheftell and S. J. Atlas, 2002. Migraine and psychiatric comorbidity: From theory and hypotheses to clinical application. Headache 42, 934-944.
(3) J. R. Saper and A. E. Lake III, 2002 Borderline personality disorder and the chronic headache patient: review and management recommendation. Headache 42, 663-674.
Uploaded 03-03-2005
Depressed migraineurs because of what they cannot do
Hungarian scientists compared headache and migraine patients with patients with back pain to see if they reacted to their pain in the same way. They talked to 635 patients, 2 in 3 of whom were women. All were studied to see if the had any tendency to depression. 114 were healthy and the others had back pain or headache/migraine or Horton´s Disease. All were asked how often and how intensely they experienced pain. The answers made it clear that ´disability´ i.e. the experience of ´not being able to´ was decisive in whether the headache and migraine patients had a tendency to depression. There was no connection between ’disability’ and depression among the patients with back pain, even though they suffered from pain most of the time and their pain was just as intense as that of the headache and migraine patients.G. Gesztloyi and D. Bereczki, 2005. Disability is the major determinant of the severity of depressive symptoms in primary headaches nut not in low back pain. Cephalalgia 25, 598-604.
Uploaded 21-10-2006
Epilepsy and migraine
59 Turkish epileptics with migraine and 56 epileptics without migraine were studied for 10 years. The group that had both migraine and epilepsy were harder hit by their epilepsy than the group without migraine. There was no tendency for many migraine attacks to worsen the epilepsy compared with fewer attacks.Unfortunately the authors give no advice about what can be done for this group of patients.
S. K. Veliooglu, C. Boz and M. Özmenoglu, 2005. The impact of migraine on epilepsy: a prospective prognosis study. Cephalalgia 25, 528-535.
Uploaded 21-10-2006
Heart attacks no more often in migraineurs
There has been some suspicion that there may be a connection between migraine and coronary problems.A study of 39,876 American women over the age of 45 and 22,011 men over the age of 40 has shown that both male and female migraineurs had a little less risk of heart attack than non-migraineurs.
The authors point out that the study did not take account of whether the migraineurs had taken preventive medicine that lowers their blood pressure.
N. R. Cook, I. M. Bensenor, P. A. Lotufo, I.M. Lee, P. J. Skerett, M. J. Chown, U. A. Ajani, J.A. E. Manson and J E. Buring, 2002. Migraine and coronary heart disease in women and men. Headache 42, 715-727.
Uploaded 03-03-2005
Meniere´s Disease and migraine
Allergy may be a connection between migraine and Meniere´s Disease. 108 patients with Meniere´s Disease were compared with a control group. The Meniere´s Disease sufferers also had migraine and allergies many more times than the control group.The scientists suggest that migraine and Meniere´s Disease may have something in common and that it has something to do with the immune system. P. Sen, C. Georgalas and M. Papesch, 2005. Co-morbidity of migraine and Meniere´s disease - is allergy the link? J. Laryngol. Otol. 119, 455-60.
Uploaded 21-10-2006
Narcolepsy (spontaneous falling asleep) and migraine
Narcolepsy is a disease that gives a tendency to fall asleep during the day. Patients can have problems in falling asleep at night but can suddenly fall asleep in the daytime.A German research team asked 100 narcolepsy patients if they had migraine. 44% of the female narcolepsy patients and 28% of the males reported that they often had migraine. That is around 4 times as many as expected.
The vast majority of narcolepsy patients had developed narcolepsy some years before they had their first migraine attack. The scientists suggest that there may be a common cause of narcolepsy and migraine.
N. Dahmen, M. Kasten, S. Wieczorek, M. Gencik, J. T. Epplen and B. Ullrich, 2003. Increased frequency of migraine in narcoleptic patients: a confirmatory study. Cephalagia 23, 14-19.
Uploaded 03-03-2005
Overweight and migraine
Overweight women in the child-bearing years have increased risk of developing what´s called Pseudotumor Cerebri. That means that they have symptoms that resemble those of a brain tumour, but there is no tumour. They develop increased pressure in their brains and thereby get tinnitus (ringing in the ears), vision disturbances, neck and back-pains and often fluid accumulates in their hands and feet.Even though an overweight woman has all these symptoms, there is no need to avoid becoming pregnant.
Since these symptoms are difficult to treat, women with them often get prescribed large doses of painkillers that can lead to them developing continuous headaches. Headache 2000, 40, 495-497.
Uploaded 03-03-2005
PMS and hysterectomy lead to more migraine
A study of 1,436 women between the ages of 40 and 54 from an island off Taiwan showed that the women with pre-menstrual syndrome (PMS) had a greater tendency to have migraine than women who weren´t so plagued by PMS. A much larger percentage of women who had had a hysterectomy also had migraine. Nearly a half of women who had a little PMS and who also had had a hysterectomy had migraine, compared with only about 20% of women before their menopause. The frequency of migraine attacks increased just about the time of menopause but only about a tenth of women suffered from migraine after their natural menopause.The numbers for women without PMS problems were a little lower - there were fewer who had migraine in all age groups.
The obvious question about women who had had a hysterectomy and who received oestrogen supplements can be answered negatively. Oestrogens were given to only about 24% of the people who had had an operation.
S.-J. Wang, J.-L. Fuh, S.-R. Ru, K.-D. Juang and P.-H. Wang. 2003. Migraine prevalence during menopausal transition. Headache 43, 470-478.
Uploaded 03-03-2005
Polycystic ovary syndrome (PCO) and migraine
Polycystic ovary syndrome (PCO) (also known as Stein-Leventhal syndrome) affects only women. Women with PCO have an abnormal hormone spectrum i.e. there aren´t many of the hormones that need to work together for ovulation to occur. The eggs in their ovaries are therefore not released, but decay in the ovary, whereas healthy women´s ovaries develop and release a single egg every month. Women with PCO often have the follwowing symptoms:
• Irregular menstruation (or none at all)
• Commonly several developed ægge-blærer in their ovary
• High blood pressure
• Pimples
• High insulin amounts or diabetes
• They cannot have children
• They often have hair on their faces and bodies
• On the other hand, they have a tendency to lose their hair
• They are often overweight (fattest around the middle)
The precise reason for PCO is not known but there are two hypotheses:
1) the pituary gland makes more lutein hormone (the hormone that causes the egg to mature) than normal and so stimulates the creation of male hormones in the ovaries; they cause the egg to decay and interfere with the production of oestrogen
2) the body´s cells develop insulin-resistance, i.e. the insulin content of the blood becomes so great that an abnormal amount of male hormones in the ovaries is released and the egg decays.
There are no publications that connect migraine and PCO, but there seems to be a connection. In many women, migraine is triggered by changes in oestrogen amounts from an already high level. Women with PCO have a generally high oestrogen content in their blood and of course it varies from day to day.
So if you have migraine and irregular menstruations, have problems in becoming pregnant, have pimples, are fattest around the middle and thinner in your upper body maybe you should have a discussion with your doctor about PCO. The doctor can tell you about treatment possibilities. There are also a number of internet pages with help to PCO patients.
Collected from various internet pages about PCO.
Uploaded 06-04-2006
Senstive skin (allodynia) in migraineurs
34 out of 42 patients with migraine told that it hurts when they brush their hair, shave or wear glasses while they have migraine. Doctors now speculate that these pains may have the same cause as migraine.Ann. Neurol. 2000, 47, 614-24.
Uploaded 03-03-2005
Stomach ulcer bacteria and migraine
There have been previous reports about a connection between the stomach ulcer bacterium Helicobacter (that many of us have in our stomachs) and migraine. A team of Turkish scientists treated 70 migraine patients who attended a stomach clinic with symptoms that resembled those from ulcers. When Helicobacter was removed, 85% of the migraine patients felt much better, including their migraine.A. Tunca, C. Turkay, O. Tekin, A. Kargil and M. Erbayrak, 2004. Is Helicobacter pylori infection a risk factor for migraine? A case-control study. Acta Neurol Belg. 104, 161-4.
Uploaded 06-04-2006
Strokes - and increased risk for male mgraineurs
A Finnish study has shown that men have an increased risk of strokes (blood clots in the brain) if they have high blood pressure (about 3 times greater than normal), heart disease (about 3 times normal), diabetes (about 4 times normal), are smokers (about double the risk) or have migraine (about double the risk). The risk that a woman will get a stroke is increased about 4 times if she uses contraceptive pills. Alcohol also gives an increased risk of strokes.Stroke 1997, 28, 26-30.
Uploaded 03-03-2005
Stroke - increased risk for migraineurs with aura
The blood flow through the middle cerebral and basilar arteries (the one that lies in the base of the brain) was studied in fifteen control persons, fifteen migraineurs with aura and fifteen migraineurs without arura. All were healthy women between the ages of 20 and 25.It was found that the migraineurs with aura had a reduced ability to increase the flow through their basilar arteries compared with migraineurs without aura and the control persons. This was measured while the person being studied held their breath for 30 seconds as the alteration (contraction or increase) in flow in the arteries at the same time.
The scientists suggest that the results show that migraineurs with aura have an increased risk of stroke. They should especially avoid using oestrogen supplements and smoking, and be careful about high blood pressure because these three factors increase the risk of stroke.
M. Silvestrini, R. Baruffaldi, M. Bartolini, F. Vernieri, C. Lanciotti, M. Matteis, E. Troisi og L. Provinciali, 2004. Basilar and middle cerebral artery reactivity in patients with migraine. Headache 44, 29-34.
Uploaded 26-05-2005
Risk of stroke among migraineurs with aura
American scientists asked 542 female migaineurs with aura between the ages of of 15 and 49 who had had a stroke about how their aura looked. Women who entirely lost vision during their aura had a 70% greater risk of having had a stroke compared with women without migraine. Women who ´only´ saw spots and lines had a 25% greater chance of having had a stroke. Women without aura had no increased risk of having had a stroke.1 in 5000 women with aura (regardless of the type) experience a stroke in any year. Overweight smokers with high blood pressure are especially at risk (1).
Another American study of female migraineurs over the age of 45 showed an increased risk equivalent to 3.8 strokes per year among 10 000 women (2). Among American women around 60 years of age, the risk of a stroke is about 30 out of 10,000 women (3).
An Italian study showed that migraineurs between 16 and 44 years old had a 2.7 times increased risk of a stroke. If they also had high blood pressure, the risk of a stroke was 9 times greater (4).
(1) Reuters February 10, 2005, from American Stroke Association´s 30th International Stroke Conference, Maryland, February 2005.
(2) T. Kurth, M. A. Slomke, C. S. Kase, N. R. Cook, I. M. Lee, J. M. Gaziano, H. C. Diener and J. E. Buring, 2005. Migraine, headache, and the risk of stroke in women: a prospective study. Neurology 64, 1020-6.
(3) Heart Disease and Stroke Statistics - 2005 Update, American Heart Association
http://www.americanheart.org/downloadable/heart/1105390918119HDSStats2005Update.pdf
(4) C. Ferrante, G. Maggioni, A. Perretti, M. (Porta, A. Terruzzi, M. Tognozzi, G. Belloni, and L.Moschini, 2005. Migraine-sparked vision loss may increase stroke risk in women; migraine may be risk factor for stroke in young adults. Conference abstract, American Stroke Association´s 30th International Stroke Conference, Maryland, February 2005.
Uploaded 06-04-2006
Blood clots and migraine with aura
A study has shown that about a half of migraineurs with aura have increased amounts of the chemical F1.2 in their blood. This chemical causes blood to coagulate and if you have more than normal amounts, there is, of course, an increased risk of clots. It is noteworthy that only about a half of migraineurs with aura have increased amounts of F1.2; the other half have quite normal amounts and are therefore not at increased risk of blood clots. The authors suggest that two different diseases are hidden within the diagnosis ´migraine with aura´. This is in agreement with the discovery that there are several different genes involved in the group of migraineurs with aura. Unfortunately, the authors didn´t test whether or not the 22 patients in the study had or didn´t have the same or different genetic make-up.R. Hering-Hanit, Z. Friedman, I, Schlesinger and M. Ellis, 2001. Evidence for activation of the coagulation system in migraine with aura. Cephalalgia 21, 137 - 139.
Uploaded 03-03-2005
Tinnitus and migraine often follow one another
There is thought to be a connection between migraine and tinnitus. Ca. 2/3 of a group of 112 Italian migraineurs complained of tinnitus symptoms during a migraine attack, and 15% of them had tinnitus even when they didn’t have migraine (1).A group of Japanese scientists wrote as long ago as 1989 (2) that basilary migraine was often recognized by short-term memory loss as well as pulsing headache, dizziness, tinnitus and paralysis, and an American review paper (3) tells that, among other things, tinnitus can be triggered by migraine with sound-aura.
The only attempt to explain what might be the connection between tinnitus and migraine is thought to be a study of nine patients, chosen because they had particularly convoluted arteries at various places in their heads. It showed that there is increased likelihood of having migraine and tinnitus, if the blood vessels in the head are twisted (4).
Even though there aren’t many studies of the connection between these two diseases, it seems that:
• There is an unexpectedly large number of migraineurs who have tinnitus
• Tinnitus is thought to ´come with´ basilary migraine
• Tinnitus triggered by migraine is apparently because of the physical condition of some blood vessels in the head, which causes tinnitus to be triggered by a migraine attack.
A search of PubMed in 2000 gave no information about special treatment of migraineurs with tinnitus.
1. A. Farri, A. Enrico, M. Lacilla and A. Sartoris, 1999.[Tinnitus during headache: clinical-instrumental evaluation]. Acta Otorhinolaryngol Ital 19, 70-75.
2. K. Yamane, S. Hashimoto, I. Kobayashi and S. Maruyama, 1989. [Basilar artery migraine associated with transient global amnesia]. No To Shinkei 41, 1103-7.
3. M. D. Seidman and G. P. Jacobson, 1996. Update on tinnitus. Otolaryngol Clin North Am 1996 29, 455-65.
4. J. M. Pelaez, R. L. Levine, F. Hafeez and D. A. Dulli, 1998. Tortuosity of carotid and vertebral arteries: a magnetic resonance angiographic study. J Neuroimaging 8, 235-9.
Uploaded 03-03-2005
Migraineurs have other symptoms too
Some diseases have been reported in the scientific literature one or more times in connection with migraine; i.e. migraine patients have a slightly higher risk than non-migraineurs of having one or more of the following diseases:
• Depression
• Anxiety
• Panic attacks
• Manic Depression
• Epilepsy
• Tourette Syndrome
• Raynaud’s Disease
• Blood pressure problems (changing)
• Apoplexy, sub-clinical alterations in the brain
• Bulging of the wall of the heart
• Snoring and sleep apnoea
• Asthma and allergy
• Lupus
• Other pains than headache
It cannot be determined whether migraine causes these diseases or whether these diseases cause migraine. All we know at present is that there is a greater than expected connection.
A. I. Scher, M. E. Bigal and R. B. Lipton, 2005.Comorbidity of migraine. Current Opinion in Neurology 18, 305–310.
Uploaded 21-10-2006