Migraine Science: Drugs, Devices, And Dark Rooms

This entry was posted by Wednesday, 10 March, 2010
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She's got a MIGRAINE, you nitwit!

I had a rental car with a broken radio. You couldn’t lower the volume or turn it off and it only got one station which had Rush Limbaugh, ranting and raving. What could be worse? – BizWhiz59

MIGRAINES

My wife says migraine headaches are worse than a date with MISTER ScienceAintSoBad . But she’s probably exaggerating.  A musician who gets migraines almost weekly says they’re “The worst thing that can happen to you that doesn’t kill you permanently”.

WHAT THEY ARE

About 30 million Americans get migraines ; they (the headaches) usually don’t hit till the teens or later.

The “classic” migraine’s a funny guy. You get visual or auditory “auras”. You’re thinking “wow! I bet there’s a spiritual relevation coming.” and, POW!, the top of your head blows off.

Mean!

The “common” migraines don’t have explicit auras although you might feel kinda “weird” or sluggish before the pain, itself, hits. The head pain varies but it can get pretty bad. It’s normally one-sided and, in case you’re not miserable enough with just pain,  there’s often nausea/vomiting too.

Far as is known, migraines are probably kicked off by some signal in the brain stem which causes arteries  (including those in the dura which encase the brain) to contract and then dilate abnormally while local levels of dopamine and serotonin (neurotransmitters) go off script too.  This is all sustained by a runaway condition in the temporal artery (a blood vessel near the temple).

WHAT THEY’RE NOT

Other kinds of headaches.

But it can be kinda hard to tell the difference. The Headache Center (Springfield, MO) says that 97% of people who thought they had sinus headaches had migraines.

Makes you wonder, doesn’t it?

WHAT YOU CAN DO

I think, somewhere in here, I’m supposed to tell you to check with your Doc first and (seriously) you should because a bad headache may be a manifestation of a tumor or an intra-cranial bleed or God-Knows-What. It’s hard ENOUGH to get readers, in the first place, I don’t wanna lose one over a missed doctor visit.

However, as a matter of general information, you might like to know the best way to minimize the discomfort and to move on with your life:

1. Take the pain meds your Doc prescribed.

2.  ice packs, cold water, etc to your head/face.

3. Don’t be a hero. Don’t read. Don’t do anything. Lie down in a dark room. Meditate, listen to music, think about ScienceAintSoBad.. restful stuff.

An article on Health Square has more detail and  goes on to describe common triggers and ways to, maybe, dodge some headaches. Worth reading if you’re cursed with this syndrome.

THE NEW STUFF

From a scientific standpoint, there’s still plenty of work to be done here. I won’t bog you down, overly, with long, long shots.

Some of the newest stuff that’s currently on the market: zolmitriptan, Amerge, and a nasal spray version of  Migranol .  (Ask your Doc).

Transcranial Magnetic Stimulation: Uses a dynamic electromagnetic field to knock down the “cortical spreading” waves at the onset of the headaches. It seemed to work about 50% of the time. It’s still very much an experiment.

Wanna go under the knife? If you do, surgical removal of certain trigger sites seems surprisingly good and may even be a surgical “cure” for many.  This is from a joint study led by Bahaman Guyuron, Chairman of Plastic Surgery at Case Medical Center.

Archives of Dermatology offers a small study with  a particularly tough form of the headache which got decent results using botulinum toxin injections. MISTER ScienceAintSoBad wishes there were more data.

A fair sized study done in Philadelphia with a “snorter” (an inhaled drug) called Levadex sounds interesting. According to the (only slightly puffy) description, patients had “significant” relief from symptoms. This was just the study that proves “safety”. Good one to keep an eye on though. Levadex.

Naturally, there are homeopathic “cures” for migraine. Make what you will of my quotation marks.

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(If you want the above cartoon on a t-shirt go here. )


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