Neurological Institute of the East Bay

Here are the posts that have been the most popular with you over the last 3 months!  If you missed any, you might want to check them out.  The most popular posts come first…

• Top 7 ways to stop Weekend Headache
• Enzyme Supplements and Migraine
• How to use Peppermint Oil or Menthol to Fight Migraine
• Gluten-free, Casein-free Diet – for Migraine?
• Nortriptyline for Chronic Pain
• Migraine and Depression: Shared Genetics
• Cyclic Vomiting Syndrome, Migraine, and CoQ10
• A New way to take Toradol
• Women with Migraine and Preeclampsia
• 1% Thursday: Take a Break

From the Headache and Migraine News Blog

Highlights from the last 3 Months (June 2010 edition)

Random other posts:

The Madrid Manifesto signed last month in Madrid, Spain, is a step toward improving migraine treatment and awareness in Europe and around the world.

The World Health Organization ranks migraine as the 12th leading cause of disability in women, and the 19th leading cause overall.  It affects 12-15% of the population, and costs the economy of Europe an estimated €27 billion every year.

And yet, after all that, it’s still often considered "just a headache".  Only 40% of patients are happy with their treatment, and that’s when they even feel confident going to the doctor in the first place.

The European Headache Alliance and its partners wants to see practical steps taken to see real change over the next five years.  That’s why the Madrid Manifesto was signed.

The manifesto first calls on the governments in Europe to be involved.  This includes promoting awareness and research, and focusing on improving quality of life for patients.

Next, a number of targets are listed for the 5 year time frame.  Here are some of them:

• The number of patients satisfied with the management and treatment of their condition should increase to 70% from the current level of 40%.
• Every patient diagnosed with Migraine should receive a proper explanation of the condition and appropriate treatment on their first visit to a healthcare professional.
• Migraine must be recognised as a disability and those affected should receive equal protection under national and European Disability and Employment laws.
• A module in headache/migraine care should be available in every medical training school for General Practitioners.

Some of these things may seem like common sense, but, as many of us know, to actually plan to make it happen is an ambitious goal.

The manifesto will be reviewed each European Migraine Day of Action, which falls on the 12th of September each year.

You can read the full Madrid Manifesto for yourself (it’s only two pages) by visiting the news release from the Migraine Association of Ireland.

From the Headache and Migraine News Blog

The Madrid Manifesto 2010

These other posts might relate:

• Migraine and Tension Type Headache Triggers in Adolescents (new study)
• Cyclic Vomiting Syndrome, Migraine, and CoQ10
• Peripheral Nerve Blocks and Trigger Point Injections – Research Needed

This week: Organize your Medical History.

I’m always reminding you that you need to work with a doctor or specialist who knows your medical history.  Great, but in this modern world you may have several doctors at one time, or several over the years as you move, change doctors, deal with different conditions, etc.

It’s critical that we be responsible for our own health information.  We need to have a handle on it before we can expect our doctors to.  After all, it’s more important to us.  That key to finding treatment may be something your doctor doesn’t even think to ask you.

There’s lots you can do to organize your medical files.  The more organized you are, the better.  However, it’s better to do something than nothing.

So if you don’t do anything else, grab a box and start throwing all your medical information in there.  Simple, yet effective.  A great place to start.

But again, the more organized you are, the better.  For example, do you have a record of all the drugs and supplements you’ve taken over a lifetime?  Doses?  Time taken?  Start now.  What about family medical history?  What conditions and diseases did your grandmother have?  Grandfather?

There are many tools online to help you organize, and many insurance companies have tools to help you as well.  However, be cautious about putting everything in an online system that could be obsolete in a few years.  Keep hard copies.

Ready to get really organized?  Here are a few online resources to get you thinking:

• How to Organise Family Medical Records
• For a Complete Medical History, Compile Your Own Health Records but be Cautious about Storing Them Online
• A host of links from MedlinePlus here.  Mostly related to the USA, but lots of great ideas for anywhere:  Personal Health Records

What is 1% Thursday?

Every Thursday at Headache and Migraine News (weather permitting) we’ll talk about one measurable, practical thing we can do to make our lives just 1% better.  Usually it will be something very easy, sometimes it will be a challenge.  Let us know if you try it, or share an idea of your own – and maybe a year from now we’ll see that things have really changed for the better!

From the Headache and Migraine News Blog

1% Thursday: Your Medical History

These other posts might relate:

• 1% Thursday: Foot Massage
• 1% Thursday: Neither hot nor cold
• 1% Thursday: Take a Break

A study of 1260 students in Germany set out to find out if certain adolescent behaviours were contributing to migraine or tension-type headache (TTH) attacks.

The researchers diagnosed students in grades 10 and 11 (ages 14-20) with either migraine, tension-type headache, and migraine + TTH.  It turns out that about 83.1% had had at least one attack in the last 6 months.  10.2% had migraine, 48.7% had TTH, and 19.8% had combined migraine and TTH.

But were there common factors among students with migraine or TTH?

For the combination TTH and migraine, the common threads were high consumption of cocktails, coffee, and smoking.  A lack of physical activity also seemed to contribute.

For migraine alone, high coffee consumption and a lack of physical activity seemed to be big contributors.

For TTH alone, a lack of physical activity was the only common thread.

So a lack of physical activity seemed to be related to all three.  For both sets with migraine, drinking lots of coffee contributed.

On a fascinating side note, there were a couple of things that didn’t seem connected at all.  Those two things were skipping meals or snacks, and not drinking enough fluids.  These are traditionally mentioned as key triggers, but in this case they didn’t seem to play a role.  Would it be different in adults?

Read the abstract of the study here: Associations of Diet and Lifestyle With Headache in High-School Students: Results From a Cross-Sectional Study

From the Headache and Migraine News Blog

Migraine and Tension Type Headache Triggers in Adolescents (new study)

These other posts might relate:

• Major shift in Migraine Thought? (part 1)
• Trigger points – do they trigger headaches?
• The Headache Screening Questionnaire

First of all, thanks to all of you who ordered the Migraine Barometer.  You used up the company’s supply once again! 

As I mentioned before, we’re hoping to get a larger shipment in soon.  Meanwhile, if you go to the Migraine Barometer page and scroll down, you can ask to be notified if the barometers return.

Now, I wanted to share a few things from around the internet that you might like to check out:

• Genetic research in medication overuse headaches:  Thoughts about the future of treating medication overuse headache from Dr. Alexander Mauskop.
• Tori Spelling & Migraines: Another Famous Migraineur:  Cutting through the gossip and finding migraine.
• Use $1.00 to Help You Measure How Much To Do:  Similar to the Spoon Theory; another way to think about life with chronic pain.
• ER Visits Due to Painkiller Abuse Soaring: Report:  A growing concern, and a reminder to treat drugs responsibly (including drugs you’re not using anymore).
• Strides Arcolab Gets FDA OK For Sumatriptan Succinate Injection:  The title says it all.
• Pediatric Migraine Treatment Practices Vary Widely in ER:  We have a lot to learn about treating migraine in children.

From the Headache and Migraine News Blog

Monday Notes (21 June 2010)

These other posts might relate:

• Cyclic Vomiting Syndrome, Migraine, and CoQ10
• Migraine Barometer – Back for a limited time!
• How Disabled is your Child with Migraine?

This week:  Try massaging your feet when your head hurts.

I’ve written before about reflexology for migraine, so it’s no secret that I’m not convinced by the evidence for reflexology in particular.  Then again, I am convinced that foot massage in general is a powerful tool to fight headache.

It’s no secret that how you treat your feet impacts your whole body.  (Read more about the head-and-foot connection in this issue of HeadWay.)  You might want to talk to your masseuse or masseur about giving you a foot massage next time you have head pain.

Then again, you might not need to spend hundreds of dollars to get some relief.  Believe it or not, a good foot roller can make quite a difference when that headache is beginning.  This very highly rated foot roller from amazon is only $15 (as I write), and you’ll see it has a bit of a twist from the normal foot rollers you’ve seen before.

Of course, another option is to have a friend do a good, deep massage on your feet when you feel that migraine attack coming on.

Whatever you do, try to get some good foot massage in next time you’re looking forward to an attack.  You might find your feet can really help your head.

What is 1% Thursday?

Every Thursday at Headache and Migraine News (weather permitting) we’ll talk about one measurable, practical thing we can do to make our lives just 1% better.  Usually it will be something very easy, sometimes it will be a challenge.  Let us know if you try it, or share an idea of your own – and maybe a year from now we’ll see that things have really changed for the better!

From the Headache and Migraine News Blog

1% Thursday: Foot Massage

These other posts might relate:

• 1% Thursday: Try a New Massage
• 1% Thursday: Neither hot nor cold
• 1% Thursday: Take a Break

The ever-popular topic of migraine and food was the theme of this month’s Headache and Migraine Disease Blog Carnival.  As you might imagine, it was a hot topic, with a lot of entries!

Staying on topic but taking a different slant, I entered my post Enzyme Supplements and Migraine.  If you haven’t read it, check it out and leave your comments.

There were lots of other good posts, but let me recommend a few especially:

• Food and Migraines – Friends? Enemies?  A quick introduction to elimination diets for migraine.
• Saccharomyces Cerevisiae Antibodies  Don’t be intimidated by the title – this is a useful addition to the discussion about migraine and yeast.
• Making food my medicine: Quotes to motivate  Awesome quotes to motivate us to use diet as a weapon against migraine.

Be sure to check out the full list of entries here:  June 2010 Headache Blog Carnival: Food, Glorious Food.  Read more about migraine and diet here.

From the Headache and Migraine News Blog

June 2010 Headache and Migraine Disease Blog Carnival

These other posts might relate:

• Do “Migraine Diets” have this in Common?
• Helping Family and Friends: Headache & Migraine Disease Blog Carnival
• Increased risk of Migraine and Heart Disease – new study

Cyclic Vomiting Syndrome (CVS) in children has been closely related to migraine.  In fact, the symptoms are common in migraine, and recent studies suggest that CVS may actually be a type of migraine.  Abdominal migraine is common in children, and stomach pain and vomiting are common (more on abdominal migraine symptoms).

Various treatments have been used for abdominal migraine and CVS – many familiar to migraineurs in general, such as biofeedback, beta-blockers, and triptans.  Another common treatment is amitriptyline, a tricyclic antidepressant with brand names such as Endep and Elavil.

Coenzyme Q10 is increasingly popular as a migraine preventative, in part because of its few side effects.  So, a study published in January (2010) set out to compare amitriptyline with co-enzyme Q10 (CoQ10) as a treatment for CVS.  162 patients took amitriptyline, and 22 took CoQ10.

Patients were watched for common aspects of a CVS attack – frequency, duration, number of times child throws up, nausea severity.  72% of the patients taking amitriptyline saw at least a 50% reduction in one of these things.  68% of patients taking coenzyme Q10 experienced at least a 50% reduction in one of these things.

So, amitriptyline is "better", right?  Not so fast.

50% of patients reported side effects with the amitriptyline, and in fact 21% had to discontinue treatment!

Side effects with the coQ10?  0% of patients.  None.

Not only is this an encouraging result for those thinking of trying CoQ10 for CVS, it’s also encouraging for (other) migraine patients who are thinking about it.  CoQ10 continues to be a good option with very few side effects.  It’s an up-and-coming preventative for children as well as adults.

For a more in-depth discussion of coenzyme Q10 and migraine, read this article.

From the Headache and Migraine News Blog

Cyclic Vomiting Syndrome, Migraine, and CoQ10

These other posts might relate:

• Fight Migraine: Be nice to your Mitochondria
• Vertigo in Children
• “Premonitory” Symptoms of Migraine in Children

Breaking News:  So here’s the deal.  I know a lot of you have been waiting for the Migraine Barometer to come back.  There have been problems with the manufacturer keeping up with the orders.

So, here’s what has happened.  There are a limited number of units now available (about a hundred, though that’s probably out of date by the time you read this!).  So what I’ve done is put up the order page for those of you who are interested.  I will keep it up until we’re out of barometers again.

We’re hoping for a large shipment soon – more like 600.  But I don’t know when that will be!  So once I get word that those are in, hopefully we can keep the order page up again for a while!  Let’s make sure they get the message that we want these barometers to stay available. 

For more about the connection between weather and migraine, check here.  For more about the Migraine Barometer, check here.

Or, go directly to the Migraine Barometer order page!

From the Headache and Migraine News Blog

Migraine Barometer – Back for a limited time!

These other posts might relate:

• The Migraine Barometer – Coming Back!
• Using a barometer for migraine
• Finally – The Migraine Barometer Returns!

More research is needed to investigate peripheral nerve blocks and trigger point injections for headache treatment, say researchers in the USA.

Last month the journal Headache published a review of the research on nerve blocks and trigger point injections for various types of headache, including cluster headache and migraine.

The results were generally positive – there does seem to be value in these types of treatment.

That being said, this field of research is somewhat chaotic.  There is little agreement on how to go about the treatments, and the research is actually very limited.

Seeing positive results so often, it’s time to do more extensive and serious research.  This will continue to be an important field of study.

For example, this month researches in Milan, Italy published an evaluation of a treatment they’ve been using for the past five years – the sphenopalatine endoscopic ganglion block for cluster headache.  The treatment involves an injection of anesthetics and corticosteroids.

Similar treatment for cluster headache has been used in other countries even longer.  It’s a temporary relief, however it’s been a real help to many patients.  The interesting thing is that it’s successful in chronic cluster patients who were not responding to drugs.

These types of techniques are valuable because they may provide an option for others who are not responding well to drugs, but are not wanting to jump to invasive surgical procedures.

But we need more research to evaluate how to best choose treatment for individual patients.

From the Headache and Migraine News Blog

Peripheral Nerve Blocks and Trigger Point Injections – Research Needed

These other posts might relate:

• Allodynia: A feature of Cluster as well as Migraine?
• Cluster or Migraine: What’s the Difference?
• Capsaicin – A Little Cayenne with your Migraine?