Neurological Institute of the East Bay

Migraine.  Maybe you have to see it to believe it.

For a long time visitors have been sharing their art and photos with us (what am I saying?  Photos are art!).  They are trying to describe some aspect of their migraine attacks visually, so we can understand just a little bit better.

I put all the entries together in a video over a year and a half ago, but there is so much new art I decided it was time for an update!

So here is a glimpse of the art from so many of our visitors.  You can take a closer look, find out who the creator is and what they have to say about their art, and even leave your own comments and ratings, by visiting our Migraine, headache, and art page.  Scroll to the bottom for links to each picture, or upload your own art!

(Note – some of this art is disturbing.  Which is, of course, appropriate considering the topic!)

From the Headache and Migraine News Blog

Migraine Art Video (take 2)

These other posts might relate:

• Migraine Art (video)
• Migraine art slideshow
• Ask and ye shall receive (migraine art revisited)

This week: Try to incorporate migraine-fighting foods into your diet.

First, a word about what migraine-fighting foods are not.  They are not foods that are specifically clinically proven to give you less migraine attacks (that would actually be very hard to prove).  They are not foods that will instantly halt a migraine attack.

I’ve read articles making great claims about certain super-foods, but when it comes right down to it food combinations are complex, and people are complex.  The best way to fight migraine is a healthy, well-balanced natural diet.

That being said, there are certain foods that may be higher in certain vitamins, or contain certain chemicals, that are known to be helpful for migraine patients for various reasons.  And there are foods that are less likely to trigger an attack.  Plus, adding foods to your diet that are natural is a great way to add variety to your diet, and explore.

But remember – you’re an individual.  If you find one of these foods to be a trigger, it’s best to avoid.  Generally speaking, here are some foods you might want to try adding to your diet, the most important being the vegetables and grains:

Peppermint, cayenne pepper, ginger, fish, spinach, broccoli, kale, oatmeal, garlic, duck, cottage cheese.

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: Migraine-fighting foods?

These other posts might relate:

• 1% Thursday: Develop Your Team
• 1% Thursday: Your Medication
• 1% Thursday: Your Medical History

Here are the posts that have been the most popular with our visitors.  The biggest hits are at the top of the list!  Feel free to share your comments.

• Enzyme Supplements and Migraine
• Nortriptyline for Chronic Pain
• Cyclic Vomiting Syndrome, Migraine, and CoQ10
• Migraine and Depression: Shared Genetics
• Those with Migraine still Stigmatized
• Grape Seed Extract – Next for Migraine?
• Women with Migraine and Preeclampsia
• 1% Thursday: Your Medication
• Migraine and REM Sleep
• The Madrid Manifesto 2010

From the Headache and Migraine News Blog

Highlights from the past 3 Months (July 2010 edition)

Random other posts:

It can … but not as much as we hoped, according to researchers in the University of Turin, Italy.

In a study published online last week, researchers reported on 198 women that suffered from menstrually related migraine.  After one or two months of observation, patients were given 50-200mg of topiramate per day for six months.

The good news is that the women had fewer migraine attacks.  Of course, this was not a blind study – patients knew they were getting treatment, which means we need to be aware of a significant placebo effect.  Still, the significant decrease in attacks is encouraging.

On the other hand, the attacks that did come were no less severe, and were not shorter than normal.

There was no difference with patients who had aura, or in patients that took oral contraceptives.

Topamax (topiramate) may help, it seems, but women will probably want to be on the lookout for other treatments, either in combination or instead of just Topamax.

More about this study: Perimenstrual migraines and their response to preventive therapy with topiramate.

Menstrual migraine – real pain, real solutions

From the Headache and Migraine News Blog

Menstrual Migraine: Will Topamax Help?

These other posts might relate:

• Generic Medications – The same but different?
• New Migraine Topamax study: Adolescents
• Migraine patients more sensitive to Topamax?

I admit, I was a bit surprised about the results of our last poll.

The question was: Has migraine/cluster/chronic headache impacted your choice of job/career?

Here’s the result:

Yes, a full 88% said YES.

Of course I knew about the incredible impact of these diseases and conditions.  But I still expected the ratio to be lower.

Now, of course, this isn’t a scientific poll.  Likely there are more people with more chronic forms of migraine and cluster and headaches.

Still, it’s a great reminder that for many people this is not an annoyance on the side – these are major, life-impacting condition.

Now, you’ve told us yes or no.  I would like to hear from the "yes" group.  Exactly how has your decision-making been impacted?  Give us examples.

Did you move to be closer to better treatment?  Did you lighten your workload?  How?  Change your work hours?  What has helped?  What hasn’t helped?  Share your comments below.

Here are some previous posts pointing out the impact of migraine in particular on society:  The Impact of Migraine in society, How does migraine really impact your life?, and an overview in What is Migraine? (The Life Impact Story)

From the Headache and Migraine News Blog

Impact of Migraine/Cluster/Headache on Job Decisions

These other posts might relate:

• How to be a better Headache or Migraine Doctor

This week: Think about how you can develop your team of medical professionals.

Yesterday I was reading an article about how to approach your doctor with new information and ideas.  It was a brief article with useful ideas about how to approach your doctor with respect.

But this statement caught me off guard: Problems can arise if you just appear to be trying to drive your own care.

I hate to break it to you, but you bet I’m trying to drive my own care.

Oh, don’t get me wrong – I have great respect for doctors and specialists.  I respect them for their experience and training.  They know things I don’t know.  I usually take my doctor’s advice – but I may ask why and ask about alternatives.

Doctors don’t have the same focus on my condition that I do.  It’s not their fault, just the way the system works.

Things get more complex when you’re working with a general practitioner, a chiropractor, a neurologist, and a pharmacist all at the same time.  And if you have a chronic condition, the list is likely longer and growing over time.  Dentist?  Optometrist?

It’s crucial that you stop thinking about all these health care providers as islands unto themselves.  It’s up to you to turn them into a team that can help you find the best treatment.

I’m not saying you put yourself at the centre of the world.  These are real people with their own lives and other patients.  Let’s not get selfish here.

However, if you want to make the best use of their time and yours, and get the best treatment for you and your family, you need to make it easy for them to work together.  You’re the person that has to make it happen.

Think about the how this week.  For example, are there health records that could be shared?  Do you have a handle on your own health information?  What about your family medical history?  Does your doctor know you’re seeing the chiropractor?  Did you tell your neurologist about the natural health expert you talked to, and what they gave you?

The members of your team may not always agree with one another – that’s fine.  But you can make better decisions if you hear what they all have to say.

Drive your own care – but do it with respect and kindness – then everybody wins.

Thanks, by the way, to the authors of What’s Wrong With Me? for really getting me thinking on this key issue.

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: Develop Your Team

These other posts might relate:

• 1% Thursday: Your Medication
• 1% Thursday: Your Medical History
• 1% Thursday: Foot Massage

Deep Brain Stimulation (DBS) is a treatment that is showing great promise when it comes to treating cluster.  Unfortunately, many people know very little about it.

DBS is probably most well known as a treatment for Parkinson’s disease, though it’s used for a variety of conditions, including cluster headache.

Though much of the mechanism of cluster remains a mystery, we do know that the posterior hypothalamus is involved.  The posterior hypothalamus is part of the hypothalamus part of your brain, located just above the brain stem.  Like migraine, there is likely a complex web of reactions going on that impact cluster.  However, the posterior hypothalamus seems to be a key part of the process.

So what would happen if we could stimulate this part of the brain directly?

DBS uses a battery operated device known as a neurostimulator.  This small device is surgically implanted.  It’s then able to target the posterior hypothalamus and deliver electric stimulation.

The neurostimulator itself is not in contact with the target area.  Instead, a lead/electrode wire is placed in the target area.  Then an extension connects the lead to the neurostimulator itself.  Multiple leads may be implanted in target areas.

Once the system is in place, it can be adjusted without further surgery.

Who is this treatment for?  The best candidate for deep brain stimulation is someone with chronic cluster headache.  In fact, it’s been suggested that even stricter criteria be used: patients who are the best candidates are ones who have attacks almost every day.  Also, these patients are usually not helped by the standard drug treatments.

Recently, researchers have started investigating the uses of DBS in other parts of the brain, such as the midbrain tegmentum.  We may find that some patients respond better to stimulation in one area, and others improve with stimulation in another area.

The good and the bad of deep brain stimulation for cluster…

The good news is that the surgery is generally safe.  However, that does come with a word of caution.  It’s important to have an expert team perform the surgery – if possible, someone with experience with DBS for cluster, since there are unique challenges for cluster patients.  The patient needs to be monitored to avoid problems such as bleeding and infection and issues with wire placement.  Usually these are not major problems, and treatment can be continued.  But you do need an expert who knows how to deal with them.

It’s also important to realize that improvement is not immediate.  Usually several weeks of stimulation are required before there is a real change.

The other challenge with DBS is that it’s still relatively new.  Yes, we have about 10 years of experience using it for cluster.  But chronic cluster is so rare that we’re still only talking about a few dozen patients.  More studies need to be done to understand how best to use DBS.

DBS seems to help about 60% of chronic cluster patients.  The good news is that those 60% end up almost pain-free.  And this is without drugs, which means a lower overall cost as well.

For more details on the use of DBS for cluster, read:  Deep brain stimulation in trigeminal autonomic cephalalgias. (2010 overview)  and DEEP BRAIN STIMULATION TREATMENT FOR CLUSTER HEADACHE (more in-depth overview from 2005).

Also check out Cluster or Migraine: What’s the Difference?

From the Headache and Migraine News Blog

Deep Brain Stimulation is helping Chronic Cluster Patients

These other posts might relate:

• Peripheral Nerve Blocks and Trigger Point Injections – Research Needed
• Cluster Headache: Seeing is one step closer to believing
• Allodynia: A feature of Cluster as well as Migraine?

Can you believe it?  For the first time I totally missed posting for 1% Thursday.  Not that I wasn’t thinking about it, mind you.  But with other responsibilities (and, of course, health issues!) I just wasn’t able to get it up.

However, here’s hoping that 1% Thursday will be back this week.

There’s lots more coming up, as always.  For example, we’ll be talking about an important cluster headache treatment that’s getting more and more attention these days.  Also, I’m looking at a natural therapy device for chronic pain.  Looks promising, but I want to give it a good try before writing about it.

Hope you’re all having a good summer or winter (depending on where you are!).  Thanks to all those who are commenting on the Facebook page and in the comments here – be sure to check out some of the great things our visitors have had to say recently!

From the Headache and Migraine News Blog

Missed it!

Random other posts:

Could grape seed extract be the next big supplement used to combat migraine?  Researchers at the Missouri State University think it may be.

Grape seed extract has been researched heavily in the last few months.  It shows a lot of promise in areas such as fighting hyperglycemia and its antioxidant properties.

This was another trial on rats.  Some were fed regular water, others water with grape seed extract.  Otherwise, their diet was normal.

The results showed that the grape seed extract helped to fight inflammation, and suppressed reaction which seem to stimulate "central sensitization" – a key part of the migraine chain-reaction.

The researchers felt that the evidence was strong for the trial of grape seed extract (GSE) in migraine patients.  They write:

Based on our findings, we predict that inclusion of GSE as a dietary supplement would be beneficial as a natural therapeutic option for chronic migraine as well as other chronic pain conditions involving the head and face.

The report was given at the 52nd Annual Meeting of the American Headache Society last month.

From the Headache and Migraine News Blog

Grape Seed Extract – Next for Migraine?

These other posts might relate:

• Chocolate for Migraine?

After all we’ve learned about the biology of migraine in the past 15 years or so, you’d think that more people would realize the seriousness of this disabling disease.  Still, a recent study suggests that there is still a stigma attached to people with migraine – and an even worse stigma if you have chronic migraine.

The research took place at the Jefferson Headache Center in Philadelphia, USA.  It was led by Dr. Jung E. Park.  Park explains why she was interesting in this research:  "Many diseases like HIV, mental illness, and cancer can be highly stigmatizing, resulting in depression, anxiety, decreased quality of life, and disruption of social relationships.  Our goal was to understand how stigma attaches to migraine."

The research team used a recently developed tool known as the Stigma Scale for Chronic Illness (SSCI).  This allowed them to compare the stigma of migraine with the stigma of other types of illness.

The study found that those with migraine suffered from a stigma similar to the stigma of such illnesses as stroke, epilepsy, multiple sclerosis, Alzheimer’s, ALS and Parkinson’s disease.  But the surprise came when they looked at chronic migraine.

The stigma associated with chronic migraine was significantly higher – much higher than the stigma of migraine itself or any other of the illnesses just mentioned.

The researchers were also suprised that there wasn’t a strong connection between stigma and quality of life or disability.  For example, someone more disabled was not stigmatized much more or less than someone less disabled.

The study was presented at the American Headache Society’s 52nd Annual Scientific Meeting last month.  The president of the AHS, Dr. David Dodick, notes:  "It is as important to understand the impact of migraine on patient quality of life as it is to understand its medical and physiological impact.  Our hope is that work like this will ultimately aid in the development of public health strategies to combat the stigmatizing effects of migraine."

We can all hope.  The other issue is, as Dr. Park notes, stigma can have a negative effect on the patient – depression and anxiety can increase, for example.  And if this stigma reaches into the medical community (as we know it does), then it can drastically impact the quality of treatment a migraine patient gets.

Read more about the study here:  Stigma of migraine is significant; worse for those with chronic migraine

From the Headache and Migraine News Blog

Those with Migraine still Stigmatized

These other posts might relate:

• 15 Diseases, disorders and syndromes that go along with Migraine
• Migraine and Depression: Shared Genetics
• Allodynia: A feature of Cluster as well as Migraine?