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Monday, September 19, 2011

NHF Regional Conference - Part II

Migraine Triggers
Dr. Frederick Freitag

Dr. Freitag recently stepped down as co-director of the Diamond Headache Clinic in Chicago, IL. His new position is at Baylor University Medical Center in Dallas, TX. He is very active in headache initiatives (including clinical research, lecturing, etc...).

Migraine Facts:
  • 1 in 4 households has a migraine sufferer
  • Migraine affects women more than men (3:1)
  • ~30 million people in the U.S. have migraine
  • 12-18% of the population have migraine (more than asthma and diabetes combined)
  • If one parent has migraine, his/her child has ~50% chance of also having migraine
  • 75% of migraine sufferers have neck pain/tenderness


Migraine is...
  • Genetic - brain programmed to be sensitive
  • Hyperexcitability / hypersensitivity of the brain
  • Neurologic process
  • Whole-body disorder
  • Chronic systemic disease
  • Attacks vary (between migraineurs and migraine attacks)
  • May be progressive
  • SULTANS --
    • (moderate to) Severe pain
    • Uni-Lateral
    • Throbbing
    • Aggravated by activity
    • Nausea or vomiting
    • Sensitivity to light and sound (environmental)


Premonitory Phase (can include any combination of the following symptoms):
  • Fatigue
  • Thirst
  • Yawning
  • Dizziness
  • Increased energy
  • Food cravings
  • Frequent urination
  • Poor concentration
  • Hypersensitivity to sound
  • Neck pain/tightness
  • Blurred vision
  • Irritability/emotional


Aura - builds gradually 5-60 minutes (usually visual)

Prodrome Phase ("Migraine Hangover") can include any combination of the symptoms from the Premonitory Phase

Comorbidities (more prevalent in people with migraines than the normal population):
  • Depression
  • Anxiety
  • Bipolar
  • Obsessive-compulsive disorder (OCD)
  • Panic
  • Sleep disorders
  • Heart disease
  • Irritable bowel syndrome (IBS)
  • Fibromyalgia
  • Stroke
  • Obesity
  • Migral valve prolapse
  • Back/neck pain
  • Patent foramen ovale (PFO)


Risk Factors (Triggers):
  • Stress (or let down)
  • Hormonal changes
  • Diet (skipping meals; specific foods)
  • Sleep disruptions
  • Weather
  • Head trauma


Food Triggers (not an exhaustive list):
  • Additives - aspartame, MSG
  • Vasoactive amines - aged cheddar, fava beans, soy products, left overs, lunch meats
  • Other foods - long list of possible food triggers
  • Alcohol - red wine, other wines/beers
  • Caffeine


Protective Factors:
  • Eat regular meals
  • Standardized sleep pattern
  • Exercise
  • Stress management (biofeedback, recreation/have fun, massage)
  • Post-menopause

2 comments:

  1. My pain is almost always bilateral...however tends to be worse on the left side. My type is also Basilar Migraine, so I think that might be an exception. Not sure...better go Web Md it!

    I also did not realize Migraine was more prevalent in people with Mitral Valve Prolapse (MVP)...which I have. I'll have to ask my neuro what she thinks!

    ReplyDelete
  2. Jessica - My migraines are also almost always bilateral... not sure why.

    ReplyDelete