Children with thyroid disease are more likely to have headaches, according to a study done by Dr. David Rothner and his colleagues at the Cleveland Clinic. 36% of children with hypothyroidism and 19% with hyperthyroidism had headaches. The types of headaches observed included chronic migraine and new daily persistent headache. The authors conclude that thyroid testing should be part of a standard evaluation of headaches in children, just like it is in adults.
Read MoreScience of Migraine
A study conducted by one of the leading headache researchers, Dr. Richard Lipton looked at possible factors that worsen migraine headaches. The study looked at people with frequent migraines (15 or more days with headache a month) and found that these patients were more likely to be female, overweight, depressed, have a lower education level and overused medications. The overused medications included narcotics, barbiturates (Fioricet, Fiorinal and Esgic) but also over-the-c0unter drugs such as Excedrin. The only exception was aspirin – it appeared to be protective, that is people taking aspirin were less likely to develop chronic headaches. Dietary caffeine and stresful life events were also more common prior to development of chronic migraines.
Read MoreFor many years headaches were thought to be triggered by elevated blood pressure. Evidence had suggested that only very sudden increase in blood pressure triggered a headache in some patients, but the myth of high blood pressure headaches has persisted. Norwegian researchers published a very surprising finding in the April issue of journal Neurology. They looked at the data on 120,000 people and found that increasing systolic blood pressure was associated with a decrease in migraine and non-migraine headaches. Even more striking was the inverse correlation with the pulse pressure (difference between systolic and diastolic pressure, for example blood pressure of 110/80 means that the pulse pressure is 30). Patients with higher pulse pressure had fewer migraine and other headaches. It can be speculated that hardening of arteries that occurs with elevated blood pressure makes them less likely to constrict and dilate, which is part of a migraine process.
Read MoreScientists in Trieste, Italy suggested a new approach to the treatment of migraine headaches. They hypothesized that combining two different approaches would yield better outcomes than either one alone. A neurotransmitter CGRP antagonists appear to be effective in the treatment of an acute migraine. Merck has a product in late stages of development that works through this mechanism and hopefully will be the first of a new class of migraine drugs. Based on laboratory research the Italian group suggests that combining a CGRP antagonist with a blocker of nerve growth factor may result in a more effective treatment. This fits with a new trend in treatment of many conditions – combining drugs that work in different ways, rather than trying to always use a single medication.
Read MoreHow long will I suffer from migraines? Will it ever go away? These are very common questions patients ask their doctors. Drs. Bigal and Lipton reviewed a recent large study that looked at what happens to migraine patients within one year of observation. The study found that migraine completely went away in 10%, improved in 3% and worsened and became chronic (occurring on more than 15 days each month) in 3%. This confirms what we’ve know all along – migraine headaches tend to go away with age. In women this often happens after menopause and in men at around similar age; however this study and our experience indicates that for many people migraines may go away earlier, at any point in their lives. The problem is that we can never predict when this will happen and in a small percentage of patients (about 3%) migraines never go away.
For many years migraines have been thought to occur more often in left-handed people, but a new study from Germany disputes this theory. A recent study published in journal Cephalalgia looked at 100 people with migraines and 100 controls and also reviewed five similar studies and found no difference in the incidence of migraines in left-handed and right-handed people. This has been the observation at our headache clinic as well.
Read MoreMigraine is most likely to occur at noon, according to an article just published in Headache by Norwegian researchers. Although only 58 patients participated in this year-long study, there was a very clear peak of occurrence at noon. This finding is different from what was reported in previous studies, which suggested that the most likely time for a migraine attack is in early morning hours. The authors speculate that the restorative effects of sleep and work stress may be responsible for their finding.
Read MoreMigraine does not cause cognitive impairment, according to a new Danish twin study. This important finding reassures millions of migraine sufferers and confirms our clinical observation.  Another recent study in mice suggested that inducing brain changes similar to what occurs during a migraine attack in humans can cause brain damage. This report was widely circulated in the media and has caused unnecessary anxiety in many migraine sufferers.  Clearly, whatever those mice experienced was not a migraine attack and, more importantly, brains of mice are very different from human brains.Â
The Danish study looked at 139 pairs of twins where one of the twins had migraines and the other one did not. Comparing their cognitive abilities revealed no difference for those who had migraine with or without aura, even after taking into account age, age of onset, duration of migraine history and number of attacks. Presence of aura is thought to indicate a more serious condition with a slight increase in the risk of stroke. However, on one cognitive test, men with migraine with aura did better than their twin without migraines.
Read MoreA recent study published in Neurology showed that migraine sufferers have thicker gray matter in the part of the brain that perceives pain. Thickening of the gray matter indicates larger number of brain cells in that area, which is not necessarily a bad thing. However, all of the commentary in the media suggests that this is another indication of brain damage in migraine patients. This study is not a cause for alarm and all of the previous research also indicates that the vast majority of migraine sufferers are not at risk of brain damage.
Read MoreMigraine is known to subside in most people, often when they reach their 40s or 50s.  A recent report from Sweden suggests that even patients with more severe migraines who end up going to a headache clinic have favorable long-term prognosis. One third of both men and women reported complete cessation of their migraines. Of the other two thirds the majority reported reduction in frequency and duration of attacks 12 years after their initial visit to the headache clinic. The bad news is that many of the patients who continued to have headaches still had some impairment of quality of life.
Read MorePain of migraine can be localized to the face and around the mouth according a two recent reports. Dr. Gaul and colleagues reported in journal Cephalalgia on two patients who had dental pain as well as typical migraine symptoms, including throbbing, sensitivity to light and noise and in one of the patients visual aura (flickering colorful lights) preceding the attack. This report confirms the fact that pain of migraine can occur anywhere in the head, including teeth, eyes, ears, forehead, top or back of the head.
Read MoreDr. Tietjen reports in the current issue of Neurology on a survey performed at six headache clinics. A total of 949 women with migraine completed the survey: 40% had chronic headache (that is headaches occuring on more than 15 days each month) and 72% had “very severe” headache-related disability. Major depression was recorded in 18%. Physical or sexual abuse was reported in 38%, and 12% reported both physical and sexual abuse in the past. Migraineurs with current major depression reported physical and sexual abuse in higher frequencies compared to those without depression. Women with major depression were more likely to report sexual abuse occurring before age 12 years and the relationship was stronger when abuse occurred both before and after age 12 years. Women with major depression were also twice as likely to report multiple types of maltreatment compared to those without depression. Similar findings have been reported in patients with chronic pain other than headaches. Brains of migraine sufferers have been found to be more excitable than brains of people without migraines. It is likely that trauma of abuse makes the nervous system even more excitable and more prone to developing chronic pain and headaches.
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