Friday, August 05, 2005

Migraine

Migraine

Migraine (2001)

From MAGNUM -- the Migraine Awareness Group:

"One pill makes you larger, and one pill makes you small and the ones that mother gives you, don't do anything at all," words the Cheshire-Cat could have uttered, but they came to us from Grace Slick in her iconoclastic lyrical interpretation of 'Alice In Wonderland'. Over a hundred years ago a fine art photographer took us on a wonderful journey through the eyes of Alice. The photographer-turned-writer drew from his personal experience with the disease he so suffered from, that of Migraine. His name was Lewis Carroll, and one may argue that if it were not for his constant Migraine attacks, he may not have been inspired to give us these gifts of fantasy by writing Alice's Adventures in Wonderland and Through the Looking-Glass and What Alice Found There.

After a century of society and the medical community blaming Migraines on their sufferers, advanced technology and the age of information gave us the knowledge to begin to understand this debilitating disease. However, dangerous and outdated myths surrounding the Migraine disease have not yet been dispelled on a widespread basis. Not only are such myths believed by many loved ones and co-workers of those with Migraines, but by those with Migraines themselves (Migraineurs). Furthermore, such myths continue to be unwittingly reported in the media. The Migraine disease is a serious health and disability problem that affects approximately 32 million Americans, most of whom are women, with up to 38 million Americans having Migraine genetic propensity. There is no known cure for the Migraine disease, only treatments for the symptoms. Furthermore, such treatments are not yet wholly effective and Migraineurs may show a diminished tolerance to a variety of medications, treatments, and pain management regiments.

[...]

Migraine is disease, a headache is only a symptom. Migraine pain is caused by vasodilation in the cranial blood vessels (expansion of the blood vessels), while headache pain is caused by vasoconstriction (narrowing of the blood vessels). During a migraine, inflammation of the tissue surrounding the brain, i.e., neurogenic inflammation, exacerbates the pain. Therefore, medicine often prescribed to treat a headache, such as beta-blockers, dilate the blood vessels and therefore can make a Migraine worse.

Unlike a headache, the Migraine disease has many symptoms, including nausea, vomiting, auras (light spots), sensitivity to light and sound, numbness, difficulty in speech, and severe semihemispherical head pain. One Migraine attack alone can last for eight hours, several days, or even weeks.

From the Medem Medical Library:

Migraine pain is typically associated with alternate constricting and relaxing of blood vessels in the brain. However, in recent years researchers have also focused attention on alterations in nerve pathways and imbalances in brain chemistry. The trigeminal nerve system is a major pain pathway; serotonin, a neurotransmitter or nerve chemical, regulates pain messages passing through the trigeminal nerve system. A malfunction or chemical imbalance in this system is believed to be an underlying cause of headaches, including migraines.

There are many possible triggers of migraine pain. Triggers themselves do not cause pain; instead, they activate already existing brain chemical imbalances. Triggers vary from person to person, but may include hormonal fluctuations caused by birth control pill use, hormone replacement therapy, and premenstrual syndrome. In women who have migraines, more than half occur right before, during or directly after their period. Migraines diminish in many women following menopause.

Other triggers include physical or mental stress, changes in sleep patterns, allergic reactions, smoking or exposure to secondhand smoke, bright lights, loud noises, alcohol, caffeine and missed meals. Diet is widely implicated in migraine. Possible dietary triggers include foods that contain the amino acid tyramine (including red wine, aged cheese, figs, chicken livers and smoked fish), chocolate, processed foods, food additives (such as monosodium glutamate [MSG]), meats containing nitrates (including hot dogs, bacon and salami), nuts, peanut butter, dairy products, onions and certain fruits (such as avocados and bananas).

No joke.  My brain hurts.

Art by Migraine Sufferers
[From the New Zealand Migraine Sufferers Support Group]

From ACHE -- "Genes and Migraine" by Kathy Gardner, MD:

Many migraineurs have other family members who also suffer with migraine headache. Mom used to have migraine headaches with her menstrual cycle, grandmother once had "sick" headaches, and brother has "sinus" headaches which are less severe but sound strangely similar to migraine if you ask questions about symptoms and triggers.

For years scientists have argued whether disorders such as migraine that tend to run in families do so because of shared genes or the shared environment. People often assume that any disorder that occurs in several family members must be genetic. However, families tend to share similar diets, exposures and lifestyles, all of which might be involved in making someone susceptible to a specific disorder. A combination of genetic and environmental factors seems to be the best overall explanation for most common disorders, including migraine.

Nevertheless, the fact that you occasionally find large families with many members suffering from migraine suggest a stronger genetic basis for those particular families. As it turns out, a definite inheritance pattern has been found in a few families who suffer with a severe form of migraine called hemiplegic migraine.

And from the American Academy of Family Physicians:

How do children describe their migraine headaches?

    • "It feels like my heart is pounding in my head."
    • "All I want to do is throw up."
    • "It is like being inside a big bass drum."
    • "I just want to go into a dark room and lie down."

Although I am fortunate not to suffer from migraines, some of my friends endure them. These "headaches" seem more like "episodes" or "attacks" to me -- occurring in patterns somewhat similar to epilepsy and Meniere's Disease.

Today's image may stem from the fact that I sympathize with migraineurs because I suffer from Meniere's Disease and periodically have to cope with bouts of intense vertigo and nausea -- not to mention permanent hearing loss and tinnitus.

I strongly suspect my disorder is genetic, and I know it's definitely not "all in my head." My experience leads me to make the same assumptions about migraineurs.

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