Posts Tagged ‘prevalence of migraine’

Dr. William Young and Dr. Stephen Silberstein are two of the many headache specialists who have furthered our understanding of migraine disease. I would classify their book, Migraines and Other Headaches (2004), as one of the “must haves” for migraine sufferers. It is a perfect introduction to the topic of migraine disease so it could easily be a “first read” for migraineurs. There is enough new material so even well read migraineurs will benefit from reading this book. Eucation about migraine disease and the necessity in having a strong patient-doctor team are two threads that are carried throughout the book.

“It is important to realize the difference between a headache cause and a headache trigger. Among other things, stress and weather changes can trigger a [migraine] headache….A brain tumor, a high fever or head trauma can cause a headache” (p. 19).

Usually well-meaning friends and family pinpoint certain foods as causing migraines. I am sure most of you have heard something along this line, “My husband’s second cousin’s wife had migraines and ever since she stopped eating chicken (beef, pork, chocoloate, brocolli, seafood) her headaches have stopped.” The authors make it clear that foods are NOT a cause of migraine, but they can be triggers. However, they were not as clear about other factors.

The scenario they chose to illustrate the difference between causes and triggers was less than helpful. They introduced a migraineur with easily treatable migraines who developed a change in her migraine pattern and a new headache. The change was caused by a herniated disk that, when corrected, reverted her to the previous migraine pattern. The authors did not make it clear that the herniated disk triggered more severe migraines and caused the new head and neck pain. They failed to emphasize that even after the herniation was corrected that the woman still had migraines and that, it could not be the cause of her migraine attacks. A less than careful reader may decided that migraines are caused by herniated disks. While that may be obviously not the case (not all migraineurs have herniated disks), I have had more than one person tell me that my migraines are caused by the problems in my neck.

Some readers may consider this to be a minor point, but my biggest battle is in explaning the difference and that, because there is no one discernable cause, migraine has no cure. There is no silver bullet.

“Headache treatment should be a two-way street, with the patient contributing a goal and desires about his headache mangagement, the physician contributing her knowledge and values, and the final plan incorporating both perspectives.” (p. 45)

Balance, give and take, progress and regress are all a part of living with migraine. Nowhere is this more evident that in the doctor-patient relationship. The authors encourage open communication about goals and expected outcomes. Migraineurs are encouraged to share their experiences, expectations, and goals with their caregivers. Physicians have the responsibility of educating their patients, letting them know what is known and not known about migraine. They need to let their patients know what is a reasonable treatment outcome. Young and Silberstein equally encourage patients to have reasonable and acheivable goals. Migraine is complex and treatment is often individualized. It takes time to acheive proper migraine managementPatients have the responsibility in making some lifestlye changes.

I found this book to be a useful resource, but I also have one more concern. There are no citations or references. I was disappointed not to have a reference for “… an important study conducted to help doctors determine what strategy to use in selecting treatments…compared two strategies of care: sequential care and stratified care” (p. 89). I would like to read the study and its outcome. It may become helpful in determining which would be most helpful for me.

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What is a Migraine?

What is a migraine? There are many, many answers to that question, but before I go any further, I want to be clear:
A migraine is NOT a headache, even though, for most sufferers, it involves head pain. But understand that a person can have a migraine without the head pain. Childhood migraines may not involve head pain.
It is not : a ploy to get out of work, school, house work, making dinner, homework, or other obligations. It is NOT “not tonight, dear, I have a headache.”
Having a migraine is NOT the fault of the migraineur.
Migraine is a disease. It is a neurological disease just as valid as diabetes, heart disease, epilepsy, or cancer. It is characterized by an abnormal response to certain triggers (certain foods, barometric pressure, stress, flashing lights, or loud noise). These triggers don’t cause the same response in people without migraine. In fact, one could say that migraine and seizure disorders are related in that both of these diseases involve triggers that result in an attack. This is why some anti-convulsants prevent or control migraines.

It is a combination of varying symptoms that are not necessarily the same in each migraineur. Not all migraine attacks involve, for example, an aura. Only 15-20% of migraineurs report an aura. An aura is a sensory disturbance the heralds the migraine attack. Some of these disturbances are visual. Migraine sufferers with aura relate seeing flashing lights, jagged lines, or a decrease in the visual field. Others report auditory hallucinations, abnormal smells or tastes.

Some auras can easily be missed. For me, the right side of my nose starts to run or I suddenly become sensitive to sound or light, lose my appetite, or get irritable.
Migraine has a genetic link. Eighty percent of migraine sufferers have a relative who also has migraine.

Migraine is prevalent. According to the Migraine Research Foundation, migraine affect 30 million Americans. Migraine affects 22 million women, 8 million men, and It ranks in the top 20 world’s most disabling illnesses. Every 10 seconds in the US, someone goes to the emergency room with headache or migraine. One in four households has someone who suffers from migraine. Ten percent of children have migraines.

Migraine is costly. According to the Migraine Research Foundation ., migraine costs American employers $13 billion a year due to more than 113 million lost work days by migraine or headache sufferers. M.A.G.U.M estimates there to be 150 million lost work days for the cost to industry and the health care system of $5-17 billion annually.

Migraine is a chronic, progressive neurological disease. For a subset of migraneurs the disease becomes chronic resulting in attacks increasing frequencyuntil migraine pain and associated symptoms are almost daily. Twelve million suffer from chronic migraine (having more than 15 migraine attacks a month). I am one of those.

Migraine research is underfunded. In an article about funding for migraine and headache research in Europe, authors Olesen, Lekander, Andlin-Soboki and Jonnson stated that “Compared with societal costs, migraine received the least public funds amongst all brain disorders, i.e. 0.025%. ” (Cephalagia, September, 2007). Funding in the US is just as bad. Shapiro and Goadsby (2007) stated that: “an estimate of the mean annual federal funding for migraine research at~$13M. This sum comprises <.05% of the total current NIH budget of ~$28B.” To put this into perspective, asthma research funding from NIH is ~21 times greater than funding for migraine. However, the economic impact for migraine is ~27 times greater than that of asthma. Considering the prevalence of both migraine and asthma, migraine per patient funding is ~37 times less than asthma (Read full article here).

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