Migraines

Migraine is a common pain disorder of the brain affecting approximately 12% of the general population. Women have migraine more frequently than men and migraine’s are most common in ages 30-40years. Migraine is often common within families, suggesting a genetic or familial link.

Causes:While the specific and unique causes of migraine are not yet fully understood, genetics, environmental factors, inflammatory changes in pain-sensitive regions and nerves of the brain, imbalances in brain chemicals (such as serotonin), and over sensitization to nerve stimulus within the brain, may all contribute to the onset of migraine.

It was once thought that migraine was caused by the dilatation of blood vessels in the brain, while the aura of migraine was caused from vasoconstriction. This “vascular theory” of migraine is no longer widely supported.

Symptoms:A typical migraine attack progresses through four phases: the prodrome, the aura, the headache, and the postdrome

Prodrome: Approximately 60% of people are affected by a prodrome, a cluster of symptoms occurring 24-48 hrs before onset of headpain. Prodrome has been associated with symptoms such as euphoria, depression, irritability, food cravings, constipation, neck stiffness, and increased yawning

Aura: 25% of people are affected by an aura, a sensory neurologic symptom (or symptoms) that are short lasting and fully reversible. Auras are most often visual, but can also be sensory, verbal, or motor disturbances.A classic visual aura is characterized as a small area with loss of vision, however other symptoms can be visual (eg, bright lines, shapes, objects), auditory (eg, tinnitus, noises, music), somatosensory (eg, burning, pain, paresthesia), or motor (eg, jerking or repetitive rhythmic movements). Other forms of aura can include the temporary absence or loss of function, such as loss of vision, hearing, feeling, or ability to move a part of the body.

Headache: Migraines are often one-sided. Common characteristics of the pain are throbbing or pulsing sensations. Frequently sensitivity to light, sound, movement, the onset of Nausea and/or vomiting, are also associated with the pain.

Postdrome: After the pain subsides, many people experience a period of feeling drained, elated, euphoria. This period may also be associated with head movements causing pain in the location of the headache

Conventional Treatment: For many sufferers of migraine, the recommendations they receive for care and treatment are limited to pharmacologic interventions (such as non-steroidal anti-inflammatories, acetaminophen or Triptan medications) with recommendations for self-examination of potential triggers.

While we similarly rely upon both identification of triggers and pharmacologic agents as needed for our patients, the largest difference is the supportive “whole person” integrated approach we take in learning, listening and responding to your needs.

Our Approach: We provide guidance and support in an integrated, personalized approach to prevention and treatment because we recognize causes of migraine are complex and vary amongst individuals. By understanding this, we are able to respond to the person suffering from migraines as a unique individual with unique needs. Our approach is to:

1: Listen to you. What are your experiences with migraine? Do you know what triggers them, what makes them better or worse?

2: We explore and discuss migraine triggers with you- we look at both those triggers you have identified and those you may not have. By working closely with you, we are able to begin addressing what your unique triggers are and develop strategies for coping and prevention. Common triggers we evaluate for include: stress, hormones, foods, food-additives, drinks, blood sugar, sleep, emotions, habits, environment, allergies, mold, muscle or joint involvement, medications, chemical sensitivity. Often an individual has identified a single trigger, but responds with dramatic improvement when un-recognized triggers are addressed. Coping strategies to deal with known triggers are also discussed and supported.

3: Address and provide you personalized support in prevention and treatment of migraine. Our goal is support every individual as the unique person they are. This means discussing and listening to what YOUR needs are in order to determine what steps to take in both prevention and treatment.

While there is a growing body of evidence supporting the benefits of complimentary and alternative medicine in the prevention of migraines, not all migraines respond to the same treatments, just as not all migraines have the same cause. Our providers use a whole-person approach in working with you to formulate both a preventative and ‘rescue’ plan in the treatment of migraines using research and clinical based evidence.

If you or a loved one suffers from Migraines, give us a call today to discuss how we can help you: 503-287-4970

 

References:

Kelman L. The triggers or precipitants of the acute migraine attack. Cephalalgia 2007; 27:394.

Kelman L. The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs. Headache 2004; 44:865.

Lipton RB, Stewart WF, Diamond S, et al. Prevalence and burden of migraine in the United States: data from the American Migraine Study II. Headache 2001; 41:646.

Lipton RB, Bigal ME, Diamond M, et al. Migraine prevalence, disease burden, and the need for preventive therapy. Neurology 2007; 68:343.

Lipton RB, Stewart WF, Stone AM, et al. Stratified care vs step care strategies for migraine: the Disability in Strategies of Care (DISC) Study: A randomized trial. JAMA 2000; 284:2599.

Silberstein SD, Rosenberg J. Multispecialty consensus on diagnosis and treatment of headache. Neurology 2000; 54:1553.