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Everything you Need to Know About Migraine
Medical Review by Headache Specialist Dr. Katherine Hamilton
Men, women, and kids worldwide know the Migraine struggle is real! Migraine disease is incredibly common and incredibly misunderstood. The struggle for information and understanding can be nearly as tough as Migraine itself.
We understand how overwhelming it can be to try to make sense of your symptoms and the conflicting info out there.
That’s why we put together this roadmap with the important evidence-based facts about Migraine.
Understanding exactly what you’re dealing with is the first step to making good choices about your care.
Fact #1: Migraine Is a Disease, Not a Headache
Simply put – Migraine is not just a headache.
Migraine is a neurological condition that is frequently disabling. It comes with a slew of symptoms that extend far beyond the head.
“One of the very big myths about Migraine is that it’s just a headache,” explains Dr. Peter Goadsby of NIHR-Wellcome Trust King’s Clinical Research Facility, “That’s completely wrong.”
Neurological condition…wait what?
“Migraine is a disorder of the brain, and it’s a disorder not just of sensory attention. What’s often forgotten are the phases that occur before a Migraine, the premonitory or prodromal phase of the attack where sufferers will have cognitive dysfunction,” Dr. Goadsby told Migraine Again.
Condition and disease are both used to describe Migraine. Those who are most severely impacted may prefer to call it a disease to capture the full impact.
Fact #2: Migraine is More Common than Asthma, Diabetes, and Epilepsy Combined
There are millions of Migraine warriors around the world.
- Migraine is the 3rd most prevalent illness worldwide.
- It ranks 6th in the world for debilitating illnesses, says the Migraine Research Foundation. (. Facts and Figures.’>2).
Fact #3: WOMEN ARE DISPROPORTIONATELY AFFECTED
Migraine disproportionately affects genders and ages.
In the US, 6% of men experience Migraine, compared to 18% of women (https://migraineresearchfoundation.org/about-migraine/migraine-facts/’>4). Emerging research suggests that fussy, colicky babies may actually be experiencing Migraine symptoms.
“There does seem to be a connection between infant colic and Migraine in childhood,” explained Dr. Amy Gelfand of the University of California, San Francisco to Migraine Again.
“Mothers who have Migraine are more likely to have a baby with colic,” she explained.
Babies with colic are also more sensitive to sounds and smells, her research found.
While the colic may pass, Migraine probably won’t. Babies with colic will likely turn into children with Migraine, says Dr. Gelfand.
Early signs of Migraine in Kids Include Head Tilting
Children will get early warning signs before their attacks. Sometimes they become fatigued and yawn excessively before the pain hits. They will often try to retreat to the dark. Children with Migraine frequently have tummy trouble, too.
Another early warning sign of Migraine in children may be benign paroxysmal torticollis. This condition is typically seen in babies as young as 4 months and in preschool children. Symptoms include things like:
- Head tilt
- Decreased appetite
Older kids may experience symptoms of benign paroxysmal vertigo, like (https://americanheadachesociety.org/wp-content/uploads/2018/05/Deborah_Friedman_-_Top_10_Things_that_you_and_Your_Patients_with_Migraine_Should_Know-1.pdf‘>6).
Migraine aura can be terrifying to experience. One scary symptom of aura is temporary blindness or ‘kaleidoscope’ vision. (Read about one woman’s experience with blinding aura here.)
Fact #7: MOST PEOPLE EXPERIENCE A MIGRAINE HANGOVER
Up 80% of people experience a “Migraine hangover” after the headache phase.
- This final phase – called the postdrome phase – lasts hours to days.
- Fatigue, headache, and difficulty concentrating are common during the postdrome
Fact #8: Migraine Has Many Causes
There is no one cause for Migraine or Chronic Migraine (CM). There are a handful of factors that increase the likelihood of episodic Migraine turning chronic.
Factors associated with Chronic Migraine include:
- headache frequency
- medication use
“As treatment is increasingly optimized, the risk of progression from one year to the next declines,” said Dr. Richard Lipton. Dr. Lipton is the lead author of the AMPP study, a large population study.
Fact #9: MIGRAINE RUNS IN FAMILIES
Nearly 80% of those with Migraine have a close family member who also has it (https://www.ajmc.com/newsroom/genomewide-association-studies-identify-vascular-dysfunction-to-be-major-cause-of-migraine-susceptibility’>8).
Authors of a 2019 study suspect that Migraine is caused by abnormalities in certain genes. These abnormalities alter the way the body regulates electrical impulses and are passed down through families (https://migraineresearchfoundation.org/about-migraine/migraine-facts/‘>10).
In the U.S. alone, acute Migraine attacks account for nearly 1.2 million emergency room visits every year (https://migraineresearchfoundation.org/about-migraine/migraine-facts/‘>12).
CM can be debilitating and accounts for a high rate of disability in Migraine warriors. Nearly 20% of those with CM are disabled.
Fact #13: MIGRAINE COMES WITH MORE THAN 40 SYMPTOMS
Migraine symptoms are not the same for everyone, but there are some that come up again and again. Nearly 15-20% of people will experience neurological symptoms before the onset of head pain (https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201 ‘>14):
- Mood changes
- Food cravings, excessive thirst, and urination
- Neck pain/stiffness
- Visual changes (vision loss, blurred vision)
- Numbness and tingling in the face or limbs
- Difficulty speaking
- Light, smell, touch or sound sensitivity
- Taste changes
- Muscle jerking
- Head pain (one or both sides), head throbbing or pulsing
Fact #14: A STRANGE MIGRAINE SYMPTOM MAY HAVE INSPIRED ALICE IN WONDERLAND!
A phenomenon called Alice in Wonderland Syndrome (AIWS) is a rare symptom that is experienced by a minority of people with Migraine. It most commonly appears during the aura phase.
Because there are several types of Migraine and more than 40 different symptoms, it can be difficult to get the right diagnosis. Doctors usually attempt to rule out other medical causes.
For example, abdominal Migraine shows up with stomach pain, nausea and vomiting, so conditions like reflux, irritable bowel syndrome, ulcers, and others are typically considered first (https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/vestibular/conditions/vestibular_migraine.html‘>18).
This type of Migraine doesn’t always come with a headache, making it trickier to diagnose correctly.
Fact #17: YOU CAN HAVE MIGRAINE AURA WITH NO HEADACHE
It is possible to experience Migraine aura that never turns into head pain.
Some people experience only aura symptoms with no headache. Others will experience aura that is sometimes followed by head pain and sometimes not.
Fact #18: CHOCOLATE DOESN’T TRIGGER MIGRAINE
People with Migraine often report “triggers” that bring on an attack. Many are related to food.
Chocolate is one of the most notorious Migraine food triggers, BUT there is no solid scientific evidence to support this claim. In fact, data presented by the tracking app N-1 Headache (previously called Curelator Headache), showed that chocolate is NOT associated with Migraine attacks in most people. (https://doi.org/10.1177/0333102412474502) ‘>20).
Fact #21: MIGRAINE CAN AFFECT MENTAL HEALTH
Anxiety and depression are common in those with Migraine, and it’s not always clear which comes first. What we do know is that people with Migraine are more likely to struggle with one or both of the conditions.
People with Migraine are 2-5 times more likely to experience depression and/or anxiety, says the American Migraine Foundation. And: (http://headacheandmigrainenews.com/large-study-links-ibs-with-migraine/’>22). (Read more: Backed Up and In Pain: The Link Between Migraine and Constipation.)
Fact #23: MEN WITH MIGRAINE HAVE A 42% HIGHER CHANCE OF DEVELOPING HEART DISEASE
Those with Migraine with aura have an increased risk for heart disease. Among men with Migraine, that risk increases by 42%.
In contrast, those with Migraine without aura have a protective gene connection for heart disease (Fournier A, et al. Associations Between Migraine and Type 2 Diabetes in Women: Findings From the E3N Cohort Study. JAMA Neurol. Published online December 17, 201876(3):257–263. doi:10.1001/jamaneurol.2018.3960.’>24).The study also found that in the time prior to a diagnosis of diabetes, women experienced less Migraine activity.
Fact #25: MIGRAINE HAS A COLOSSAL IMPACT
The disease takes a massive toll on individuals, families, and the community as a whole. Attacks have a ripple effect on caregivers, spouses, children, co-workers, employers and more. Research studies like the Chronic Migraine Epidemiology and Outcome study (CaMEO) demonstrate that the impact of migraine is measurable and can be more than twice as bad for people with Chronic Migraine vs. Episodic Migraine.
Fact #26: MIGRAINE IS COSTLY
Migraine attacks are responsible for a loss of 157 million workdays in the US every year (https://migraineresearchfoundation.org/about-migraine/migraine-facts/ ‘>26)! This is exceedingly high when compared to other diseases. Compare that to heart disease and kidney disease, which cost $47.5 billion and $57.5 billion annually in the US (https://migraineresearchfoundation.org/about-migraine/migraine-facts/ ‘>28).
Healthcare costs are exceedingly high for families with Migraine and can be 70% higher than the average family.
Fact #27: MANY EMPLOYERS DON’T THINK MIGRAINE IS A VALID EXCUSE FOR MISSING WORK
Along with the symptoms comes the stigma of an invisible condition. Migraine warriors are frequently forced to miss work.
Too often, people won’t tell their bosses they’re calling out for Migraine, probably because of the negative stigma associated with it.
Fact #28: MIGRAINE TAKES A TOLL ON RELATIONSHIPS
Relationships are significantly impacted by Migraine. A 2014 study found: (https://migraineresearchfoundation.org/about-migraine/migraine-facts/ ‘>30)
Fact #30: THERE IS ONLY 1 HEADACHE SPECIALIST PER 78000 PEOPLE WITH MIGRAINE IN THE US
There are only about 500 certified headache specialists in the US to treat ~39 million people with Migraine! (https://migraineresearchfoundation.org/about-migraine/migraine-facts/ ‘>32).
Fact #31: RESEARCH DOES NOT GET NEARLY ENOUGH FUNDING
There’s also limited funding available for research. Compared to high-profile diseases like Parkinson’s, Migraine receives significantly fewer research dollars – even though it is much more common.