Migraine: Myth versus Reality
“There is no condition of such magnitude that is as shrouded in myth, misinformation, and mistreatment as is this condition [Migraine], and there are few conditions which are as disabling during the acute attack.”
-Dr. Joel R. Saper, M.D., F.A.C.P., Director, Michigan Head-Pain & Neurological Institute
A young science such as the one attempting to rid the world of migraine disease can fall prey to all manner of outlandish and occasionally dangerous explanations and treatments. For centuries both society and medicine has blamed migraines on the migraineurs. All the way back to the stone age where we find archeological evidence from the stone age of “trepanation”, drilling holes in one’s head to relieve migraine pain. Oddly enough this practice has persisted into this century, with no scientific backing, naturally. Advances in science and medicine have given us the knowledge base to begin to better comprehend this genetic, neurological disease. Nevertheless, many dangerous myths about migraine stubbornly persist. These myths are endorsed by family members, co-workers, and sadly, the migraineurs themselves. Hopefully as our knowledge base grows, and well-designed scientific research emerges, many of these myths will be dispelled. As this process continues, responsible scientific reportage should help to reframe how we think about and treat this disease in all its manifestations.
Until then, even the best informed of use should be aware of some of the most dangerous myths and misconceptions associated with migraine disease. Following are five of the most flagrant examples:
MYTH 1: Migraine is just an irritating headache, you’ll get over it
REALITY: The migraine headache is actually a symptom of a poorly understood, underlying neurological disease. It will not just simply “go away” and may often persist for days on end. Other symptoms such as nausea, visual distortions (aura), and dizziness (migraine associated vertigo) often accompany the event. There may be other symptoms depending on the individual. It is now considered to be a genetically based disease. The Association of Migraine Disorders has funded research in the genetics area, with considerable success.
MYTH 2: Migraine is just a bad headache, with no serious side effects
REALITY: This is a dangerous myth. The scientific literature, both in the US and worldwide, clearly shows the relationship between stroke and migraine. Especially migraine with aura. A recent meta-evaluation of 14 studies in the US and Canada found migraineurs, especially with aura, at 2.2 times greater risk for stroke. These are just the physical problems. Migraineurs, all 36 million in the US may find it difficult to work consistently, and as a result the economic losses can be staggering, in the billions of dollars. Don’t forget the impact a chronic illness can have on relationships and family life. Truly devastating. The personal psychological results will challenge the strongest constitution. Just a headache? Hardly.
MYTH 3: There is no cure for migraines
REALITY: It is true there are no permanent cures for migraines yet, but there are effective treatments. “Botox” is licensed in the United States for migraine sufferers and reports positive results with minimal side effects. Also, since the 1990s triptans have been shown to work well in over 80% of sufferers. There are different formulations that work with different delivery systems. Migraineurs who are so sick they cannot hold medicine, down may need a nasal spray or an injection. New formulations seem to be approved regularly. Another relatively new development are the neurostimulation devices, such as the “Cephaly Headband”. By delivering a gentle electrical pulse via a band surrounding the head, the CHB reports positive preventative results. There are also other neurostimulation devices available, and will be the source of another blog. Finally, studies have also shown that 400mg of magnesium (or more) and 150 to 400mg of vitamin B2 can help prevent migraines. Different approaches may work with different people. Work with a migraine literate doctor to arrive at the best treatment plan for you.
MYTH 4: Premenstrual Syndrome causes migraine
REALITY: The two conditions can be associated, but not all women suffer with PMS, and not all women with migraines have PMS. Migraines are known to be sensitive to hormonal fluctuations, which usually take place prior to a woman’s period. An episode that occurs two days prior to, or three days following a period, is popularly known as a “menstrual migraine,” Generally it is comparable to other migraines but usually doesn’t include an aura. Migraines with aura have recently been linked to cardiovascular problems. At present no causation has been demonstrated between PMS and migraines.
MYTH 5: Any Physician can diagnose and effectively treat migraine disease
REALITY: This is dangerously wrong. In reality, migraine disease, and all conditions on the migraine spectrum comprise one of the most misdiagnosed, incorrectly treated, and misunderstood diseases known to science. Neurologists as a group have stated that migraine disease is consistently unrecognized and misdiagnosed. A recent survey showed 60% of women and 70% of men with migraine have been overlooked for a migraine diagnosis. This lack of knowledge in the medical community and resultant erroneous publications enable the myths and misunderstandings about migraine to thrive. Eventually this misinformation is delivered to the public-at-large. Once attitudes are entrenched, especially those coming from a respected source, they can be most difficult to change. But in this case they must. Too much pain and suffering hang in the balance.
Perhaps the best defense against this body of misinformation is to find a migraine literate physician, regardless of specialty. As mentioned before, the science is young, but there are many practitioners who are well-informed and can responsibly treat this disease. Finally, don’t just defer to authority. Be your own advocate, and take charge of management of your illness. There are fine physicians available to work with you.