Migraine

Migraine headaches commonly occur in people with ME/CFS. In a 2011 study by Ravindran, et al, migraine headaches were found in 84%, and tension-type headaches in 81% of a cohort of CFS patients. This compared to 5% and 45%, respectively, in a cohort of healthy controls.

Symptoms
Migraine without aura is defined by the following diagnostic criteria outlined in The International Classification Of Headache Disorders, 3rd edition:

Migraine without aura diagnostic criteria
 At least five headache attacks that  Last 4–72 hours without successful treatment  Headaches have at least two of the following four characteristics:  unilateral location;  pulsating quality;  moderate to severe pain intensity; and  aggravation by or causing avoidance of routine physical activity.</ol>  During the headaches at least one of the following:</li> <ol> nausea and/or vomiting</li>  photophobia and phonophobia (avoidance of loud noises)</li></ol>  Not better accounted for by another ICHD-3 diagnosis.</li> </ol>


 * Migraines without aura may also be called common migraine'  or  hemicrania simplex.

Migraines in ME/CFS
Migraines is one of several illnesses or conditions experienced alongside of ME/CFS.

The Canadian Consensus Criteria recognizes migraines in the possible neurological symptoms of ME/CFS.

Potential treatments
Migraine treatment consists of:
 * Abortive treatments, that aim to stop a migraine attack or reduce the symptoms


 * Prevention, which aims to reduce how often migraines occur and their intensity

Migraine attack treatments

 * Triptans, e.g. Sumatriptan, brand name Imitrex (13 out of 14 newly diagnosed migraine subjects responded to sumatriptan in one CFS patient cohort) or zomitriptan, brand name Zomig
 * Small molecule CGRP antagonists, known as gepants, which are the newest group of migraine drugs
 * General pain medications, which are sometimes combined, for example acetaminophen and naproxen

Migraine prevention

 * Migraine elimination diets, which rely on identifying particular foods, drinks or additives that trigger migraines, for example avoiding the consumption of nitrates and tyramine
 * CGRP antagonists, particularly CGRP monoclonal antibodies but possibly some gepants
 * Drugs developed for other uses that are known to reduce migraines, including propranolol, amitriptyline (Elavil), topiramate (Topamax) or botulinum toxin type A (Botox injections)
 * Acupuncture
 * Daith piercing

Notable studies

 * 2011, Migraine headaches in chronic fatigue syndrome (CFS): comparison of two prospective cross-sectional studies.
 * 2013, Migraine in gulf war illness and chronic fatigue syndrome: Prevalence, potential mechanisms, and evaluation. (Full Text)
 * 2016, Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort (Full Text)

Learn more

 * Oct 18, 2016, Migraines could be caused by gut bacteria, study suggests
 * May 19, 2018, The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit?