Migraine: Difference between revisions

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'''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 [[Chronic fatigue syndrome|CFS]] patients.<ref name=":0" />  This compared to 5% and 45%, respectively, in a cohort of healthy controls.<ref name=":0" />  
[[File:Migraine-art.jpg|left|thumb|320px|Source: [https://www.flickr.com/photos/tudedude/14019222689 Migraine by Tudor Barker]]]<br style="clear:both">
'''Migraines''' commonly occur in people with [[ME/CFS]].  In a 2011 study by Ravindran, et al, migraine headaches were found in 84%, and [[tension-type headache]]s in 81% of a cohort of [[chronic fatigue syndrome]] patients.<ref name="Ravindran2011" />  This compared to 5% and 45%, respectively, in a cohort of healthy controls.<ref name="Ravindran2011" />  


==Symptoms==
==Symptoms==
<ref name="NHS-overall" />
==Phases==
Migraine phases:
;Prodromal (pre-headache) stage
:changes in mood, energy levels, behaviour and appetite that can occur several hours or days before an attack
;Aura phase (if present)
:visual problems are very common, e.g. flashes of light (scintillations) or blind spots (scotoma), aura symptoms last for 5 to 60 minutes
;Headache phase
:usually a moderate or severe pulsating or throbbing pain on one side of the head, often accompanied by [[nausea]], [[vomiting]] or [[photophobia|extreme light sensitivity]] and extreme sensitivity to loud sounds, which last from 4 hours to 3 days
;Postdromal or resolution stage
:the severe headache and other symptoms gradually fade, but there may be [[fatigue|tiredness]] for few days after<ref name="NHS-symptoms">{{Cite web|url=https://www.nhs.uk/conditions/migraine/symptoms/ | title = Migraine - Symptoms | last = | first = | authorlink = | date = | website = [[National Health Service]]|language=en|archive-url=|archive-date=|url-status=|access-date=2021-10-15}}</ref><ref name="Khan2021"/><ref name="NHS-overall" />
[[File:Migraine-phases.jpg|left|thumb|600px|Migraine phases.<br />Source: [https://www.sciencedirect.com/science/article/pii/S0753332221003425 Khan et. al. (2021). Biomedicine & Pharmacotherapy, 139, 111557.]<ref name="Khan2021"/>]]<br style="clear:both">
==Types ==
===Migraine without aura===
'''Migraine without aura''' is defined by the following diagnostic criteria outlined in ''The International Classification Of Headache Disorders, 3rd edition'':  
'''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===
====Migraine without aura diagnostic criteria====
<ol style="list-style-type:upper-alpha"><li> At least '''five''' headache attacks that</li>
<ol style="list-style-type:upper-alpha"><li> At least '''five''' headache attacks that</li>
<li> Last 4–72 hours without successful treatment</li>
<li> Last 4–72 hours without successful treatment</li>
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</ol>
</ol>


:Migraines without aura may also be called '''common migraine'<nowiki/>'' or  '''''<nowiki/>''hemicrania simplex''.<ref name="ICHD-3">{{Cite journal|last=Headache Classification Committee of the International Headache Society|date=2018|title=The International Classification of Headache Disorders|edition=3rd|url=https://doi.org/10.1177/0333102417738202|journal=Cephalalgia|language=en|volume=38|issue=1|pages=1–211|doi=10.1177/0333102417738202|issn=0333-1024}}</ref>
:Migraines without aura may also be called '''common migraine'' or  '''hemicrania simplex'''.<ref name="ICHD-3">{{Cite journal | last = Headache Classification Committee of the International Headache Society | date = 2018 | title = The International Classification of Headache Disorders|edition=3rd | url =https://doi.org/10.1177/0333102417738202|journal=Cephalalgia|language=en|volume=38|issue=1|pages=1–211|doi=10.1177/0333102417738202|issn=0333-1024}}</ref>


===Migraine with aura diagnostic criteria===
===Migraine with aura===
====Migraine with aura diagnostic criteria====


:Visual, sensory and central nervous system symptom in beginning shortly before a migraine headache are known as an '''aura''', although migraine with aura without migraine headaches are also recognized.
:Visual, sensory and central nervous system symptom in beginning shortly before a migraine headache are known as an '''aura''', although migraine with aura without migraine headaches are also recognized.
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<li> at least one aura symptom is '''positive''' </li>
<li> at least one aura symptom is '''positive''' </li>
<li> the aura is accompanied, or followed within 60 minutes, by headache</li></ol>
<li> the aura is accompanied, or followed within 60 minutes, by headache</li></ol>
<li> Not better accounted for by another ICHD-3 diagnosis.</li>
<li> Not better accounted for by another ICHD-3 diagnosis.<ref name="ICHD-3" /></li></ol>
</ol>
 
The recognized types of migraine with aura are:
*Typical aura with headache
*Typical aura without headache
*Migraine with brainstem aura
*Hemiplegic migraine, including familial hemiplegic migraine (FHM) type 1, type 2, type 3 and with other loci
* Sporadic hemiplegic migraine (SHM)
* Retinal migraine


Migraines without aura may also be called '''Classic or classical migraine''', '''ophthalmic, hemiparaesthetic, hemiplegic or aphasic migraine''', or '''complicated migraine'''.<ref name="ICHD-3" />
Migraines without aura may also be called '''Classic or classical migraine''', '''ophthalmic, hemiparaesthetic, hemiplegic or aphasic migraine''', or '''complicated migraine'''.<ref name="ICHD-3" />
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===Chronic migraine ===
===Chronic migraine ===
<ref name="ICHD-3" />
<ref name="ICHD-3" />
===Silent migraine ===
Migraine symptoms that do not result in a headache are known as silent migraines, e.g. migraine aura symptoms without head pain.migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop.<ref name="NHS-overall">{{Cite web|url=https://www.nhs.uk/conditions/migraine/ | title = Migraine | last = | first = | authorlink = | date = | website = [[National Health Service]]|language=en|archive-url=|archive-date=|url-status=|access-date=2021-10-15}}</ref>


===Abdominal migraine ===
===Abdominal migraine ===
<ref name="ICHD-3" />
<ref name="ICHD-3" />
==Triggers ==
[[File:Migraine_triggers.jpg|left|600px|Migraine triggers.<br />Source: [https://www.sciencedirect.com/science/article/pii/S0753332221003425 Biomedicine & Pharmacotherapy, 139, 111557]<ref name="Khan2021"/>]]<br style="clear:both">
Common migraine triggers include:
* Food and drinks, e.g., chocolate, alcohol, aged cheese, [[gluten sensitivity|gluten]]
* Lifestyle patterns, e.g. [[stress]], weather changes, or fasting
* Genetics
* Physiological and biochemical factors, e.g. insulin or oestrogen  [[hormone]] levels, increased [[oxidative stress]]<ref name="Khan2021"/><ref name="NHS-overall" />


==Migraines in ME/CFS==
==Migraines in ME/CFS==
Migraines is one of several illnesses or conditions experienced alongside of ME/CFS.<ref>{{Cite web|url=https://ammes.org/overlapping-conditions/|title=Overlapping Conditions – American ME and CFS Society|website=ammes.org|language=en-US|access-date=2018-08-12}}</ref><br>
Migraines is one of several illnesses or conditions common in people with [[ME/CFS]].<ref name="ammes">{{Cite web|url=https://ammes.org/overlapping-conditions/ | title = Overlapping Conditions – American ME and CFS Society|website=ammes.org|language=en-US|access-date=2018-08-12}}</ref><ref name="ICC2011primer">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 = Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 =  L | authorlink11 = Lucinda Bateman | last12 = Bell | first12 = DS | authorlink12 = David Bell | last13 = Carlo-Stella | first13 =  N | authorlink13 = Nicoletta Carlo-Stella | last14 = Chia | first14 =  J | authorlink14 = John Chia | last15 = Darragh | first15 =  A | authorlink15 = Austin Darragh | last16 = Gerken | first16 =  A | authorlink16 = Anne Gerken | last17 = Jo | first17 =  D | authorlink17= Daehyun Jo | last18 = Lewis | first18 =  DP | authorlink18 = Donald Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Light | first20 =  KC | authorlink20 = Kathleen Light | last21 = Marshall-Gradisnik | first21 =  S | authorlink21 = Sonya Marshall-Gradisnik | last22 = McLaren-Howard | first22 =  J | authorlink22 = John McLaren-Howard | last23 = Mena | first23 =  I | authorlink23 =  Ismael Mena | last24 = Miwa | first24 =  K | authorlink24 =  Kunihisa Miwa | last25 = Murovska | first25 =  M | authorlink25= Modra Murovska | last26 = Stevens | first26 =  SR | authorlink26 =  Staci Stevens | title = Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners | date = 2012
| isbn = 978-0-9739335-3-6 | url = http://www.investinme.org/Documents/Guidelines/Myalgic%20Encephalomyelitis%20International%20Consensus%20Primer%20-2012-11-26.pdf }}</ref><br>


The [[Canadian Consensus Criteria]] recognizes migraines in the [[:Category:Neurological signs and symptoms |possible neurological symptoms]] of [[ME/CFS]].
The [[Canadian Consensus Criteria]] recognizes migraines in the [[:Category:Neurological signs and symptoms|possible neurological symptoms]] of [[ME/CFS]], and the [[International Consensus Criteria]] recognizes [[headache]] conditions including [[migraine]] and [[tension-type headache]] in the diagnostic criteria for [[myalgic encephalomyelitis]].<ref name="ICC2011primer" />


==Possible causes==
==Possible causes==
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=== Migraine attack treatments ===
=== Migraine attack treatments ===
*[[:Category:Triptans|Triptans]], e.g. [[Sumatriptan]], brand name Imitrex (13 out of 14 newly diagnosed migraine subjects responded to sumatriptan in one [[Chronic fatigue syndrome|CFS]] patient cohort)<ref name=":0" /> or [[zomitriptan]], brand name Zomig<ref>{{Cite web|url=https://www.drugs.com/health-guide/migraine.html|title=Migraine Guide: Causes, Symptoms and Treatment Options|website=Drugs.com|language=en|access-date=2021-10-12}}</ref>
*General [[analgesic|pain medications]], including [[acetaminophen]] and [[Nonsteroidal anti-inflammatory drug|nonsteroidal anti-inflammatories]] (NSAID), for mild to moderate migraines. Different types of medications are sometimes combined, for example acetaminophen and [[naproxen]].<ref name="Khan2021">{{Cite journal | last = Khan | first = Johra | last2 = Asoom | first2 = Lubna Ibrahim Al | last3 = Sunni | first3 = Ahmad Al | last4 = Rafique | first4 = Nazish | last5 = Latif | first5 = Rabia | last6 = Saif | first6 = Seham Al | last7 = Almandil | first7 = Noor B. | last8 = Almohazey | first8 = Dana | last9 = AbdulAzeez | first9 = Sayed | date = 2021-07-01 | title = Genetics, pathophysiology, diagnosis, treatment, management, and prevention of migraine|url=https://www.sciencedirect.com/science/article/pii/S0753332221003425|journal=Biomedicine & Pharmacotherapy|language=en|volume=139|pages=111557|doi=10.1016/j.biopha.2021.111557|issn=0753-3322}}</ref>
*Small molecule [[:Category:CGRP antagonists|CGRP antagonists]], known as [[:Category:Gepants|gepants]], which are the newest group of migraine drugs<ref name=":1">{{Cite journal|last=Negro|first=Andrea|author-link=|last2=Martelletti|first2=Paolo|author-link2=|last3=|first3=|author-link3=|last4=|first4=|author-link4=|last5=|first5=|author-link5=|last6=|first6=|author-link6=|last7=|first7=|last8=|first8=|date=Jun 2019|title=Gepants for the treatment of migraine|url=https://pubmed.ncbi.nlm.nih.gov/31081399/|journal=Expert Opinion on Investigational Drugs|volume=28|issue=6|pages=555–567|doi=10.1080/13543784.2019.1618830|issn=1744-7658|pmc=|pmid=31081399|access-date=|quote=|via=}}</ref>
*[[:Category:Triptans|Triptans]] for moderate or severe migraine e.g. [[sumatriptan]] (Imitrex): 13 out of 14 newly diagnosed migraine subjects responded to sumatriptan in one [[Chronic fatigue syndrome|CFS]] patient cohort<ref name="Ravindran2011" /> or [[zomitriptan]] (Zomig)<ref name="drugscom">{{Cite web|url=https://www.drugs.com/health-guide/migraine.html | title = Migraine Guide: Causes, Symptoms and Treatment Options|website=Drugs.com|language=en|access-date=2021-10-12}}</ref>
*General pain medications, which are sometimes combined, for example [[acetaminophen]] and naproxen
*Small molecule [[:Category:CGRP antagonists|CGRP antagonists]], known as [[:Category:Gepants|gepants]], which are the newest group of migraine drugs<ref name="Negro2019">{{Cite journal | last = Negro | first = Andrea | authorlink = | last2 = Martelletti | first2 = Paolo | authorlink2 = | date = Jun 2019 | title = Gepants for the treatment of migraine|url=https://pubmed.ncbi.nlm.nih.gov/31081399/|journal=Expert Opinion on Investigational Drugs|volume=28|issue=6 | pages = 555–567|doi=10.1080/13543784.2019.1618830|issn=1744-7658|pmc=|pmid=31081399|access-date=|quote=|via=}}</ref>
*There is some limited evidence for [[transcranial magnetic stimulation]] (TMS) in migraines with aura, this is a non-invasive brain based treatment<ref name="NHStreat">{{Cite web|url=https://www.nhs.uk/conditions/migraine/treatment/ | title = Migraine - Treatment | last = | first = | authorlink = | date = | website = [[National Health Service]]|language=en|archive-url=|archive-date=|url-status=|access-date=2021-10-15}}</ref>


=== Migraine prevention ===
=== Migraine prevention ===
*[[Migraine elimination diet|Migraine elimination diets]], which rely on identifying particular foods, drinks or additives that trigger migraines, for example avoiding the consumption of [[nitrates]] and [[tyramine]]
*[[Migraine elimination diet]]s, which rely on identifying particular foods, drinks or additives that trigger migraines, for example avoiding food or drinks containing [[nitrates]] or [[tyramine]]<ref name="Khan2021" /><ref name="NHS" />
*CGRP antagonists, particularly [[Calcitonin gene-related peptide monoclonal antibody|CGRP monoclonal antibodies]] but possibly some gepants<ref name=":1" />
*CGRP antagonists, particularly [[Calcitonin gene-related peptide monoclonal antibody|CGRP monoclonal antibodies]] but possibly some gepants<ref name="Negro2019" />
*Drugs developed for other uses that are known to reduce migraines, including propranolol, [[amitriptyline]] (Elavil), [[topiramate]] (Topamax) or botulinum toxin type A (Botox injections)<ref name=":1" />
*Drugs developed for other uses that are known to reduce migraines, including propranolol, [[amitriptyline]] (Elavil), [[topiramate]] (Topamax) or botulinum toxin type A (Botox injections)<ref name="Negro2019" /><ref name="NHS" />
*Acupuncture<ref>{{Cite web|url=https://www.nhs.uk/conditions/migraine/prevention/|title=Migraine - Prevention|last=|first=|authorlink=|last2=|first2=|authorlink2=|date=2017-10-23|website=[[National Health Service]]|language=en|archive-url=|archive-date=|url-status=|access-date=2021-10-12}}</ref>
*Acupuncture<ref name="NHS">{{Cite web|url=https://www.nhs.uk/conditions/migraine/prevention/ | title = Migraine - Prevention | last = | first = | authorlink = | date = 2017-10-23 | website = [[National Health Service]]|language=en|archive-url=|archive-date=|url-status=|access-date=2021-10-12}}</ref>
*[[Daith piercing]]<ref>{{Cite journal|last=Cascio Rizzo|first=Angelo|last2=Paolucci|first2=Matteo|last3=Altavilla|first3=Riccardo|last4=Brunelli|first4=Nicoletta|last5=Assenza|first5=Federica|last6=Altamura|first6=Claudia|last7=Vernieri|first7=Fabrizio|date=2017|title=Daith Piercing in a Case of Chronic Migraine: A Possible Vagal Modulation|journal=Frontiers in Neurology|language=English|volume=8|pages=|doi=10.3389/fneur.2017.00624|issn=1664-2295|pmc=5711775|pmid=29230190|via=}}</ref>
*[[Daith piercing]], a type of ear piercings not routinely recommended<ref name="Cascio2017">{{Cite journal | last = Cascio Rizzo | first = Angelo | last2 = Paolucci | first2 = Matteo | last3 = Altavilla | first3 = Riccardo | last4 = Brunelli | first4 = Nicoletta | last5 = Assenza | first5 = Federica | last6 = Altamura | first6 = Claudia | last7 = Vernieri | first7 = Fabrizio | date = 2017 | title=Daith Piercing in a Case of Chronic Migraine: A Possible Vagal Modulation|journal=Frontiers in Neurology|language=English|volume=8|pages=|doi=10.3389/fneur.2017.00624|issn=1664-2295|pmc=5711775|pmid=29230190|via=}}</ref>
* Natural or alternative dietary supplements including [[magnesium]], [[feverfew]], the B vitamin [[riboflavin]], [[CoQ10]], and others.<ref name="Sun2011">{{Cite journal | last = Sun-Edelstein | first = Christina | authorlink = | last2 = Mauskop | first2 = Alexander  | authorlink2 =  | date = Mar 2011 | title = Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments: March 2011|url=https://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2011.01846.x|journal=Headache: The Journal of Head and Face Pain|language=en|volume=51|issue=3 | pages = 469–483|doi=10.1111/j.1526-4610.2011.01846.x|pmc=|pmid=|access-date=|quote=|via=}}</ref><ref name="Barmherzig2021">{{Cite journal | last = Barmherzig | first = Rebecca | last2 = Rajapakse | first2 = Thilinie | date = 2021-05-10 | title = Nutraceuticals and Behavioral Therapy for Headache|url=https://doi.org/10.1007/s11910-021-01120-3|journal=Current Neurology and Neuroscience Reports|language=en|volume=21|issue=7|pages=33|doi=10.1007/s11910-021-01120-3|issn=1534-6293}}</ref><ref name="Sun2009">{{Cite journal | last = Sun-Edelstein | first = Christina | authorlink = | last2 = Mauskop | first2 = Alexander  | authorlink2 =  | date = Jun 2009 | title = Foods and Supplements in the Management of Migraine Headaches|url=https://journals.lww.com/clinicalpain/Abstract/2009/06000/Foods_and_Supplements_in_the_Management_of.15.aspx|journal=The Clinical Journal of Pain|language=en-US|volume=25|issue=5 | pages = 446–452|doi=10.1097/AJP.0b013e31819a6f65|issn=0749-8047|pmc=|pmid=|access-date=|quote=|via=}}</ref> [[Butterbur]] is not recommended due to liver toxicity.<ref name="NCCIH">{{Cite web|url=https://www.nccih.nih.gov/health/providers/digest/dietary-supplements-for-headaches-science | title = Dietary Supplements for Headaches: What the Science Says | last = | first = | authorlink = | date = | website = [[National Center for Complementary and Integrative Health]]|language=en|archive-url=|archive-date=|url-status=|access-date=2021-10-13}}</ref>
*Migraines with aura may be reduce with [[transcranial magnetic stimulation]], although evidence for this is limited <ref name="NHStreat" />


==Notable studies==
==Notable studies==
*2011, Migraine headaches in [[chronic fatigue syndrome]] (CFS): comparison of two prospective cross-sectional studies.<ref name=":0">{{Cite journal|last=Ravindran|first=Murugan K|last2=Zheng|first2=Yin|last3=Timbol|first3=Christian|last4=Merck|first4=Samantha J|last5=Baraniuk|first5=James N|author-link5=James Baraniuk|date=5 Mar 2011|title=Migraine headaches in Chronic Fatigue Syndrome (CFS): Comparison of two prospective cross-sectional studies|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058027/|journal=BMC Neurology|language=en|volume=11|issue=1|pages=|doi=10.1186/1471-2377-11-30|issn=1471-2377|pmc=|pmid=21375763|via=}}</ref>
*2011, Migraine headaches in [[chronic fatigue syndrome]] (CFS): comparison of two prospective cross-sectional studies.<ref name="Ravindran2011">{{Cite journal | last = Ravindran | first = Murugan K | last2 = Zheng | first2 = Yin | last3 = Timbol | first3 = Christian | last4 = Merck | first4 = Samantha J | last5 = Baraniuk | first5 = James N | authorlink5 = James Baraniuk | date = 5 Mar 2011 | title = Migraine headaches in Chronic Fatigue Syndrome (CFS): Comparison of two prospective cross-sectional studies|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058027/|journal=BMC Neurology|language=en|volume=11|issue=1|pages=|doi=10.1186/1471-2377-11-30|issn=1471-2377|pmc=|pmid=21375763|via=}}</ref>
*2013, Migraine in [[Gulf War Illness|gulf war illness]] and [[chronic fatigue syndrome]]: Prevalence, potential mechanisms, and evaluation.<ref>{{Cite journal|last=Rayhan|first=Rakib U.|last2=Ravindran|first2=Murugan K.|last3=Baraniuk|first3=James N.|date=2013|title=Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation|url=https://www.ncbi.nlm.nih.gov/pubmed/23898301|journal=Frontiers in Physiology|volume=4|pages=181|doi=10.3389/fphys.2013.00181|issn=1664-042X|pmid=23898301|via=}}</ref>  [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721020/ (Full Text)]
*2013, Migraine in [[Gulf War Illness|gulf war illness]] and [[chronic fatigue syndrome]]: Prevalence, potential mechanisms, and evaluation.<ref name="Rayhan">{{Cite journal | last = Rayhan | first = Rakib U. | last2 = Ravindran | first2 = Murugan K. | last3 = Baraniuk | first3 = James N.| date = 2013 | title = Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation | url =https://www.ncbi.nlm.nih.gov/pubmed/23898301|journal=Frontiers in Physiology|volume=4|pages=181|doi=10.3389/fphys.2013.00181|issn=1664-042X|pmid=23898301|via=}}</ref>  [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3721020/ (Full Text)]
*2016, Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the [[American Gut Project]] Cohort<ref>{{Cite journal|last=Gonzalez|first=Antonio|last2=Hyde|first2=Embriette|last3=Sangwan|first3=Naseer|last4=Gilbert|first4=Jack A.|last5=Virre|first5=Erik|last6=Knight|first6=Rob|date=Oct 18, 2016|title=Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort|url=https://msystems.asm.org/content/msys/1/5/e00105-16.full.pdf|journal=American Society for Microbiology|volume=1|issue=5|pages=|via=}}</ref> [https://msystems.asm.org/content/msys/1/5/e00105-16.full.pdf (Full Text)]
*2016, Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the [[American Gut Project]] Cohort<ref>{{Cite journal | last = Gonzalez | first = Antonio | last2 = Hyde | first2 = Embriette | last3 = Sangwan | first3 = Naseer | last4 = Gilbert | first4 = Jack A. | last5 = Virre | first5 = Erik | last6 = Knight | first6 = Rob | date = Oct 18, 2016 | title = Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort|url=https://msystems.asm.org/content/msys/1/5/e00105-16.full.pdf | journal=American Society for Microbiology|volume=1|issue=5|pages=|via=}}</ref> [https://msystems.asm.org/content/msys/1/5/e00105-16.full.pdf (Full Text)]
 
==News and articles==
*Oct 18, 2016, [https://www.theguardian.com/science/2016/oct/18/migraines-could-be-caused-by-gut-bacteria-nitrates-food-trigger-study-suggests Migraines could be caused by gut bacteria, study suggests]<ref>{{Cite web|url=http://www.theguardian.com/science/2016/oct/18/migraines-could-be-caused-by-gut-bacteria-nitrates-food-trigger-study-suggests | title = Migraines could be caused by gut bacteria, study suggests | last = Devlin | first = Hannah | date = 2016-10-18 | website = the Guardian|language=en|access-date=2018-08-11}}</ref>
*May 19, 2018, [https://www.healthrising.org/blog/2018/05/19/migraine-drug-explosion-fibromyalgia-chronic-fatigue/ The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit?]<ref>{{Cite news | url=https://www.healthrising.org/blog/2018/05/19/migraine-drug-explosion-fibromyalgia-chronic-fatigue/ | title = The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit? - Health Rising | last = Johnson | first =Cort | date = 2018-05-19|work=Health Rising|access-date=2018-08-11|archive-url=|archive-date=|url-status=|language=en-US}}</ref>
 
==Learn more ==
*[https://www.nhs.uk/conditions/migraine/treatment/ Migraine treatment] - National Health Service
*[https://www.nccih.nih.gov/health/providers/digest/dietary-supplements-for-headaches-science Dietary Supplements for Headaches: What the Science Says] - National Center for Complementary and Integrative Health


== See also ==
== See also ==
* [[Headache]]
* [[Headache]]
*[[Analgesic]] (pain killer)
* [[Magnesium]]
 
* [[Analgesic]] (pain killer)
==Learn more==
*Oct 18, 2016, [https://www.theguardian.com/science/2016/oct/18/migraines-could-be-caused-by-gut-bacteria-nitrates-food-trigger-study-suggests Migraines could be caused by gut bacteria, study suggests]<ref>{{Cite web|url=http://www.theguardian.com/science/2016/oct/18/migraines-could-be-caused-by-gut-bacteria-nitrates-food-trigger-study-suggests|title=Migraines could be caused by gut bacteria, study suggests|last=Devlin|first=Hannah|date=2016-10-18|website=the Guardian|language=en|access-date=2018-08-11}}</ref>
*May 19, 2018, [https://www.healthrising.org/blog/2018/05/19/migraine-drug-explosion-fibromyalgia-chronic-fatigue/ The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit?]<ref>{{Cite news|url=https://www.healthrising.org/blog/2018/05/19/migraine-drug-explosion-fibromyalgia-chronic-fatigue/|title=The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit? - Health Rising|last=Johnson|first=Cort|date=2018-05-19|work=Health Rising|access-date=2018-08-11|archive-url=|archive-date=|url-status=|language=en-US}}</ref>


==References==
==References==

Latest revision as of 13:58, July 25, 2023


Migraines 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 chronic fatigue syndrome patients.[1] This compared to 5% and 45%, respectively, in a cohort of healthy controls.[1]

Symptoms[edit | edit source]

[2]

Phases[edit | edit source]

Migraine phases:

Prodromal (pre-headache) stage
changes in mood, energy levels, behaviour and appetite that can occur several hours or days before an attack
Aura phase (if present)
visual problems are very common, e.g. flashes of light (scintillations) or blind spots (scotoma), aura symptoms last for 5 to 60 minutes
Headache phase
usually a moderate or severe pulsating or throbbing pain on one side of the head, often accompanied by nausea, vomiting or extreme light sensitivity and extreme sensitivity to loud sounds, which last from 4 hours to 3 days
Postdromal or resolution stage
the severe headache and other symptoms gradually fade, but there may be tiredness for few days after[3][4][2]


Types[edit | edit source]

Migraine without aura[edit | edit source]

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[edit | edit source]

  1. At least five headache attacks that
  2. Last 4–72 hours without successful treatment
  3. Headaches have at least two of the following four characteristics:
    1. unilateral location;
    2. pulsating quality;
    3. moderate to severe pain intensity; and
    4. aggravation by or causing avoidance of routine physical activity.
  4. During the headaches at least one of the following:
    1. nausea and/or vomiting
    2. photophobia and phonophobia (avoidance of loud noises)
  5. Not better accounted for by another ICHD-3 diagnosis.
Migraines without aura may also be called common migraine or hemicrania simplex'.[5]

Migraine with aura[edit | edit source]

Migraine with aura diagnostic criteria[edit | edit source]

Visual, sensory and central nervous system symptom in beginning shortly before a migraine headache are known as an aura, although migraine with aura without migraine headaches are also recognized.
  1. At least two migraine attacks fulfilling criteria B and C
  2. One or more of the following fully reversible aura symptoms
    1. visual
    2. sensory
    3. speech and/or language
    4. motor
    5. brainstem
    6. retinal
  3. At least three of the following characteristics:
    1. at least one aura symptom spreads gradually over five minutes or longer
    2. two or more aura symptoms occur in succession
    3. each individual aura symptom lasts 5 to 60 minutes
    4. at least one aura symptom is unilateral (one sided)
    5. at least one aura symptom is positive
    6. the aura is accompanied, or followed within 60 minutes, by headache
  4. Not better accounted for by another ICHD-3 diagnosis.[5]

The recognized types of migraine with aura are:

  • Typical aura with headache
  • Typical aura without headache
  • Migraine with brainstem aura
  • Hemiplegic migraine, including familial hemiplegic migraine (FHM) type 1, type 2, type 3 and with other loci
  • Sporadic hemiplegic migraine (SHM)
  • Retinal migraine

Migraines without aura may also be called Classic or classical migraine, ophthalmic, hemiparaesthetic, hemiplegic or aphasic migraine, or complicated migraine.[5]

Chronic migraine[edit | edit source]

[5]

Silent migraine[edit | edit source]

Migraine symptoms that do not result in a headache are known as silent migraines, e.g. migraine aura symptoms without head pain.migraine aura without headache, also known as silent migraine – where an aura or other migraine symptoms are experienced, but a headache does not develop.[2]

Abdominal migraine[edit | edit source]

[5]

Triggers[edit | edit source]

Migraine triggers. Source: Biomedicine & Pharmacotherapy, 139, 111557[4]


Common migraine triggers include:

  • Food and drinks, e.g., chocolate, alcohol, aged cheese, gluten
  • Lifestyle patterns, e.g. stress, weather changes, or fasting
  • Genetics
  • Physiological and biochemical factors, e.g. insulin or oestrogen hormone levels, increased oxidative stress[4][2]

Migraines in ME/CFS[edit | edit source]

Migraines is one of several illnesses or conditions common in people with ME/CFS.[6][7]

The Canadian Consensus Criteria recognizes migraines in the possible neurological symptoms of ME/CFS, and the International Consensus Criteria recognizes headache conditions including migraine and tension-type headache in the diagnostic criteria for myalgic encephalomyelitis.[7]

Possible causes[edit | edit source]

Potential treatments[edit | edit source]

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[edit | edit source]

Migraine prevention[edit | edit source]

Notable studies[edit | edit source]

News and articles[edit | edit source]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 Ravindran, Murugan K; Zheng, Yin; Timbol, Christian; Merck, Samantha J; Baraniuk, James N (March 5, 2011). "Migraine headaches in Chronic Fatigue Syndrome (CFS): Comparison of two prospective cross-sectional studies". BMC Neurology. 11 (1). doi:10.1186/1471-2377-11-30. ISSN 1471-2377. PMID 21375763.
  2. 2.0 2.1 2.2 2.3 "Migraine". National Health Service. Retrieved October 15, 2021.
  3. "Migraine - Symptoms". National Health Service. Retrieved October 15, 2021.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 Khan, Johra; Asoom, Lubna Ibrahim Al; Sunni, Ahmad Al; Rafique, Nazish; Latif, Rabia; Saif, Seham Al; Almandil, Noor B.; Almohazey, Dana; AbdulAzeez, Sayed (July 1, 2021). "Genetics, pathophysiology, diagnosis, treatment, management, and prevention of migraine". Biomedicine & Pharmacotherapy. 139: 111557. doi:10.1016/j.biopha.2021.111557. ISSN 0753-3322.
  5. 5.0 5.1 5.2 5.3 5.4 Headache Classification Committee of the International Headache Society (2018). "The International Classification of Headache Disorders". Cephalalgia (3rd ed.). 38 (1): 1–211. doi:10.1177/0333102417738202. ISSN 0333-1024.
  6. "Overlapping Conditions – American ME and CFS Society". ammes.org. Retrieved August 12, 2018.
  7. 7.0 7.1 Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
  8. "Migraine Guide: Causes, Symptoms and Treatment Options". Drugs.com. Retrieved October 12, 2021.
  9. 9.0 9.1 9.2 Negro, Andrea; Martelletti, Paolo (June 2019). "Gepants for the treatment of migraine". Expert Opinion on Investigational Drugs. 28 (6): 555–567. doi:10.1080/13543784.2019.1618830. ISSN 1744-7658. PMID 31081399.
  10. 10.0 10.1 "Migraine - Treatment". National Health Service. Retrieved October 15, 2021.
  11. 11.0 11.1 11.2 "Migraine - Prevention". National Health Service. October 23, 2017. Retrieved October 12, 2021.
  12. Cascio Rizzo, Angelo; Paolucci, Matteo; Altavilla, Riccardo; Brunelli, Nicoletta; Assenza, Federica; Altamura, Claudia; Vernieri, Fabrizio (2017). "Daith Piercing in a Case of Chronic Migraine: A Possible Vagal Modulation". Frontiers in Neurology. 8. doi:10.3389/fneur.2017.00624. ISSN 1664-2295. PMC 5711775. PMID 29230190.
  13. Sun-Edelstein, Christina; Mauskop, Alexander (March 2011). "Alternative Headache Treatments: Nutraceuticals, Behavioral and Physical Treatments: March 2011". Headache: The Journal of Head and Face Pain. 51 (3): 469–483. doi:10.1111/j.1526-4610.2011.01846.x.
  14. Barmherzig, Rebecca; Rajapakse, Thilinie (May 10, 2021). "Nutraceuticals and Behavioral Therapy for Headache". Current Neurology and Neuroscience Reports. 21 (7): 33. doi:10.1007/s11910-021-01120-3. ISSN 1534-6293.
  15. Sun-Edelstein, Christina; Mauskop, Alexander (June 2009). "Foods and Supplements in the Management of Migraine Headaches". The Clinical Journal of Pain. 25 (5): 446–452. doi:10.1097/AJP.0b013e31819a6f65. ISSN 0749-8047.
  16. "Dietary Supplements for Headaches: What the Science Says". National Center for Complementary and Integrative Health. Retrieved October 13, 2021.
  17. Rayhan, Rakib U.; Ravindran, Murugan K.; Baraniuk, James N. (2013). "Migraine in gulf war illness and chronic fatigue syndrome: prevalence, potential mechanisms, and evaluation". Frontiers in Physiology. 4: 181. doi:10.3389/fphys.2013.00181. ISSN 1664-042X. PMID 23898301.
  18. Gonzalez, Antonio; Hyde, Embriette; Sangwan, Naseer; Gilbert, Jack A.; Virre, Erik; Knight, Rob (October 18, 2016). "Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort" (PDF). American Society for Microbiology. 1 (5).
  19. Devlin, Hannah (October 18, 2016). "Migraines could be caused by gut bacteria, study suggests". the Guardian. Retrieved August 11, 2018.
  20. Johnson, Cort (May 19, 2018). "The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit? - Health Rising". Health Rising. Retrieved August 11, 2018.