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

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.

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)

See also

• Headache
• Analgesic (pain killer)

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?

phonophobia Sound intolerance or hypersensitivity, e.g. during a migraine. (Learn more: www.merriam-webster.com)

antagonist A chemical that reduces or helps block the activity of another chemical in the body. For example, most antihistamines are H1 antagonists because they block the H1 histamine receptor, which helps relieve allergy symptoms. The opposite of an agonist.