Migraine
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 CFS patients.[1] This compared to 5% and 45%, respectively, in a cohort of healthy controls.[1]
Symptoms[edit | edit source]
Phases[edit | edit source]
Migraine phases:
- Prodromal
- Aura phase (if present)
- Headache phase
- Postdromal
Diagnostic criteria[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]
- 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.
- During the headaches at least one of the following:
- nausea and/or vomiting
- photophobia and phonophobia (avoidance of loud noises)
- Not better accounted for by another ICHD-3 diagnosis.
- Migraines without aura may also be called common migraine or hemicrania simplex'.[3]
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.
- At least two migraine attacks fulfilling criteria B and C
- One or more of the following fully reversible aura symptoms
- visual
- sensory
- speech and/or language
- motor
- brainstem
- retinal
- At least three of the following characteristics:
- at least one aura symptom spreads gradually over five minutes or longer
- two or more aura symptoms occur in succession
- each individual aura symptom lasts 5 to 60 minutes
- at least one aura symptom is unilateral (one sided)
- at least one aura symptom is positive
- the aura is accompanied, or followed within 60 minutes, by headache
- Not better accounted for by another ICHD-3 diagnosis.[3]
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.[3]
Chronic migraine[edit | edit source]
Abdominal migraine[edit | edit source]
Triggers[edit | edit source]
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[2]
Migraines in ME/CFS[edit | edit source]
Migraines is one of several illnesses or conditions common in people with ME/CFS.[4][5]
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 headaches in the diagnostic criteria for myalgic encephalomyelitis.[5]
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]
- General pain medications, including acetaminophen and nonsteroidal anti-inflammatories (NSAID), for mild to moderate migraines. Different types of medications are sometimes combined, for example acetaminophen and naproxen.[2]
- Triptans for moderate or severe migraine e.g. sumatriptan (Imitrex): 13 out of 14 newly diagnosed migraine subjects responded to sumatriptan in one CFS patient cohort[1] or zomitriptan (Zomig)[6]
- Small molecule CGRP antagonists, known as gepants, which are the newest group of migraine drugs[7]
Migraine prevention[edit | edit source]
- Migraine elimination diets, which rely on identifying particular foods, drinks or additives that trigger migraines, for example avoiding food or drinks containing nitrates or tyramine[2][8]
- CGRP antagonists, particularly CGRP monoclonal antibodies but possibly some gepants[7]
- Drugs developed for other uses that are known to reduce migraines, including propranolol, amitriptyline (Elavil), topiramate (Topamax) or botulinum toxin type A (Botox injections)[7][8]
- Acupuncture[8]
- Daith piercing, a type of ear piercings not routinely recommended[9]
- Natural or alternative dietary supplements including magnesium, feverfew, the B vitamin riboflavin, CoQ10, and others.[10][11][12] Butterbur is not recommended due to liver toxicity.[13]
Notable studies[edit | edit source]
- 2011, Migraine headaches in chronic fatigue syndrome (CFS): comparison of two prospective cross-sectional studies.[1]
- 2013, Migraine in gulf war illness and chronic fatigue syndrome: Prevalence, potential mechanisms, and evaluation.[14] (Full Text)
- 2016, Migraines Are Correlated with Higher Levels of Nitrate-, Nitrite-, and Nitric Oxide-Reducing Oral Microbes in the American Gut Project Cohort[15] (Full Text)
News and articles[edit | edit source]
- Oct 18, 2016, Migraines could be caused by gut bacteria, study suggests[16]
- May 19, 2018, The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit?[17]
Learn more[edit | edit source]
- Dietary Supplements for Headaches: What the Science Says - National Center for Complementary and Integrative Health
See also[edit | edit source]
References[edit | edit source]
- ↑ 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.
- ↑ 2.0 2.1 2.2 2.3 2.4 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.
- ↑ 3.0 3.1 3.2 3.3 3.4 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.
- ↑ "Overlapping Conditions – American ME and CFS Society". ammes.org. Retrieved August 12, 2018.
- ↑ 5.0 5.1 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
- ↑ "Migraine Guide: Causes, Symptoms and Treatment Options". Drugs.com. Retrieved October 12, 2021.
- ↑ 7.0 7.1 7.2 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.
- ↑ 8.0 8.1 8.2 "Migraine - Prevention". National Health Service. October 23, 2017. Retrieved October 12, 2021.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ "Dietary Supplements for Headaches: What the Science Says". National Center for Complementary and Integrative Health. Retrieved October 13, 2021.
- ↑ 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.
- ↑ 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).
- ↑ Devlin, Hannah (October 18, 2016). "Migraines could be caused by gut bacteria, study suggests". the Guardian. Retrieved August 11, 2018.
- ↑ Johnson, Cort (May 19, 2018). "The Migraine Drug Explosion Begins: Could Fibromyalgia and ME/CFS Benefit? - Health Rising". Health Rising. Retrieved August 11, 2018.