Demystifying Migraine - World Brain Day July 22nd 2019
Migraines are many things, they come in many different forms, frequencies and severities. Migraines come with many stories, and are often laden with the fears of ‘the next bad one’ or the dread that ‘they will never ever go away’.
The experience of a migraine is a completely subjective one, it is unique to the person, and like any complex pain experience, it is shaped by the things we think, feel, and do, and by the memories of previous experiences – along with all of the physiological happenings inside your body, and your brain, in the phases before, during and after the migraine.
There has long been an association with migraine and a certain mysteriousness regarding reasons they occur. But this is rapidly changing. On the 22nd of this month it is – ‘all eyes on’, or rather, ‘all brains on’ migraine for The World Federation of Neurology and the International Headache Society’s World Brain Day. A huge network of incredible scientists will put the complexities of migraine on the main stage, and direct global attention to the painful truth about migraine and the fact they are under-recognised, under-diagnosed and under-treated at an international level.
This is the year for advances in migraine assessment, diagnosis and treatment. Finally.
The perfect opportunity to clear up some misconceptions about migraines, myths that are so widely and deeply entrenched, that many people who suffer with them will not use migraine as the reason for their sick leave, and will no longer have conversations about how they are really feeling with their friends and loved ones. Hopefully World Brain Day 2019 will help to change this.
Migraine myths, misconceptions and mysteries…
“Isn’t a migraine just a really bad headache?”
Migraine is not a bad headache, migraine is not a tension headache or a sinus headache. Migraine is a serious neurological disease / disorder, the most common brain disease in the world. Chronic migraines can alter the brains structure and aspects of function. Migraine sufferers also contend with increased risk of other diseases including stroke.
“Migraines are just a ‘woman’ thing aren’t they, ‘that time of the month’ and all that?”
The World Health Organisation estimates migraine affects around 15% of the population – and is the most common neurological disease. Migraine is VERY common, 4.9 million Australians experience migraine. Migraines affect men, women, children, even babies.
Women are disproportionately affected by migraine, roughly 3 times that of men, and contributing factors include of the impact of hormones including estrogen, on cerebral blood flow and serotonin, but men also have estrogen and are impacted by increased levels of it as well.
“I suffer with migraines – I have to give up coffee and I can never have chocolate again”
In some people particular foods may contribute negatively to the experience of migraine, and removal of these from the diet may decrease the frequency or severity of the migraine. It is likely that even if this individual did not experience migraine they would still have some sensitivity to these foods. Equally fasting can be a trigger for migraine in some. It has also been suggested that some individuals may reach for chocolate (for example) during the warning stages when the migraine is already underway, then, perhaps, blame the innocent chocolate for the migraine.
Either way, with regard to what we put into ourselves, and the results that come out (migraine or not) …it usually pays to have an open mind and be prepared to go without for a period and monitor the impact.
“I’ve been told there is nothing I can really do to stop them, I just have to put up with them.”
FALSE – there are a lot of options available, with existing and new treatments being researched every day. The World Federation of Neurology acknowledges the lack of awareness and access to effective treatment options.
Headache Australia states that successful treatment is ‘not just a matter of taking a tablet but a case of each individual developing a migraine management plan that will probably involve lifestyle modifications and complimentary therapies as well’.
Neuroimaging is revealing magnificent detail into the ‘migraine brain’, including blood flow within the brain, areas of the brain activated during migraine and the type of activity the brain is producing. When we understand the individual’s brain map, an individually designed treatment program can be designed and embarked upon. Neurofeedback and neuromodulation techniques should be guided by these unique brain maps and be highly specified for the individual. Biofeedback has also shown significant positive results for migraine sufferers, particularly with reducing the frequency and increasing the sense of deep self-control (right down to the nervous system level) for sufferers during a migraine.
These are exciting times for migraine sufferers, tune in on the 22nd to hear from a highly esteemed panel of international experts on World Brain Day, 2019 World Migraine Day.
About the author - Emily Goss, OT. Senior Clinician, The Perth Brain Centre.