diary of a migraine lad

Avoiding Food Triggers. Avoiding foods that trigger migraine is important in people who are susceptible to these triggers. Keeping a headache diary that includes tracking diet and headache onset can help identify them. [ See Table Foods That May Trigger Migraines.]

Healthy Diet. One study indicates that a diet low in fat and high in complex carbohydrates may significantly reduce the frequency, severity, and duration of migraine headaches. Such a diet is healthy in general in any case.

Eating Regularly. Eating regularly is important to prevent low blood sugar. People with migraines who fast periodically for religious reasons might consider taking preventive medications.

Vitamin B2 Supplements. There is reasonable evidence on the benefits of vitamin B2 for migraine sufferers. In one study, patients who took 400 mg of vitamin B2 (riboflavin) reduced their migraine attacks by half, although the vitamin had no effect on the severity or duration of migraines that did occur. In another study, it helped increase the effectiveness of beta-blockers, drugs used to prevent migraines in some people. Vitamin B2 is generally safe, although some people taking high doses develop diarrhea.

Smelling Pleasurable Foods. One interesting study suggested that smelling certain pleasurable foods may reduce migraine pain. (The study used green apples as part of the experiment; patients with headaches who liked the smell of green apples had less pain. The scent had no effect on those who didn't like the fruit.)

Sleep Hygiene

Improving sleep habits is important for everyone, and especially those with headaches.

Aerobic Exercise

Exercise is certainly helpful for relieving stress and an analysis of several studies reported that aerobic exercise might help prevent migraines. It is important, however, to warm up gradually before beginning a session, since sudden, vigorous exercise might actually precipitate or aggravate a migraine attack.

Behavioral Treatments

Behavioral techniques that reduce stress and empower the patient may help some people with migraines. These methods generally include the following:

• Biofeedback therapy.
   

• Cognitive-behavioral therapy.
   

• Relaxation techniques.

This approach may help counteract the tendency for muscle contraction and uneven blood flow associated with some headaches. They may be particularly beneficial for pregnant and nursing women, who cannot take most medications.

Biofeedback. Studies have demonstrated some effectiveness from biofeedback for migraine headaches. Biofeedback training teaches the patient to monitor and modify physical responses, such as muscle tension, using special instruments for feedback.

Cognitive Behavioral Therapy. Behavioral therapy may be useful alone but is particularly beneficial for patients who are on preventive drug treatments. It typically employs the headache diary to track activities and headaches. The patient then works with the therapist to change or add behaviors or medications that will reduce the frequency and severity of attacks.

Alternative Treatments

Non-Drug Therapies. Alternative non-drug therapies used for headache management include hypnosis, meditation, visualization and guided imagery, acupuncture, acupressure, yoga, and other relaxation exercises. There is no clear evidence that any of these techniques have specific value for migraines. Some studies report the following:

• Relaxation Techniques. Muscle relaxation techniques may be helpful. One interesting 2001 study reported that relaxation treatments appeared to help adolescents with migraine but not tension headaches.
  
   

• Electrical Stimulation. Small studies have found that therapy with transcutaneous electrical stimulation (TENS) may reduce migraine headache episodes. The procedure involves a very mild electrical sensation across the skin. One course of TENS takes about a half hour. One report suggests that using TENS with acupuncture points, along with self-hypnosis and relaxation techniques, may be an effective management option among patients with migraine headaches, but long-term and well-conducted studies are needed to confirm this.

Feverfew. There is some clinical evidence that the herbal medicine feverfew helps prevent migraines and even help reduce their severity. It should be noted, however, that, like all effective headache remedies over use can cause a rebound effect. Some experts recommend purchasing feverfew in dried leaf form. It appears to be safe, but side effects can be distressing, particularly canker sores in the mouth (5% to 15% of cases) and stomach distress. This agent should not be taken during pregnancy or in women hoping to become pregnant. People with any blood clotting disorders should not take it. As with most alternative medications, herbal products are not government tested or controlled. Many brands do not have enough of the active ingredient to be effective. Be sure to let your doctor know if you are taking an herbal preparation to treat your migraines.

Glucosamine. Glucosamine is a natural substance being used with some success for patients with osteoarthritis. Anecdotal reports are suggesting that the use of this agent may prevent migraines. As with other natural remedies, products are not regulated by the FDA. It is being well studied for arthritis, however, and to date has few side effects. Many available brands (e.g., CVS, Walgreens, Wal-Mart) are manufactured with appropriate ingredients.

Coenzyme Q10. Coenzyme Q10 is a natural substance that is important for the transport of electrons. One study reported that patients who took it experienced a significant reduction in migraine headaches after three months.

Magnesium. Studies have reported that some migraine patients, such as women with menstrual migraine, may have a magnesium deficiency. Intravenous magnesium sulfate has been useful for migraine relief in people with low levels of magnesium, although it does not appear to have any benefits for people with normal levels of magnesium. Over-the-counter supplements are of uneven quality and costly, and many magnesium salts are not absorbed well and may cause diarrhea. Studies are underway to determine the most effective magnesium preparation and its benefits, if any, in menstrual migraines.

WASHINGTON (Reuters) - People with migraines also may be suffering from some brain damage as brain cells swell and become starved of oxygen -- a finding that may help explain why migraine sufferers have a higher risk of stroke, researchers reported on Sunday.

Similar brain damage can occur with concussions and after strokes, the researchers said in this week's issue of the journal Nature Neuroscience.

They said their findings suggest that migraine sufferers should not simply get pain relief but should take drugs that prevent the migraine, which is often preceded by "aura" -- a series of visual disturbances that can include flashes of light or black spots.

The research, which was done in mice, also suggests giving oxygen may help reduce the damage, said Takahiro Takano, Maiken Nedergaard and colleagues at the University of Rochester in New York, working with a team at the Danish pharmaceutical group Novo Nordisk.

They studied a process called cortical spreading depression, known as CSD, a wave of changes in cells associated with migraine, stroke and head trauma.

They used a precise two-photon microscopic and oxygen sensor microelectrodes to look at the brains of live mice while they caused this process.

They saw a swelling occur and the brain cells became starved of oxygen. The nerve cells were damaged -- specifically the dendrites, the long, thin spikes that stretch from one nerve cell to another.

28 MILLION SUFFERERS IN U.S.

"This observation may have direct clinical implications, as several lines of work support the notion that cortical spreading depression constitutes the neurological basis of migraine with aura, and spontaneous waves of CSD may contribute to secondary injury in stroke and traumatic brain injury," the researchers wrote.

Migraine is a severe and debilitating form of headache, affecting 28 million people in the United States alone.

Two studies, including one published last week in the Archives in Internal Medicine, show that people who have migraines are more likely to have heart attacks.

A 2004 study in the British Medical Journal found that migraine sufferers are twice as likely to suffer a stroke as people who do not have the headaches.

Women are much more likely to suffer the characteristic pain of a migraine.

Usual pain medication often has little effect on migraine but a class of drugs called triptans, also called serotonin agonists, and ergotamine drugs, can be used to prevent the worst effects if patients take them at the first sign.

Giving the mice rich doses of oxygen seemed to shorten the duration of the wave of brain effects seen in CSD, the researchers said. They noted that migraine and cluster headache patients are sometimes treated with high-pressure oxygen.

It is not clear if the effects of migraine are permanent, the researchers said. Some studies have suggested they are while others have shown no difference in memory and other cognitive effects in migraine patients.