Refractory migraines may respond to occipital nerve stimulation, according to Dr. Joel Saper who led a multicenter trial of this treatment. An electrode was surgically implanted in the back of the head, where the occipital nerve is located, and a pacemaker-size device was implanted under the skin. The trial looked at 110 patients who had more than 15 days with migraines each month and who did not respond to a variety of medications. 66 patients completed the diary information for three months following the start of treatment. The results were encouraging - 39% of patients improved, compared with 6% in the control group. None of the patients had any adverse events.
Written by Dr. Mauskop | 09.11.2008 | No comments
Patients who suffer from migraine headaches are 30% less likely to develop breast cancer. It is well established that fluctuating estrogen levels throughout the menstrual cycle can trigger migraine attacks. These fluctuations are reduced during pregnancy and menopause, resulting in cessation of migraine attacks in two thirds of women. At this point it is not clear what common estrogen-based mechanisms are responsible for the reduction of breast cancer risk in migraine sufferers.
Written by Dr. Mauskop | 09.11.2008 | No comments
It is well known that if you take a snapshot of the population, about 18% of women and 6% of men suffer from migraine headaches. However, a report by Dr. Stewart and his colleagues in the latest issue of Cephalalgia indicates that cumulative lifetime migraine incidence is much higher - 43% of women and 18% of men have migraine headaches at some point in their lives. Migraine incidence peaked between the ages of 20 and 24 in women and 15 and 19 in men. In 75% of cases migraine started before the age of 35.
Written by Dr. Mauskop | 02.11.2008 | No comments
Magnesium is effective in preventing migraine headaches according to a new study published in the last issue of journal Magnesium Research. The researchers found that patients treated with magnesium, compared to those treated with placebo, had fewer migraine attacks and the attacks were milder. In addition, magnesium treated patients had improved blood flow in their brains, while those on placebo did not. This is just another confirmation of previous findings of the efficacy of magnesium in the treatment of migraine headaches. Since magnesium is very inexpensive and extremely safe, every patient with migraine headache should be given a trial of magnesium supplementation.
Written by Dr. Mauskop | 19.10.2008 | 1 comment
15,056 patients with migraine and tension-type headaches were treated with acupuncture in a largest acupuncture study, which was financed by the German government. Results published in the latest issue of journal Cephalalgia by S. Jena and colleagues indicate that “acupuncture plus routine care in patients with headache was associated with marked clinical improvements compared with routine care alone”. This study should dispel any remaining doubt about the efficacy of acupuncture in the treatment of headaches.
Written by Dr. Mauskop | 19.10.2008 | No comments
Progressive muscle relaxation is an integral part of biofeedback training, but can be used by itself for the treatment of migraine and tension-type headaches. A group of researchers at the Ohio State University published an article in the journal Pain which reports the effect of progressive muscle relaxation on experimental pain in healthy volunteers. A single 25-minute tape-recorded session of progressive muscle relaxation resulted in a higher pain tolerance and reduced stress from pain. It can be safely assumed that regular practice sessions will result in even better results and all pain patients, including those with headaches should be encouraged to learn this simple technique.
Written by Dr. Mauskop | 19.10.2008 | No comments
Botox is effective for chronic migraines, according to a statement released by Allergan, maker of Botox. The company reported that a large multi-center trial (the New York Headache Center was one of the trial sites) yielded positive results. This report did not surprise us or our colleagues who routinely use Botox in treating patients with chronic migraines. The excitement we feel is due to the fact that many of our colleagues have been skeptical about the efficacy of Botox. Much more importantly, we hope that this definitive study will compel insurance companies to pay for this treatment.
Written by Dr. Mauskop | 12.09.2008 | 2 comments
Cluster headaches cause the worst pain imaginable, leading some patients to thoughts of suicide. They occur in about 0.1% of the population, while migraine headaches afflict 12%, which may explain why so much less research has been conducted on cluster than on migraine headaches. Injectable sumatriptan (Imitrex) is the only drug approved by the FDA for cluster headaches. We do use many other medications “off-label” for both acute and prophylactic treatment, but none have been subjected to rigorous research. That is none, until recently - zolmitriptan nasal spray (Zomig NS) has been shown to be effective in relieving cluster headaches within 30 minutes. While the dose of Zomig NS for migraines is 5 mg, in this latest trial both 5 and 10 mg dose was studied. The 10 mg dose was better than 5 mg dose in patients with episodic cluster headaches (74% vs 52%), but these two doses were equally effective in patients with chronic cluster headaches (41% vs 42%). The advantage of Zomig NS over Imitrex injection is that it is easier to use and does not involve a painful injection, while the advantage of Imitrex is that it works faster. Zomig NS is now approved for acute treatment of cluster headaches in Germany, Netherlands and Denmark.
Written by Dr. Mauskop | 07.09.2008 | 2 comments
Children with thyroid disease are more likely to have headaches, according to a study done by Dr. David Rothner and his colleagues at the Cleveland Clinic. 36% of children with hypothyroidism and 19% with hyperthyroidism had headaches. The types of headaches observed included chronic migraine and new daily persistent headache. The authors conclude that thyroid testing should be part of a standard evaluation of headaches in children, just like it is in adults.
Written by Dr. Mauskop | 04.09.2008 | No comments
Women with menstrual migraines who also have chronic migraines can be successfully treated with hormonal therapy, according to a study by Drs. Calhoun and Ford published in journal Headache. Surprisingly, controlling menstrual migraines led to improvement in chronic migraines as well. Chronic migraine is defined as a headache with migraine features that occurs on more than 15 days each month and it affects a staggering 4%-5% of the population. Hormonal therapy usually consists of taking an oral contraceptive continuously for many months, thus eliminating menstrual periods and often headaches and PMS symptoms. Oral contraceptives should not be taken by patients who have visual aura - visual disturbance that usually lasts 30 minutes and precedes the headache.
Written by Dr. Mauskop | 03.09.2008 | 2 comments
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