Your Migraine Questions Answered Here! (Part 1 of 3)
I just finished listening to migraine health activist Teri Robert participate in a migraine panel on the Diane Rehm show on NPR. I learned SO MUCH from this hour long interview, and I am so excited to share it with you over the next few days. (For those of you who listened, please e-mail me corrections if I wrote something wrong.) It seemed like they were overwhelmed by calls and e-mails, which just shows how prevalent our disease is!
I’ll paraphrase a bit of what they said here:
The Diane Rehm Show on NPR, Thursday, August 16, 2012 at 11 AM:
Panel:
- Dr. Perry Richardson, neurologist at George Washington University Hospital
- Teri Robert, author of “Living Well With Migraine Disease and Headache.”
- Dr. David Dodick, neurologist at the Mayo Clinic and chair of the American Migraine Foundation.
- Dr. Story Landis, director of the National Institute of Neurological Disorders and Stroke at the National Institutes of Health.
1) What is migraine?
- Migraine is a brain disorder, not a blood disorder. For the past 3 centuries, migraine was considered a vascular disorder but over the past decade, we’ve come to realize it’s a brain disorder. New medications will target the brain and nerves themselves now that we know more about the hyperexcitability of brain networks in migraineurs.
- The headache pain is only one stage of migraine but it can be disabling. We should take the word “headache” out of “migraine headache” because it’s disabling pain beyond just a headache.
- The origin of the word migraine comes from the word for “one side of the head.”
2) What doesn’t a migraine show up in a typical MRI?
- Migraine is a disease. A disease means having an abnormal structure or an abnormal function. MRI’s of a migraine brain are typically normal in structure. However, a functional scan of the brain (used primarily by researchers and not radiologists) shows differently. Migraine disease is a disorder of FUNCTION, rather than structure.
- When someone is having a migraine, we see the activation of certain regions and networks in the brain, particularly those networks that process sensory information like light, noise, pain, and emotion. We notice this happening NOT simply during a migraine attack but in between migraine attacks as well. Previously, migraines were thought to just come and go in a person and they were considered “normal” in between attacks.
- However, we now recognize the fact that it’s an abnormal processing in the brain that continues between attacks. A migraine brain processes sensory information in an abnormally excitable way.
3) How is migraine diagnosed?
- A migraine diagnosis lacks a formal, scientific test. Instead, diagnosis is based on a description of the event and potential sensitivity symptoms.
- For example, people may note that they are yawning, craving food, or experiencing a shift in mood as early as the day before the pain begins. The day after the pain they may be completely disabled.
4) What kind of doctor treats a migraine?
- Look for a migraine specialist, not necessarily a neurologist.
- In the experience of Dr. Dodick, during medical school, he had 0 hours of education on migraine and headache disorders. In his residency to become a neurologist, he had 2 hours of migraine education. As he said, it’s hard to get inspired to chase a career in a disorder in which they have no education.
- Now headache medicine is an accredited specialty of neurology, and boards certify headache specialty.
Did any part of this interview surprise you? Will you share it with your migraineur and non-migraineur friends?
