Talk:Migraine

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To-do list for Migraine: edit · history · watch · refresh

Strike through when complete:

  • Expand intro
  • Add info on serotonin transporter gene to intro and body text
  • New section: Epidemiology
  • Add the most common types migraine without aura (common migraine) and migraine with aura (classic migraine) to Migraine#Types instead of just the rarer forms.* Move "Clinical picture" references to appropriate location
  • Convert references to inline <ref> </ref> tags
  • Add brainstem generator theory
  • Add criticism of competing theories
  • Solve article size issue (separate treatments article?)

See WP:MEDMOS for additional style suggestions
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Feb04--July07


Contents

[edit] Foods

I've had a persistent headache for around the last two weeks. The only thing I've changed in my lifestyle is that I started eating 60 - 90g of whey powder a day as a protein supplement. I was suprised to see it mentioned (albeit without citation) on the whey Wiki that this may be a side effect. I can personally attest to this being correct for some. The onset of the headache coincides almost identically with the consumption, beginning shortly after. —Preceding unsigned comment added by 79.75.163.169 (talk) 00:47, 8 April 2008 (UTC)

[edit] Prism Spectacles

The statement, "Prism has been proven effective at relieving motion sickness..." includes a link to a single study (Brain Research Bulletin, Vol. 47, No. 5, pp. 503–505, 1998) that claims a correlation between use of prism spectacles and decrease in motion sickness. However, the study includes no control group and the correlation could very be a placebo effect despite the authors' reasoning against placebo effect: "A placebo effect is unlikely because alleviation of car sickness was not the original intention of the prescription." That is, it is quite an overstatement to say that the article "proves" any such correlation. For this reason the statement about prism spectacles has been removed. —The preceding unsigned comment was added by 18.74.1.18 (talk) 05:00, 2 March 2007 (UTC).

[edit] Effectiveness of spinal manipulation on migranes

The current Chiropractic section of this article is misleading based on the most recent systematic reviews.

"Despite claims that spinal manipulation is an effective treatment for headache, the data available to date do not support such definitive conclusions." [1]

As well, a recent systematic review of systematic reviews concluded, "In conclusion, we have found no convincing evidence from systematic reviews to suggest that SM (spinal manipulation) is a recommendable treatment option for any medical condition."[2]Dyltron 13:31, 7 March 2007 (UTC)

[edit] Where are the references?

This article makes a lot of bold claims without any references - the entire pathophysiology section has virtually no supporting evidence.

Here is a list of but a few claims that need to be supported with references:

The vascular theory has been discredited
Cortical spreading depression is responsible for the disorder
That this view is supported by neuroimaging techniques
MSG in large doses was associated with adverse symptoms
The article says that this claim was derived from a "large and definitive study"

and yet this study is not referenced, why not?

Caffeine has been shown to partially reverse this effect, and probably accounts for its benefit.

I could go on, of course, since most of the claims about the causes and treatments for migraine are not referenced.

The article should not state that something has been "shown" by a study without citing any studies. 142.103.92.142 02:36, 22 April 2007 (UTC)

[edit] Famous Migraine Sufferers

Hi, I added an external link with info on famous migraine sufferers —The preceding unsigned comment was added by 213.16.166.234 (talk) 19:46, 23 April 2007 (UTC).

[edit] User:MarkWiseman edit's

MarkWiseman's- I don't understand why you have made the edits you have made. Firstly it comes off too POV and seems to go against WP:NPOV, you removed a lot of valid and cited texted information. Also Migraine is considered a neurological disease not disorder.

Please explain your reasoning.--Sugarcubez 06:55, 23 June 2007 (UTC)

Actually, Sugarcubez, I believe you should explain why you consider a migraine a disease? According to the National Institute of Neurological Disorders and Stroke (National Institute of Health), a migraine headache is classified as a neurological disorder. [3]. Migraine is also referred to as a disorder in the remainder of the article. MarkWiseman's edit is not POV but fact. Postoak 05:39, 24 June 2007 (UTC)

Actually Migraine is considered a disease [4][5][6][7][8][9][10][11][12] please look at the Migraine disease infobox- Classification & external resources it is classified there as well. And changing disease to disorder is not the only change he made, his other changes were not fact if you had actually read them, and how is removing factual cited paragraphed information fact?--Sugarcubez 18:46, 24 June 2007 (UTC)

Also I never said his change of disease to disorder was POV (although it actually is) I said his additions were so actually, Postoak I think you should please re-read the users removal and additional in the edits, and the links I gave you and Migraine infobox please--Sugarcubez 18:53, 24 June 2007 (UTC)


OK, let's talk...Sugarcubez, as I mentioned previously, according to the National Institute of Neurological Disorders and Stroke (National Institute of Health), a migraine headache is classified as a neurological disorder. Please see this reference: [13]. I did check your links and most contradict what you are trying to prove.

First, I'm unable to access the publication by Dr. Loder referenced in the article. However, here is a professional education monograph provided by the National Headache Foundation (incidentally, Dr. Loder and several other specialists are faculty members) for continuing medical education credit that specifically classifies migraine as a disorder. From Advanced in Migraine Prophylaxis, "Migraine is a common, disabling, inherited malfunction of the pain-regulating mechanism of the brain; it afflicts as many as 28 million Americans. Fortunately, the treatment of this disorder has advanced dramatically in recent years, with new drugs available for both acute treatment and prophylaxis." The publication is available here: [14]. Also, here is an additional link to an abstract for another article by Elizabeth Loder, MD and David Biondi, DO: [15]

Additionally,

  • According to the National Headache Foundation, a migraine is a category of headache which is classified as a disorder. [16]
  • According to the World Headache Alliance, "Migraine headache is now recognized as a neurologic disorder involving alterations occuring in the central nervous system." [17]

Second, here are additional scientific publications and research studies from the National Institute of Health:

  • From Migraine-related disability: impact and implications for sufferers' lives and clinical issues, Holmes WF, MacGregor EA, Dodick D., "Migraine is a common, debilitating disorder that imposes a large personal burden on sufferers and high economic costs on society." [18]
  • From Migraine: epidemiology, impact, and risk factors for progression., Lipton RB, Bigal ME. "Migraine is a chronic and sometimes progressive disorder characterized by recurrent episodes of headache and associated symptoms." [19]
  • From Migraine: diagnosis, management, and new treatment options., Gallagher RM, Cutrer FM., "Migraine is a paroxysmal disorder characterized by attacks of headache, nausea, vomiting, photophobia, and phonophobia." [20]
  • From The global burden of headache: a documentation of headache prevalence and disability worldwide., Stovner Lj, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, Steiner T, Zwart JA., "Globally, the percentages of the adult population with an active headache disorder are 46% for headache in general, 11% for migraine, 42% for tension-type headache and 3% for chronic daily headache. Our calculations indicate that the disability attributable to tension-type headache is larger worldwide than that due to migraine. On the World Health Organization's ranking of causes of disability, this would bring headache disorders into the 10 most disabling conditions for the two genders, and into the five most disabling for women." [21]
  • From The IHS classification criteria for migraine headaches in adolescents need minor modifications., Raieli V, Raimondo D, Gangitano M, D'Amelio M, Cammalleri R, Camarda R., "The operational and diagnostic criteria for migraine and all other headache disorders released in 1988 by the International Headache Society are universally considered reliable and exhaustive." [22]

Next, you suggested that I look at the diagnosis classification infobox. Ok, let's take a look:

  • ICD-10 - G43 Episodic and paroxysmal disorders (G40-G47)
  • ICD-9 - 346 Other Disorders Of The Central Nervous System 340-349
  • OMIM - References the Headache Classification Committee of the International Headache Society (1988) proposed a classification for headache disorders which provided operational diagnostic criteria for all varieties of facial pain and headache, including migraine.
  • Diseases DB - Migraine Disorders: "A class of disabling primary headache disorders, characterized by recurrent unilateral pulsatile headaches. The two major subtypes are common migraine (without aura) and classic migraine (with aura or neurological symptoms). (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1)"
  • Medline - classifies a migraine as a "primary headache" and does not mention disease. In fact, the reference states "Migraine headaches generally represent no significant threat to your overall health. However, they can be chronic, recurrent, frustrating, and they may interfere with your day-to-day life."
  • eMedicine - "Although migraine is a term applied to certain headaches with a vascular quality, overwhelming evidence suggests that migraine is a dominantly inherited disorder characterized by varying degrees of recurrent vascular-quality headache, photophobia, sleep disruption, and depression."
  • Me SH - MeSH Heading - Migraine Disorders "A class of disabling primary headache disorders, characterized by recurrent unilateral pulsatile headaches. The two major subtypes are common migraine (without aura) and classic migraine (with aura or neurological symptoms). (International Classification of Headache Disorders, 2nd ed. Cephalalgia 2004: suppl 1)

Continuity within Wikipedia:

  1. Migraine is referenced as a disorder throughout the migraine article. Did you actually read the article?
  2. The neurology article clearly classifies migraine as a disorder.

Finally, speaking about POV:

  1. You stated that this was POV in your edits above - "Firstly it comes off too POV and seems to go against WP:NPOV" and again here "Also I never said his change of disease to disorder was POV (although it actually is). Is this not what you intended to say?
  2. Your request for third-party assistance was rejected because of your non neutral request where you state "the addition of seemingly POV statements." [23]
  3. Yes, I did read MarkWiseman's edits. They were contributed in good faith (WP:AGF). His edits [24] included citations per WP:VERIFY.

Thank you, Postoak 23:14, 24 June 2007 (UTC)


Yes Postoak as you mentioned before National Institute of Neurological Disorders and Stroke. The NIH says the different types of neurological disorders, and migraine headaches are part of the brain/neurological disorders as all headaches are, but the migraine itself is a disease as like the links I gave you say.

Yes saying "Typically people..." does seem to go against neutral point of view. But I am curious as to how the removal of valid cited information in good faith?[25]--Sugarcubez 00:35, 25 June 2007 (UTC)

Even the original ciation (which is still there) say it is a disease. And I believe in Oliver Sacks's book Migraine he states it there as well the migraine itself is a disease.

Actually, the original citation does not say it is a disease. The title does include the word disease (Disease Modification in Migraine: A Concept That Has Come of Age?) but the title does not specifically state this is a disease. This article might discuss other disease states that are related to migraines, but I'm not sure since I don't have the article in front of me. However, I've provided additional sources where these two physicians do refer a migraine to a disorder. Please review the sources I provided above.

The scientific sources state that this is a disorder. Did you look at the sources that I provided above? Are you saying that we are to ignore the NIH classifaction for migraines based on the MAGNUM link you provided? If the NIH classifies it as a disorder, my gut feeling is to believe the National Institute of Health instead of the MAGNUM link. MAGNUM apparently is also in the business of selling books for the cause " Living Well with Migraine Disease and Headaches: What Your Doctor Doesn't Tell You... That You Need to Know" [26] and art [27]. Looks like somone is trying to make some bucks here. Perhaps you feel that this a reliable source, but sorry I don't.

Furthermore, removing information from an article and replacing it with other information is not always considered bad faith. He clarified the lead, corrected false information and added two references. Postoak 01:34, 25 June 2007 (UTC)
Interesting, here's another book from Oliver Sacks -- Migraine: Understanding a common disorder written in 1985, [28] Postoak 03:55, 25 June 2007 (UTC)
  • Um, okay let me try and explain this to you it is impossible for Migraine to be a disorder, headaches are the disorder, Migraines is the disease. As well since Migraine and headaches are different it is a disease. AIDS and Alzheimer's is even listed at NIH as well, so by your logic since brain disorder are listed they are all automatically disorders? Migraine is a disease by definition. And if you go to Oliver Sacks website he did not write that book you are pointing to. And what scientific sources say it is a disorder? Because by scientific reasons it is a disease, it has been proven.--Sugarcubez 20:32, 25 June 2007 (UTC)
And MAGNUM has been around for decades and is a great orginization for the Migraine disease, so going around insulting that is not going to get you anywhere--Sugarcubez 20:34, 25 June 2007 (UTC)
The scientific journals and NIH classify it as a disorder. I plan to agree with the scientific journals than your explanation above. You only have provided two references that claim this is a disease. Both are questionable to me and definately in the minority. The mention that MAGNUM is selling books and art to make money is not an insult, it is a fact. Simply follow the links I provided. You ask what scientific sources say migraine is a disorder? Again, please check the references above. Furthermore, the book I referenced above was written by Oliver Sacks so I'm amazed that you say it isn't. Postoak 23:57, 25 June 2007 (UTC)
Also, does migraine being referenced as a disorder throughout the migraine article or the fact that the neurology article clearly classifies migraine as a disorder concern you? See Migraine#Pathophysiology How about the "Nervous System Pathology" infobox at the bottom of the article where migraine is classified as a episodic and paroxysmal disorder? Should we rewrite the article and replace all references of disorder with disease? Should we change the neurology article? I will request input from other editors and get their feedback. Thanks, Postoak 00:11, 26 June 2007 (UTC)
I agree that the evidence for it being considered a disorder appears to be stronger than the evidence for it being called a disease. --Arcadian 02:52, 26 June 2007 (UTC)
Yes I too agree that disorder is more correct, certainly according to the sourced science views. From my reading of the specific meaning, the more medical science (informed) view seems to be using the term disorder in a categorical way. When the term disease is used, the source is either an informal web source, or it is an author with an informal style (e.g. Sachs). So, disorder does seem to be more accurate (more scientifically correct) and far more strongly supported by good sources. Newtonspeed 03:57, 26 June 2007 (UTC)

What is this evidence calling Migraine a disorder? That makes no sense, because by medical means Migraine is known to be a disease. Why don't we go on and call AIDS a disorder then? --Sugarcubez 23:39, 28 June 2007 (UTC)

  • Even read Alzheimer's and similar it states what the condtion is, but latter in the article states it as a disorder.--Sugarcubez 23:52, 28 June 2007 (UTC)

[edit] Disease versus disorder

I may be missing something here, but is there a difference between a disease and disorder? According to the [UMLS] metathesaurus, when I searched disorder, it took me to the disease entry and says:

"Concept: Disease

CUI: C0012634

Semantic Type: Disease or Syndrome


Definition: A definite pathologic process with a characteristic set of signs and symptoms. It may affect the whole body or any of its parts, and its etiology, pathology, and prognosis may be known or unknown. (MeSH)

top term heading for all specific disorders and diseases; a disease is a deviation from or interruption of the normal structure or function of any part, organ or system (or combination thereof) of the body that is manifested by a characteristic set of symptoms and signs; a disorder is a derangement or abnormality of function. (CRISP Thesaurus)

Conceptually broad term referring primarily to physical illness. Also used when particular disorders are not specified. Use a more specific term if possible. For general discussions of health impairment consider also the term HEALTH. (Psychological Index Terms)

Any abnormal condition of the body or mind that causes discomfort, dysfunction, or distress to the person affected or those in contact with the person. Sometimes the term is used broadly to include injuries, disabilities, syndromes, symptoms, deviant behaviors, and atypical variations of structure and function. (from Wikipedia) (NCI Thesaurus)

Synonyms:

  • Disease
  • Clinical disease AND/OR syndrome
  • Clinical disease AND/OR syndrome present
  • Disease (disorder)
  • disease (or disorder)
  • Disease AND/OR syndrome present
  • Disorder"

They seem to be synonyms to me, but the UMLS is a difficult read. I am not convinced that the authors of the many citations above carefully considered in their writing whether to use the word disease versus disorder.Badgettrg 04:46, 26 June 2007 (UTC)

Well I thought I had something to contribute to wikipedia and thought about adding to the page on ADHD. Got put off by the amount of squabbling about if it was neurological or psychological. Now I am giving wikipedia another go I get caught up in the same sort of semantic debate. I made the edit because the description, especially the bit on how to tell if it was "vascular" were plain wrong. That is the bit we should be discussing. Mark 05:47, 26 June 2007 (UTC)

In reply, I think that even if it were synonymous with disease, disorder is the term used by the most authoritative sources and for the sake of consistency it can be used. I too would be against unnecessary squabbling over semantics. This case seems to have a pretty straight solution though. Newtonspeed 12:09, 26 June 2007 (UTC) Newtonspeed 12:09, 26 June 2007 (UTC)
Yes the man difference is a disorder is mainly a collective form whereas a disease is by itself, hence neurological disorders and learning disorders, headache disorders, etc. When stating what the condition it is called by that unless it is part of a disorder, that is why later in the article it says disorders. And that is why it makes no sense to say disorder--Sugarcubez 23:52, 28 June 2007 (UTC)
Sugarcubez, can you please rewrite what you just said? I don't understand what you're trying to say.QuizzicalBee 01:51, 29 June 2007 (UTC)
  • Sigh: disorder- Is mainly dealing with a group , disease - The actual condition. So it is impossible for Migraine to be a disorder since it itself is the condition. Just like Alzheimer's it is part of the brain disorders but it is a neurodegenerative disease. Migraine is also apart of the brain and headache disorders, therefore it makes no sense calling it a disorder--Sugarcubez 05:18, 29 June 2007 (UTC)
Consensus has been met, it will remain disorder. Postoak 02:59, 29 June 2007 (UTC)
It remains disorder? It has never been disorder it has been known for years on here and in medical science as a disease you can't try and change that now, there is no consensus.--Sugarcubez 05:18, 29 June 2007 (UTC)
From the Merriam-Webster Medical Desk Dictionary, ISBN 1-40181-188-4:
Disease = An impairment of the normal state of the living animal body or one of its parts that interrupts or modifies the performance of the vital functions and is a response to either an environmental or specific infective agent or to an inherant defect of the organism, or to a combination of these factors. Synonyms include sickness and illness.
Disorder = An abnormal physical or mental condition. Synonyms include ailment.
Migraine = A condition that is marked by recurrent...
As the word condition appears in both the migraine as well as the disorder definition, and not at all in the disease definition, I would concur with those who insist on it being described as a disorder. As a dentist who has sat through many lecures on trigeminal neuralgia (TN), migraines and cluster headaches, I find these to all be of comparable level in terms of classification schemes and categorization mechanisms, and the TN article refers to that as a disorder. I assert that, as put forth by the migraine article itself, migraine headaches are a manifestation of neurological depression as a response to the release of inflammatory mediators, IMHO, this would not qualify as a disease. With this and the substantial support above, I am removing this from the dispute resolution request page as per instructions set forth there. DRosenbach (Talk | Contribs) 13:45, 29 June 2007 (UTC)
I agree with this. Migraines are a cluster of various neurochemical and physiologic issues, with different types of migraines (with aura, without aura, abdominal migraines, etc.), so "disorder" is more appropriate than "disease". It is a more inclusive term.QuizzicalBee 14:25, 29 June 2007 (UTC)


In the field of headache and migraine treatment, it has become accepted that migraine is indeed a disease. Dr. Richard Lipton, who is a leading epidemiologist in the field, and other top experts term migraine a "disease." The WHO now includes migraine in thier "Global Burden of Disease" studies (see http://www.who.int/healthinfo/statistics/bod_migraine.pdf). Don't we want Wikipedia to be the most up-to-date it can be? TeriRobert 16:30, 29 June 2007 (UTC)

Sugarcubez, dispute resolution has gone along with calling migraine a disorder, not a disease. The sources used to back this up are certainly not spam, nor are they invalid. I have no idea why you have called them both "spam" and "not valid sources". Please stop reverting them with those erroneous labels.QuizzicalBee 13:33, 1 July 2007 (UTC)

Sugarcubez, your edit [29] was reverted based on dispute resolution above. Please do not use false, inflammatory or uncivil wording in your edit summaries. Thanks, Postoak 17:26, 13 July 2007 (UTC)
Sigh There appears to be unnecessary hair-splitting and pedantry here. From Cancerweb on-line medical dictionary, migraine is a disease. Whether you choose to call migraine a disease or a disorder depends upon the source that you use. From the clinician's or the patient's perspective, it doesn't matter. Axl 19:05, 20 July 2007 (UTC)

[edit] Migraine can it be a daily Severe life threatening condition?

There are a couple of references to this on the page with no citation. I cannot find any. Has anyone heard of it. I think it should be removed if no citations are found.Mark 04:23, 29 June 2007 (UTC)

How could there be a reference and no citation? Migraine is considered a serious disease mainly because people have died from it as well as have a higher chance of Stroke, Heart Attack, Aneurysm and Coma. As well as migraine headaches can be chronic/daily.--Sugarcubez 05:12, 29 June 2007 (UTC) Hi Sugarcubez. You really keep me on my toes with use of language. What I tried to say was that it says twice on the page that migraine in life threatening and one of these times it says daily severe life threatening experience. I understand about increased risk of stroke etc but I dont want people with migraine to think they are going to die during an episode of migraine because of the migraine. i agree migraine can be a severe, chronic disabling condition. 125.239.185.185 08:33, 1 July 2007 (UTC)

[edit] Migraine is a neurological disorder?

It is impossible for Migraine to be a neurological disorder, the headache is the disorder, the actual disease is the Migraine. So the first sentence makes no sense what so ever. Not only is there many proof that it is a disease, but go ask any intelligent doctor. The sources to this were removed, I don't get it--Sugarcubez 21:23, 10 August 2007 (UTC)

Removed dispute notice. One person having an issue with the article does not mean it is "under dispute". CoderGnome 02:11, 11 August 2007 (UTC)

[edit] Claims re: coffee and ice cream

While I would be delighted to learn that coffee and ice cream could treat and/or prevent migraine, I do feel the claims made for them in this article should cite reliable sources. Currently, they don't. Perodicticus 14:13, 28 August 2007 (UTC)

[edit] Where?

In Serotonin Agonists, there is talk of reduction in lost productivity, with average values given. Average for where? The US? International? Also, there's no reference. -md 84.203.37.64 05:58, 7 September 2007 (UTC)


[edit] Cause of Migraine: Vitamin B6 deficiency

Last march, I had daily migraine attacks. I scanned whole net to eliminate this menace once and for all. After many experimentations, I zoomed on Vitamin B6. I took two B-Complex pills daily after dinner and miracle! Migraine attacks stopped completely.

I hope, I will find reliable sources to add this to article. —Preceding unsigned comment added by Neo. (talk • contribs) 17:11, 22 September 2007 (UTC)

[edit] Marijuana for treating migraine

I am aware of purely anecdotal accounts of marijuana being used to treat migraines. Can anyone come up with a scientific source accounting for this? As a proponent of medical cannabis, I would write a section about it, but without a proper source it won't do much good. --GSchjetne 13:51, 2 October 2007 (UTC)

[edit] Dubious

The triptan section currently has a single, meaningless references and makes a number of disputable statements that overstate the role of triptans. SOme contrary references are now addedBadgettrg 09:51, 3 October 2007 (UTC)

[edit] Possible?

Is it possibly a trigger... after wearing my glasses a while,I notice spots from time to time (smudges). After a while they build up, until my vision is somewhat blurry, but things are mostly viewable. Anyway, so the otherday, I had a building headache, but after I cleaned my glasses, everything was fine. Could splotches on my glasses really be a trigger? —Preceding unsigned comment added by 24.251.84.221 (talk) 09:23, 22 October 2007 (UTC)

I've had migraines for 13 years, with at least 1 a month, and I've never seen and correlation between the frequency with glasses, without glasses, with glasses cleaned or without, and as I've had them chronically for the past few months (1 every other day best, usually every day, lasting up to 4 days at a time). I have been to doctors, neurologists, & hospital ocular experts. I actually asked them if my glasses could be doing anything. They told me that they'd never heard of glasses that are the right prescription causing migraine attacks, so from that I don't think that the specks would do anything. —Preceding unsigned comment added by 82.21.96.187 (talk) 02:35, 13 December 2007 (UTC)

[edit] Menstrual Migraine

I would like to suggest that a subheading for menstrual migraine be added. Menstrual migraine is distinct from other migraines and because of its effect on a large population of women it should be included in this article. Approximately 21 million women in the US suffer from migraines,[1] and about 60% of them suffer from menstrual migraines.[2] It should be noted that I am an employee of a company that markets a medicine for this condition, but I intend to maintain WP:NPOV and limit my edits to raise awareness around this debilitating condition.

  • There are two types of menstrual migraine – Menstrually Related Migraine (MRM) and Pure Menstrual Migraine (PMM)
  • MRM is a headache of moderate-to-severe pain intensity that happens around the time of a woman’s period and at other times of the month as well.
  • PMM is similar in every respect but only occurs around the time of a woman’s period.[3]
  • The exact causes of menstrual migraine are uncertain but evidence suggest there may be a link between menstruation and migraine due to the drop in estrogen levels that normally occurs right before the period starts.[4]
  • Menstrual migraine has been reported to be more likely to occur during a five-day window, from two days before to two days after menstruation.[5]

When compared with migraines that occur at other times of the month, menstrual migraines have been reported to

  • Last longer—up to 72 hours[6]
  • Be more severe[1,5,7,9]
  • Occur more often with nausea and vomiting[2]
  • Be more difficult to treat—occur more frequently[8]

References:

1-Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M (2001). "Prevalence and burden of migraine in the United States: data from the American Migraine Study II". Headache 41 (7): 646–57. PMID 11554952. 

2-Granella F, Sances G, Zanferrari C, Costa A, Martignoni E, Manzoni GC (1993). "Migraine without aura and reproductive life events: a clinical epidemiological study in 1300 women". Headache 33 (7): 385–9. PMID 8376100. 

3- "The International Classification of Headache Disorders: 2nd edition" (2004). Cephalalgia 24 Suppl 1: 9–160. PMID 14979299. 

4-Brandes JL (2006). "The influence of estrogen on migraine: a systematic review". JAMA 295 (15): 1824–30. doi:10.1001/jama.295.15.1824. PMID 16622144. 

5-MacGregor EA, Hackshaw A (2004). "Prevalence of migraine on each day of the natural menstrual cycle". Neurology 63 (2): 351–3. PMID 15277635. 

6-Granella F, Sances G, Allais G, et al (2004). "Characteristics of menstrual and nonmenstrual attacks in women with menstrually related migraine referred to headache centres". Cephalalgia 24 (9): 707–16. doi:10.1111/j.1468-2982.2004.00741.x. PMID 15315526. 

7-Couturier EG, Bomhof MA, Neven AK, van Duijn NP (2003). "Menstrual migraine in a representative Dutch population sample: prevalence, disability and treatment". Cephalalgia 23 (4): 302–8. PMID 12716349. 

8-Martin VT, Wernke S, Mandell K, et al (2005). "Defining the relationship between ovarian hormones and migraine headache". Headache 45 (9): 1190–201. doi:10.1111/j.1526-4610.2005.00242.x. PMID 16178949. 

KatieM07 (talk) 20:45, 27 November 2007 (UTC) Please note that this user is an employee of Endo Pharmaceuticals, Inc., the marketer of FROVA® (frovatriptan succinate)

I've worked up the above references giving the markup (if you look in edit mode) and PubMed links. Any neurologists amongst us to proof read this as a correct & accepted understanding of this ? David Ruben Talk 23:45, 27 November 2007 (UTC)

[edit] Links

I reverted to the longer list of links. WP:NOT and WP:EL do not give a numerical limit on links, and the current list is organized. WP:NOT states that link lists should not "dwarf articles and detract from the purpose", and this list does not as the article itself is very long and the links supplement the article. Maybe a couple could come out (diagnostic criteria could be linked in-line instead, as an example), but overall, the links are very worthwhile and beneficial to the article. Reducing it down to only nine links was excessive cutting and lessened the thoroughness and value of the overall article. VigilancePrime 05:37, 3 December 2007 (UTC)

[edit] I accidently found a cure for my migraines

For the last 12+ years I have suffered from Severe migraines. I usually kept every window in my house covered with thick material to block the sunlight. Once a migraine set in my day would be resigned to lying in darkness with my head as close to an air conditioning vent as possible. After visiting several doctors and being prescribed various medications I was beginning to lose hope. I even went to an eye doctor, My vision was fine no cause for worry. The first sign of hope came upon visiting a new dentist, After the initial examinination he said "Wow! I bet you get terrible headaches." after further explanation I learned about how a misaligned jaw can create serious tension on the jaw muscles and cause serious headache pain. I am currently undergoing treatment from a TMJ specialist with positive results I have met several previous patients of this doctor who also claim to be migraine free after years of suffering. In my searching the web for migraine information I never found anything that mentioned the JAW. I hope that by posting this here maybe other sufferers can find help as I did, I'm sorry if I make some drug manufacturers angry by this post.Singerdave2001 (talk) 22:12, 1 January 2008 (UTC)MigraineFree


thanks you so much this might end up being my cure

all my life my jaw has been off, my doctor told me that because i was born through a C section the doctors might have dislocated my jaw when pulling me out and that it might not have been noticed so it was never fixed

i'm now 22 and i've had migraines for as long as i can remember, they usually last anywhere from 4 to 24 hours and i usually have atleast 5 a month sometimes 3 or 4 a week

for me i usually start getting a small headache that gets worse and worse over 1-3 hours after that the pain is horrible and just gets worse and worse it usually gets to the point where my day is just ruined, i'm forced to find a dark quiet place to go sleep it off

i've tried many over the counter pills and none really seem to work, Tylenol Ultra seems to work best but it only actually works if i take them before the pain starts to peak, over all the best cure has been to try sleeping which is hard to do with so much pain —Preceding unsigned comment added by 216.209.148.146 (talk) 10:54, 2 April 2008 (UTC)

[edit] MIGRAINE PATHOPHYSIOLOGY

I believe that the section on migraine pathophysiology is inaccurate. The cortical spreading depression is actually the mechanism behind migraine aura, not necessarily behind the headache pain itself. While the mechanism underlying aura and the mechanism underlying headache pain may be related, this connection is under dispute. I am new to Wikipedia, so I don't know how to make these corrections myself. However, if someone else would like to take this on, I would be happy to provide you with proper sources from the scientific literature in order to update this section of the page. --Giraffewithspots (talk) 05:28, 13 January 2008 (UTC)

If you can provide reliable sources then there are many of us willing to Wikify information into good articles, just point us in the direction of anything applicable meeting WP:VERIFY. ALLOCKE|talk 22:28, 9 April 2008 (UTC)

[edit] Denuelle study

User: Sbyrnes321, your Revision of 00:45, 7 February 2008 removes my paragraph. You state "This is one of thousands of migraine studies, and doesn't stand out as worthy of inclusion. Also, text is plagiarized".

While not disputing that there have been thousands of migraine studies, I wonder could you refer me to one other where PET was used for patients with naturally occurring episodes or to one other which implicates the hypothalamus so directly? Or for that matter, where PET or the hypothalamus are mentioned elsewhere in this article?

You accuse me of plagiarism. If by this you mean that I have taken the facts reported in the BBC article and re-written them in my own summary, using some of the same words, that may be true. But I rather resent being accused of stealing ideas. After all the facts are the facts, aren't they? I thought that was what wiki editing was all about.

I do not have access to the journal "Headache" (to which I provided a direct web link for anyone interested) and only have this BBC report to go on. If your issue is with really with "plagiarism" then I would urge you to read the original journal article yourself and to re-write it in YOUR own words.

You are obviously an able and industrious wikipedian and I do not dispute the quality of your edits. I cannot claim to be a migraine expert. But I do resent having my edit, made in good faith, summarily thrown away quite so expertly. I'm sure we don't want an article where all the interesting or topical facts have been very carefully "tidied away". I honestly judged that the Denuelle study was a small breakthrough and of genuine interest to students and sufferers alike. Martinevans123 (talk) 21:10, 7 February 2008 (UTC)

Hello! Sorry, I certainly didn't mean offense. I referred to it as plagiarism because there were a number of direct quotes that were not inside quotation marks. For example, BBC said, "to capture an attack as it happened, patients rushed to hospital without self-medicating, arriving on average around three hours after the onset of the migraine." Your text was identical, except that you changed "around" to "about". Perhaps "plagiarism" isn't the right word for what this is, in which case, sorry for offending you. At the very least, though, it's a fair-use violation of BBC's copyrighted text (see WP:FU). Paraphrasing is okay, of course, but I believe that changing one word to a synonym is insufficient.
I'm not an expert on migraine pathophysiology either, but adding a whole paragraph on the role of the hypothalamus, when the "pathophysiology" section is so small to start with, really seems to throw off the balance to me. If the section were going to be expanded, the place to go would be a review article or textbook, to add in the theories, details, and observations that are the most widely accepted in the migraine-expert community. Once there's a thorough background and framework in place, then it would be appropriate to cite recent studies that expand or alter that basic understanding, like this one.
To be more specific, in the spirit of WP:NPOV, the quantity of information should bear a relation to its importance. By putting in a paragraph about this one study, in such a tiny section, it's implying that this study is as important or more important than the thousands of other studies that could also be included in this category -- studies looking at the brainstem, midbrain, cortex, etc., using methodologies of molecular genetics, population genetics, MRI, PET, blood-sample analysis, etc. It's not anything wrong or unimportant about the study or the paragraph in itself, it's the context, or lack thereof, in the surrounding text.
Sorry again for leaving a mean-spirited comment, though. :-) --Steve (talk) 02:23, 8 February 2008 (UTC)
Thank you for your apologies which are fully accepted. Your reasoning is perfectly valid and I agree with you. Perhaps we could compromise on a single short sentence? I realise that there is a trade-off between topicality and balance in such articles as this - I supppose what I'm reeally looking for is a "news" subsection that could be edited on a weekly/ monthly basis. Thanks, anyway. Martinevans123 (talk) 10:48, 8 February 2008 (UTC)

[edit] Edit

Changed a line that said "lasting from four to 72 hours" to "lasting from 4 to 72 hours", its proper grammer... Ganon391 (talk) 11:47, 5 May 2008 (UTC) Ganon391


[edit] PFO Theory?

Maybe the possibility of PFO as a cause of migraine (mentioned in the surgical treatment section) should be added as another theory for migraine? 66.253.237.191 (talk) 23:42, 5 May 2008 (UTC)

PFO isn't a cause of migraine -- the disease, disorder, or whatever you want to call it. A PFO can trigger individual migraine episodes. When you read the research, you see that PFO closure doesn't eliminate all migraine attacks; migraineurs still have migraines from other triggers. Also, it's still unclear how effective PFO closure actually is in treating migraine. The MIST trial in the UK showed a 37% reduction of "migraine burden" with PFO closure. That percentage is barely higher than the rate of success for placebo. US and Canadian trials are not complete yet. TeriRobert (talk) 15:30, 14 May 2008 (UTC)

[edit] Clarity, please! re serotonin levels

The article's section on serotonin is as follows:

"Serotonin theory

Serotonin is a type of neurotransmitter, or "communication chemical" which passes messages between nerve cells. It helps to control mood, pain sensation, sexual behaviour, sleep, as well as dilation and constriction of the blood vessels among other things. Serotonin levels in the brain may lead to a process of constriction and dilation of the blood vessels which trigger a migraine.[26] Triptans activate serotonin receptors to stop a migraine attack.[26]"

The next-to-last sentence leaves open whether it is low or high serotonin levels that are thought to trigger a migraine. Or perhaps it is fluctuating levels??? Something else??? A little clarity goes a long way.Daqu (talk) 04:11, 3 June 2008 (UTC)

[edit] Prodrome phase and aura phase are not differentiated.

An aura is a prodrome. The article is currently written to imply that they are distinct migraine phases, and that one may occur after another. But an aura is just a specific type of prodrome, with other types also possible. There's no qualitative difference between migraines with or without aura, except the nature of the prodrome. And, in fact, auras are the most common prodromes, and scotomas are the most common auras. --76.217.92.71 (talk) 08:07, 14 June 2008 (UTC)