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Migraine Headache: Overview
Medscape Reference
Sept 16, 2013

Attached is a :acrobat: comprehensive, up to date medical overview of Migraine headache, its diagnosis and treatment.

Access to some of the hyperlinks in the article, may require opening a free Medscape account.


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Thank you, Steve for thinking about us migraine sufferers. As someone who is seeing one of the top specialists in Canada, I'm no further ahead and still searching for answers. After many years of chronic migraine I feel a big part of my solution is to heal my own body by understanding the emerging data, keeping up with the research, and becoming my own nutritionist. I'm very excited to delve into this. You have given me a push to keep seeking with an open mind. . . Even though it's often overwhelmig to do so. Thanks!



As a fellow migraineur, I understand your situation. My own doctor had me keep detailed logs for several years to figure out my triggers, and although I make a concious effortyo avoid them, there often seem to be confounding factors that may or may not trigger a migraine episode for me.

Luckily my prescribed medication (a triptan) is always available to abort the attacks when they occur, so the episodes, although relatively frequent, do not significantly affect my ability to function.

How long have you been living with your migraines, and what successes or failures have you experienced in treatments so far?

To what extent do your migraine episodes affect your ability to keep on functioning, if at all?


Hey Steve!
"Confounding factors" really resonates with me. I too have done a lot of work to isolate triggers, but they are wiley creatures that change their shape and form. As an example, I can drink certain juices with no problem, but if I've endured a 3-day migraine and a day later I drink some cranberry juice... It will prompt the headache cycle in varying degrees. Sometimes just the act of digestion I feel can trigger an episode, so often times I'm even afraid to eat. But then I'm worried if I don't eat, that could also be triggering. These conditions, or 'triggers' are not easy to pinpoint as I feel they usually work in combination for me. Very hard to isolate.

I feel at this point, a lot of my avoidance behaviours are based on instincts (as in memories collected over the years, some conscious, some not).

I think my first migraine occurred at around age 8. And then they came in like rolling thunder at age 16. Debilitating 2, or 3-day long episodes which left me unable to function. Crying and tearing at my hair for hours. What a torture. I wish I had known then I could have gone to the Emergency for medication. It just never occured to me at that age. By 20yrs old, after a parade of drs saying "try this, try that" I had a neurologist who prescribed the one medication that stopped the pounding, which wasccodeine. Although I'm not happy about using a narcotic, years later it still works, and in fairly small quantities.

Strangely, as my grandmother often told me they would, the migraines stopped at age 30. Gone for 10yrs! Only to return around the time I turned 40. I tried Imitrex when it first came out and reacted badly to it. I've had many doctors, including multiple neurologists, a neurosurgeon, anaesthesiologist, and neurosurgeon with a headache subspecialty who I see regularly at the moment. No big improvements, however. I've gone back and tried the newer Triptans but they are like popping Tic-Tacs... They don't stop the migraine. They keep throwing the samples at me, and I keep them, and even take them in desperate moments.. But they just don't work. So, that situation is a little comical, I don't know why they keep giving me them. I also had a 13 week course of local injections into my head to numb the nerves and break the firing of the pain signals. Again this had no effect, except to bring on migraines when I had none.

Sorry to bombard you with so much info, but it's been many years of trying many things. To answer your last question, it has literally taken over my life. That has been challenging to my self-esteem. It makes it more difficult when people walk around saying "oh, I have a migraine" when they really have no understanding of what that a true migraine can do to a person. So, it's difficult to talk about. When you have some form of headache more days than not, you start to sound like a broken record. Who wants to hear about it everyday? I get tired of hearing myself, yet the headache is part of my daily reality. So, I feel this condition can be very isolating.

Thank you for your reply... it's genuinely appreciated. Can you tell me a bit of your headache backstory?


As you have probably noticed, Psychlinks contains a sizeable collection of articles dealing with Migraine, which you may find helpful.

One particular article I found especially informative was

I suppose another strategy to investigate that might be helpful could be one designed to manage chronic pain.

I found this article on Medscape that discusses how physicians can assist their patients cope with chronic physical pain.

You are quite right that people with Migraine might experience discrimination in the same way people with some forms of mental illness encounter uninformed or insensitive people who think you can "just snap out of it" because it's "just a headache".

Can you tell me a bit of your headache backstory?

I've had headaches ever since I can remember, even as a child, but it was only later that I learned it was migraine. Imitrex relieve my symptoms for only a few years, but suddenly it lost its usual effectiveness and worked less than 50% of the time for me. My doctor then prescribed Zomig that gave me relief for over a decade; but earlier this year there were production problems with the product, so my doctor changed the prescription to Frova (frovatriptan).

In fact, Frova has the added benefit for me that its effectiveness extends into the next day,because of its longer half life, and for me that's important because I often get recurring attacks.

So, all in all I can manage the attacks, by taking my medication as soon as I begin feeling the onset of a migraine, although sometimes I hope against hope that it will pass, and end up having to take it anyway.

Your grandmother was right in that migraine tends to remit in women with age, as we men tend to carry on with migraine until our golden years......I wonder if that might be "Womens' revenge for childbirth":eek:


Haha...! It's possible. If that's true and the revenge doesn't gender discriminate, I'm in big trouble too. 43 and no children, eeep! :)

I really appreciate your time in thoughtfully responding. The information you provided is helpful. I go through cycles of really wanting to figure out this puzzle and find my solution (because my drs can't seem to), and just feeling defeated by it. I actually didn't know that there was a trove of info here regarding migraine. I joined this community because I've been dealing with the depression/anxiety knock-off of chronic pain, and was feeling quite low for a time. Things have improved, but it is a fight.

I too have this ongoing conundrum of 'do I take the drug now, or will it pass?' Especially, because there is a real crackdown of narcotics and everyone has demonized these drugs. I feel I must ration them, which isn't always the best choice. So, I find it difficult as I don't have any other options at the moment.

Thanks for the suggestions. I'm actually trying to find a group for chronic pain sufferers with the help of my Psych, who is wonderful. I'm also really interested in the article for doctors. My family doctor doesn't know me very well and I'm finding communication difficult with her. So, I will try anything to improve that situation before moving on to another doctor.

I can't imagine how you coped as a child. I only remember one headache that young and it was terrible. I think it must be so much more difficult to treat children. Frova, Zomig, and the lot, I have tried. I've never heard that the effectiveness can wane over time. That's challenging if it's your drug. I'm a little envious that Trips work for so many people. They are passing those things out like confetti!

Thanks again for your valuable insight. I'll definitely hunt around and try to mine the resources offered here. Who knew?! :))


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