Tackling Migraines Quickly With Beta-Blocker Eye Drops

Eye Drops For Migraines

Eye Drops With Beta Blockers Contain Migraine Pain (1)

In the latest edition of the journal Missouri Medicine, ophthalmologists Carl V. Migliazzo and John C. Hagan have have outlined how administering just 1-2 drops per eye of eye drops containing beta blockers stub migraine pain and in some cases almost cure migraineurs of attacks.

The eye doctors conducted their study on a population that comprised of women only migraineurs who were suffering for many years, even decades with migraine attacks.

Dr. Migliazzo seemed to have struck upon this treatment entirely by coincidence when he had been routinely managing his glaucoma patients with these eye drops. As per him, “People would report to me spontaneously saying: ‘You know, doctor, my headaches started getting better after I started on this medication.’” (2) And since then he has recommended it to his patients who also experience migraines. He does accept that there may be a placebo affect at work for some patients who said it worked for them. To obtain more data on his study, Dr. Migliazzo wants to examine more patients and have a control group as well to check on the eye drops placebo effect.

However, there may be a good scientific rationale behind why eye drops containing beta blockers work for migraine patients. Beta blockers are primary drugs in the current scenario to manage hypertension, certain heart conditions and are also prescribed as prophylaxis for migraines. Besides, they are very cheap and safe with really low side effects. In addition to this, beta blockers reach the blood stream relatively faster and in time to save a migraine attack.

During a study of one beta blocker, a patient told researchers that he not only had fewer chest pains, but fewer migraines as well. His migraines returned only after he was switched to a placebo.

According to Dr. Mittal who is working with Dr. Hagan, “Eye drops containing beta quickly drain into the nose, where they’re rapidly absorbed into the bloodstream through the mucus membrane. If you can get something in their system as soon as possible, you have a better chance” to stop migraine attacks.” (3)

So it sounds like a case that certainly requires further testing and research. Dr. Hagan hopes that someone will pursue this research to be sure if this certainly works or if there is a large placebo effect at work. Earlier studies from the 1980s have shown some migraineurs benefiting from the use of such eye drops but no further testing had been pursued on the matter.

SOURCES

  1. Image Credit: Putting Drops In Eye Stock Photo by Marin; Freedigitalphotos.net; Web September 2014; http://www.freedigitalphotos.net/images/Healthcare_g355-Putting_Drops_In_Eye_p112466.html
  2. Eye drops may hold quick relief for migraine sufferers; Kansas City News; Web September 2012; http://www.kansascity.com/news/local/article1379677.html
  3. Eye drops may hold quick relief for migraine sufferers; Life Extension Foundation; web September 2014; http://www.lef.org/news/LefDailyNews.htm?NewsID=22812&Section=Disease

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More Frequent Migraines During Peri-menopause: Study

Menopause and Migraines

Study Shows Increase In Attacks During Menopause Transition (1)

A first of it’s kind study conducted by researchers at the University of Cincinnati Headache and Facial Pain Program shows conclusive proof that there is a recordable increase in the number of migraine episodes in women undergoing peri-menopause.

Peri-menopause is a phase of transitioning menopause. It could begin several months to years before actual menopause and is characterized by the woman experiencing some or all of symptoms such as irregular periods, fatigue, hot flashes, memory lapses, dry vagina, loss of libido, thinning of bones, incontinence, mood swings and breast tenderness etc. (2) All this is caused primarily due to the drop in the levels of female reproductive hormones such as estrogen and progesterone.

It was seen that headache instances rose during both peri-menopause and menopause when compared to pre-menopause. Pre-menopause was characterized by regular periods. As per Vincent T. Martin, M.D who is a professor of Medicine in the Department of Internal Medicine, University of Cincinnati, “Ours is the first study to demonstrate that the frequency of migraine attacks increases during the menopausal transition. The results of our study validate the belief by many women that their headaches worsen during the transition into menopause” (3)

Summary of the research study is as follows:

Particulars Numbers Comments
Total Women studied 3,603
Age range (women) 35 -65 years
Group classification
  1. High Frequency >10 episodes a month
  2. Low-Mod frequency < 10 attacks a month
Analysis classification
  1. 34% – premenopausal
  2. 35% – perimenopausal
  3. 30% – menopausal
  4. High Freq was 50-60% more common in perimenpausal and menopausal women

 

According to Richard B. Lipton, M.D., professor of Neurology and director of the Montefiore Headache Center at the Albert Einstein College of Medicine, “Given that migraines tend to worsen during menstruation, it may seem paradoxical that when periods become irregular during the peri-menopause or absent during menopause that headache become more frequent. We believe that both declining estrogen levels that occur at the time of menstruation as well as low estrogen levels that are encountered during the menopause are triggers of migraine in some women.” (3)

SOURCES

  1. Young Woman Suffering From Headache By Stock Images; FreeDigitalPhotos; Web August 2014; http://www.freedigitalphotos.net/images/young-woman-suffering-from-headache-photo-p171720
  2. Menopause Health Center – Perimenopause; Web MD; Web August 2014; http://www.webmd.com/menopause/guide/guide-perimenopause
  3. Women with Migraines Experience More Headaches During The Menopausal Transition; Science Daily News; Web August 2014; sciencedaily.com/releases/2014/06/140624215851.htm

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Cosmetic Eyelid Surgery Offers Significant Relief To Some Migraineurs: Study

Migraine Blog Eyelid

Eyelid Nerve Decompression Surgery Benefits Some Migraineurs (1)

What some migraineurs are willing to risk to shut off that pain. Turns out that getting under a knife that works on your eyelid is a risk well worth taking for them. This is not a procedure recommended for every migraineur. To be eligible for this eyelid cosmetic surgery, you need to meet certain criteria and thus screened to check if you should do this. The surgery essentially decompresses the nerves in the eyelid that trigger migraine episodes in many.

Dr. Oren Tessler, Assistant Professor of Clinical Surgery at LSU Health Sciences Center New Orleans School of Medicine, have seen that more than 90% of the patients who underwent this surgery experienced relief and also got a bonus cosmetic eyelid surgery. The study and it’s findings have been published in the medical journal Plastic and Reconstructive Surgery.

The study examined 35 patients all of whom suffered from chronic nerve decompression triggering migrainous episodes. All of them had used some sort of nerve blocking treatment earlier or Botox at some point of time trying to tackle the pain.

As per Dr. Oren, “Surgery is a valid treatment for migraines in certain patients. We believe that these patients should have ready access to migraine trigger site decompression surgery. Although larger studies are needed, we have shown that we can restore these patients to full and productive lives.” (2)

The eyelid nerve decompression surgery is an alternative to the much done endoscopic approach where sensors are passed under scalp skin. However, this latter method makes it unsuitable for many depending on their anatomy. Also endoscopes are not available with every team and neither is it safe to assume endoscopy expertise in ever surgeon. However, in the eyelid cosmetic surgery for the screened and selected patients simply involved making a minor slit in their upper eyelid resulting in release of the decompressed nerve and subsequent deactivation of the nerve involved in the migraine episodes. (3)

The team involved in the study also included surgeons from Massachusetts General Hospital and Harvard Medical School.

Some statistics on the surgery:

  • An overall positive response of 90.7%
  • Complete elimination of migraines in 51% of the patients.
  • 33% of the patients had between 50 and 80% of their symptoms resolved.

SOURCES

  1.  Caucasian Girl’s Blue Eye; Image Credit – Serge Bertasius Photography; Free Digital Photos; Web August 2014; http://www.freedigitalphotos.net/images/Younger_Women_g57-Caucasian_Girls_Blue_Eye_p154783.html
  2. Surgeons report significant migraine relief from cosmetic eyelid surgery technique; Eureka Alert; Web August 2014; http://www.eurekalert.org/pub_releases/2014-07/lsuh-srs073114.php
  3. Cosmetic eyelid surgery technique can help cure migraine: Study; Business Standard; Web August 2014; http://www.business-standard.com/article/news-ani/cosmetic-eyelid-surgery-technique-can-help-cure-migraine-study-114080101045_1.html

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Sex Migraine Is For Real: Loyola Neurologist

Migraine Sex

Migraines & Headaches After Sex (HAS) More Common Than Reported (1)

‘Not tonight honey, I have a headache’ may not be an excuse in avoidance after all,  because for some, especially men, migraines and headaches develop after sexual intercourse, making them avoid it. It is estimated that only as many as 1% of migraning adults actually report experiencing migraines or severe headaches after they have had sex. (2) The real percentage is considered much higher but generally goes under-reported since there is a feeling of discomfort talking about it on the part of the patients who suffer this type of a migraine and doctors who should be asking if the patients suffer this type of an ordeal.

According to Dr. Jose Biller who is the chair of Loyola’s Department of Neurology, and is certified in Headache Medicine by the United Council for Neurologic Subspecialties, “Many people who experience headaches during sexual activity are too embarrassed to tell their physicians, and doctors often don’t ask. Headaches associated with sexual activity can be extremely painful and scary. They also can be very frustrating, both to the individual suffering the headache and to the partner.” (3)

Though a fair percentage of headaches associated with sex (HAS) are considered benign and not life-threatening, others need running neurological diagnostics to look at and rule out dangerous causes such as brain aneurysm, stroke, cervical artery dissection or subdural hematoma etc. It is confirmed that HAS are 3-4 times more likely to occur in men than women.

Basically, the study has identified 3 types of HAS:

Type

Area Intensity Timing

1

Head and Neck Dull

Before Orgasm

2

Back of the head Intense Pain lasting hours

During Orgasm

3

Half Head, Any side Mild To Extreme Pain

After Sex

The cause for the third type of HAS has been identified as internal leaking of spinal fluid extending from lower portions of the skull to lower spine. The pain worsens when a person stands as the brain sags down. Relief is felt when the person lies down.

The different types of HAS require different types of treatment and management. However, the best bet still is on exercising regularly, keeping weight under control, not consuming too much alcohol and reducing exposure to known migraine triggers.

SOURCES

  1. Image Credit: Couple Lying In Bed Back-to-Back Stock Photo; Image by Ambro; Free Digital Photos; Web June 2014; http://www.freedigitalphotos.net/images/CouplesPartners_g216-Couple_Lying_In_Bed_BacktoBack_p76440.html
  2. Headaches during sex likely more common than reported; Science Daily News; Web June 2014; http://www.sciencedaily.com/releases/2014/06/140610100303.htm
  3. Sex headaches: More common than you’d think; Loyola Medicine Publication; Web June 2014; http://loyolamedicine.org/newswire/news/sex-headaches-more-common-youd-think

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Danger Of Ischemic Stroke In Older Migraineurs

stroke_isc_web Older Migraineurs Have Higher Chances Of Suffering Silent Brain Injuries – (1)

A new study published in the May 15th issue of American Heart and Stroke Association’s medical journal Stroke, suggests that older migraineurs have an double the risk of suffering from silent brain injuries and ischemic stroke than those who do not experience migraines.

Silent strokes can be asymptomatic i.e they do not show symptoms but increase the risk of future strokes. Silent stroke or a silent brain infarction is caused by a blood clot getting into the brain artery and thus interrupting the supply of blood, oxygen and nutrients to brain tissue surrounding the clot thus killing it.

As per Teshamae Monteith, M.D., lead author of the study, “I do not believe migraine sufferers should worry, as the risk of ischemic stroke in people with migraine is considered small. However, those with migraine and vascular risk factors may want to pay even greater attention to lifestyle changes that can reduce stroke risk, such as exercising and eating a low-fat diet with plenty of fruits and vegetables.” (2)

He raised caution that if an older migraineurs had other coexisting conditions like a high blood pressure (hypertension) or a sedentary lifestyle, it would add to the risk factor for suffering silent strokes and brain damage. He thus advised them to take medication to address hypertension and to bring it under control.

The study was a research on diverse ethnic groups including people of Hispanic and African origin. It was a collaborative investigation conducted by University of Miami and Columbia University.

Some of the highlights of the study were as follows: (3)

  • Approximate 40% of the population studied comprised of men.
  • The average age of the population was around 71 years old.
  • 65% of the population under study was of Hispanic origin.
  • Of the 546 studied, 104 had a history of migraines.

Some conclusions arrived at were as:

  • Risk of silent brain infarctions in those with migraine double even after adjusting other stroke risk factors.
  • Migraines with aura were not a deciding factor in measuring risk of silent strokes.
  • No real increase in the volume of white matter/ Small blood vessel anamolies was associated with migraines.
  • Some lesions came across in radiographic images as having ischemic origins but more research was required to confirm this.

According to Monteith, “We still don’t know if treatment for migraines will have an impact on stroke risk reduction, but it may be a good idea to seek treatment from a migraine specialist if your headaches are out of control. (4)

Previous studies indicated migraine could be an important stroke risk factor for younger people.

SOURCES:

  1. Image Credit: Ischemic stroke; Heart & Stroke Foundation – Canada; Web May 2014; http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3484151/k.7916/Stroke__Ischemic_stroke.htm
  2. Older migraine sufferers may have more silent brain injury; Science Daily News; Web May 2014; http://www.sciencedaily.com/releases/2014/05/140515163826.htm
  3. Abstract of the study can be accessed at: http://stroke.ahajournals.org/content/early/2014/05/15/STROKEAHA.114.005447.abstract
  4. Older people with migraines ‘more likely to have silent brain injury’; Medical News Today; Web May 2014; http://www.medicalnewstoday.com/articles/276842.php

Details of the study published in AHA journal, Stroke: http://stroke.ahajournals.org/content/early/2014/05/15/STROKEAHA.114.005447.full.pdf+html

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Butterbur Found Effective In Treating Migraines: Studies

butterbur

The Daisy-family Petasites Prove Themselves Effective In Migraine Treatment (1)

Butterbur, Petasites or Sweet Coltsfoot are residents of moist regions like marshes, ditches  and riverbeds and do well in temperate regions in the northern hemisphere. Studies have shown that certain species contain chemicals petasin and isopetasin which occur in high concentrations in the plant’s root and are very effective in treating migraines. 

In my post of April 26th, 2012, titled ‘New Guidelines from American Academy of Neurology On Reduction of Migraine Frequency’ I had outlined how the AAN listed out Butterbur as one of the herbal formulae that they found effective in the management of migraines. (2) 

The organic compound petasin found in butterbur is a combination of the ester of petasol and angelic acid known to stub inflammatory response in the body. It is also a proven muscle relaxant. Moreover, irritable blood vessels that are known to add to the woes of a migraineur are also soothed by petasin and isopetasin by control of blood pressure and spasmodic capillary action. Several German researches have found that incidences of migraines could be reduced by as much as 50% even in long-term patients. (3) 

Here are a list of studies that have expanded on the find: 

  • Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society; AHRQ (US Dept Of Health & Human Services); http://www.guideline.gov/content.aspx?f=rss&id=36897
  •  The First Placebo-Controlled Trial of a Special Butterbur Root Extract for the Prevention of Migraine: Reanalysis of Efficacy Criteria; European Neurology; Diener HC, Rahlfs VW, Danesch U. Eur Neurol. 2004;51(2):89-97. http://www.petasites.eu/PDF/Eur_Neurol.pdf
  •  An extract of Petasites hybridus is effective in the prophylaxis of migraine. NCBI Resources – PubMed; Grossmann M, Schmidramsl H. Int J Clin Pharmacol Ther. 2000 Sep;38(9):430-5. http://www.ncbi.nlm.nih.gov/pubmed/11020030
  •  Petasites hybridus root (butterbur) is an effective preventive treatment for migraine.NCBI Resources – PubMed; Lipton RB, Gobel H, Einhaupl KM, Wilks K, Mauskop A. Neurology. 2004 Dec 28;63(12):2240-4. http://www.ncbi.nlm.nih.gov/pubmed/15623680

Butterbur is available as a herbal tea though it is hard to palate because of it’s bitter taste. However, capsules of butterbur may be a better option. Doctors usually recommend 50-75 mg twice daily as effective prophylactic dosage.

It is imperative that you consult a doctor before taking any butterbur preparation. 

Once advised, choose a brand that says ‘PA-Free’ indicative of the removal of toxic chemical pyrolizidine alkaloid which is toxic to the liver. (4)  

SOURCES: 

  1. Image Credit: Butterbur 628x 323; Spring Allergy Relief; Prevention.com; Web February 2014; http://bit.ly/1nMkgOH
  2. New Guidelines from American Academy of Neurology On Reduction of Migraine Frequency; Migrainingjenny.wordpress.com; Web February 2014; https://migrainingjenny.wordpress.com/2012/04/26/new-guidelines-from-american-academy-of-neurology-on-reduction-of-migraine-frequency/
  3. Butterbur: For Migraines, Allergies, And More; Chiroeco.com; Web February 2014; http://www.chiroeco.com/chiropractic/news/14902/856/butterbur-%20for%20migraines-%20allergies-%20and%20more/
  4. Butterbur In The Treatment Of Migraines; WholesomeOne.com; Web February 2014; http://www.wholesomeone.com/article/butterbur-treatment-migraines

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Finally A Stroke Guideline For Women!

Brain-Haemorrage

Hemorrhagic Stroke Risk In Women Addressed By AHA/ASA For The First Time (1)

Recent research has shown that migraineurs and especially those who experience aura are at an increased risk of a stroke (brain hemorrhage) or a heart attack during a migraine episode. My post of June 20th, 2013 speaks of this research (on high risk of stroke among the migraining population): http://bit.ly/1iON349

A stroke may be either ischemic or hemorrhagic in nature. A hemorrhagic stroke is the rupturing of an artery in the brain which results in bleeding in the tissues surrounding the rupture and killing the brain cells there which are devoid of blood, oxygen and nutrition. An ischemic stroke occurs when there is an obstruction like cholesterol or clot in the arteries in the brain. These account for almost 90% of all strokes and are less likely to result in fatality if given immediate attention. However, migraineurs are more susceptible to the deadlier hemorrhagic strokes. (2)

[Read WebMD research on how women with migraine with aura may be at increased risk for an additional type of stroke called hemorrhagic stroke here: http://bit.ly/1cmHW6Y ]

Given that women are more susceptible to migraines with aura, the higher risk of getting a stroke is inherent yet there have been no guidelines to date to address stroke issues in women. Finally a guideline has been issued by The American Heart Association/American Stroke Association for health professionals to prevent strokes in women. Here are a few of the important recommendation highlights you should know:

1. FOR MIGRAINEURS

“Women are four times more likely to have migraines than men, and they often coincide with hormone swings. Migraines alone don’t raise the risk of stroke, but ones with aura do. Using oral contraceptives and smoking raise this risk even more, so the guidelines urge stopping smoking.” (3)

2. FOR ELDERLY WOMEN

Women over 75 years of age should be screened for atrial fibrillation as it is an increased stroke risk factor.

3. FOR WOMEN WITH HYPERTENSION/ HIGH BLOOD PRESSURE

Low dose aspirin or calcium supplement therapy is recommended to cut of stroke risk

4. WOMEN WITH PRE-ECLAMPSIA

Preeclampsia is a condition where a pregnant woman experiences both high blood pressure and a significant increase in protein in her urine. Women with preeclampsia are twice as likely to get a stroke and four times as likely to suffer from high blood pressure later in life. In addition, they are to be treated for weight and cholesterol issues as well as smoking.

5. PREGNANT WOMEN:

Such women who are pregnant and suffer from high blood pressure (>=160/110 mmHg) should be given medication for high blood pressure. Those who are expectant are to be treated for readings in the range of 150-159 mmHg/100-109 mmHg. (4)

SOURCES

  1. Image Credit: Brain Hemorrhage; Sanitarian.net; Web February 2014; http://www.sanitarian.net/wp-content/uploads/2010/11/Brain-Haemorrage.jpg
  2. Study Shows Increased Risk of Heart Disease and Stroke for Migraines With Aura; WebMD.com; Web February 2014; http://www.webmd.com/stroke/news/20100824/migraines-with-aura-may-raise-stroke-risk
  3. Guidelines For Stroke Prevention In Women Issued; Forbes.com; Web February 2014; http://www.forbes.com/sites/robertglatter/2014/02/09/guidelines-for-stroke-prevention-in-women-issued/2/
  4. Stroke prevention in women: guidelines set for the first time; Medical News Today; Web February 2014; http://www.medicalnewstoday.com/articles/272351.php

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