Listen to part one of the discussion on migraines with Dr. Michael Lenz, MD and Dr. Sarah Cheyette, a pediatric neurologist.
#1: Migraines, like fibromyalgia, are more common than one realizes.
Both migraines and fibromyalgia are likely very under diagnosed. In America about 46 million people have migraines and 15 million have ADHD which are likely both underrepresented. Migraines and Fibromyalgia also overlap with other disorders that are very common. There are at least 60 million people with sleep disorders and 50 million with anxiety and 20 million with depression? Are these all different people?
Those suffering with migraines often have multiple illnesses they struggle with as well. There is a lot of overlap with all these conditions
#2: What are migraines?
It is a headache intrinsic to the brain, also known as a primary headache disorder. Secondary causes are problems like inflammation from an infection, bleeding in the brain, a tumor, and a stroke for example.
There is a little sensitive nest of the cells in the brain we can't see involved in self-regulation that become upset. Common triggers include not eating, stress, a sleep disorder, menstrual hormone changes, and excessive light exposure or exercise changes in one direction or another from too much or too little.
When these cells get triggered, it sends different messages to parts of the brain relaying information down the trigeminal nerve which gives sensation to different parts of the head. Your brain doesn't have any pain sensors in it. There are other sensory changes with migraines like vision changes. While experiencing a migraine, you can have distorted vision or loss of vision in the visual cortex due to depression of brain electrical activity. This is referred to as a spreading depression where the neurons involved go to sleep.
Other people may have the vomiting center activated. Others may have depression in areas of the brain involved in thinking. This is typically experienced as brain fog. Brain fog is part of fibromyalgia as well and contribute to processing information more slowly, inefficiently, and less effectively. This can lead to more stress and lead to a worsening downward spiral.
#3: Pick Your Parents very carefully
If you have one parent with migraines you have a 50% chance of getting migraines and if both your parents have migraines then you have over a 90% chance of developing migraines over your lifetime. Genetics of migraines are very important.
A lot of people with migraines are unaware they are actually having migraines. For example 90% of people who have been diagnosed as having recurrent sinus headaches or infections actually have migraines that have been misclassified. Over the life spectrum, migraines and other central nervous system processing pain syndromes can manifest to vacillating intensities and various times. They manifest commonly with abdominal pain in preadolescents which transforms more into classic migraines in young women once regular menstrual cycles begin. Other examples are people who may have self diagnosed themselves as having a sensitive stomach or gluten intolerance who have irritable syndrome or functional dyspepsia.
#4: Migraines like regular
You might get through the finals and work stress fairly well, but then arrive to the relaxing weekend or go vacation. The coast is clear, but then the migraine is triggered. It is likely the brain is designed to tolerate stress when there is something very important to accomplish, but sends out an alarm of pain if it is pushed too hard alerting one to avoid that situation again. These experiences are familiar for those with fibromyalgia flares as well where there is a delay in pain and fatigue onset to the day or two after high levels of activity.
One way to think about migraine triggers are like a hot air balloon. Each trigger adds additional weight to the balloon. Once it hits a critical weight it starts to sink.
#5: Surprising connection between infantile colic and migraines.
Research has shown a connection of migraines with another pain processing problem, infantile colic. infants typically have a parent with some central pain processing problem such as irritable bowel, migraines, fibromyalgia, or another comorbid condition like restless leg syndrome which is present in one of the parents ninety percent of the time. If you have an infant with colic, consider whether you, your spouse or partner, or other relatives have a history of migraines or irritable bowel syndrome. The infant is more susceptible to develop these conditions later in life. Early awareness by parents can help prepare them and anticipate problems. This can help remind parents of the importance for themselves and their child, of implementing consistent schedules, a healthy diet, and regular exercise as they go through life.
#6. Migraine thermometers?
There are no migraine thermometers and it is often hard to tell how much pain a child with migraines is experiencing. You have often observe the activity of the child or person experiencing a migraine of fibromyalgia flareups based on their activity. If a child is laying in their room and not playing and looking depressed they are likely in a lot of distress. Many kids are misinterpreted as having attention seeking and inappropriate avoidance of being in the classrooms, and that they really are just a hypochondriac. Sound familiar? If you are like many who are suffering with fibromyalgia, this echos your childhood memories.
Many kids and adults will have abdominal pain or nausea, particularly in the morning. For many the causes include stress and can be a conditioned response where Sunday evening they start getting pain anticipating being in school the next day or going to work at a job that is very stressful.
#7: ADHD and Migraines
The connection between migraines and ADHD hasn't been recognized until the last several years, and routinely not recognized in those with ADHD who are suffering from migraines.. Dr. Cheyette talks about the importance of this connection which she made during her years in clinical practice as a pediatric neurologist. Other studies have shown this relationship.
To learn more about fibromyalgia and related problems you can get connected with the resources below.
Learn more about Dr. Sarah Cheyette at her website.