Migraine and headache disorders education, advocacy and awareness are my passions. Being able to attend the 53rd Annual Scientific Meeting of the American Headache Society in Washington, D.C. earlier this month was an honor and thrill. The theme of this intensely scientific and exhausting meeting was ‘New Discoveries in Headache Medicine' and I was eager to see just what these discoveries would be. Could a new treatment be coming out? Would these "new discoveries" be useful tools Migraineurs could easily access to help with the debilitating pain of Migraine disease?
A big "Aha!" moment came when Teri and I attended two back-to-back sessions on Saturday morning: Biology and Clinical Characteristics of the Premonitory Stage (or prodrome) and Treatment of Premonitory Phase of Migraine: What is the Evidence? Prodrome is the first phase of a Migraine attack and can occur anytime from two to 48 hours before it. During this phase, Migraineurs can experience seemingly unrelated symptoms: excessive urination, yawning, fatigue, different eating habits and gastrointestinal issues. But by keeping a Migraine diary, it's helpful for patients and doctors alike to tell if these symptoms are connected to the attack. This is important because, if so, a select group of people who were treated with Amerge (a triptan) during prodrome were able fend off a Migraine! Teri and I almost fell off our chairs. Domperidone, a dopamine antagonist or antinausea medication, was also shown to be effective for Migraine with aura during prodrome, but it's not available in the United States. Would other medications in this class work too?
Another fascinating session was Epidemiology of Childhood Maltreatment and the Relationship to Headache and its Comorbidities. There are quite a number of studies being done on childhood maltreatment and the relationship between Migraine and headache. I must admit I have a hard time with this. It seems yet again we are putting the onus on the patient. If a Migraineur was emotionally, physically or verbally abused as a child does that mean they have an increase risk of more Migraine and/or headache disorders? It gives me an "icky" feeling inside to yet once again have another reason to stigmatize our disease. But here's the thing, the numbers seem to be showing a correlation and that can't be ignored. The bottom line is this; if you have been a victim of abuse of any kind and have Migraine disease and/or headache disorders, it may not be a bad idea to talk to your doctor. There is help out there.
Other topics included Migraine and Genetics, Is the Thalamus a Potential Target for Migraine Treatment? and a very interesting lecture called Detoxification for MOH Is Not Necessary! Some, and I do mean some, Migraine specialists feel that detoxification is not needed for patients with medication overuse headache (MOH) if they use topiramate (Topamax) or Botox for prevention for chronic Migraine. Very interesting stuff!
