Published just last year, The Migraine Brain: Your Breakthrough Guide to Fewer Headaches, Better Health, by Carolyn Bernstein, MD, and Elaine McArdle, has gained quite a bit of publicity, being featured on The Today Show and NPR, as well as winning a number of awards. In fact, I had to wait almost a month to get a copy of this book through my local library.
The best part of the book is probably expressed in the book flap introduction:
You know that your migraine isn't just a headache. But you may not know that migraine actually is a neurological disease. ... it's a debilitating, complex, and chronic condition that manifests in a combination of symptoms that can include excruciating head pain as well as other distinctive physical and emotional effects. Yet it's also a disease that you can get control of, improve, and manage ...
It is refreshing to find a publication with such wide reach finally referring to Migraine as a neurological disease. Other positives include:
- Discussion of how the Migraine brain is different from a non-Migraine brain;
- Description of the four phases of a Migraine attack;
- Explanation of the importance of identifying triggers;
- Focus on a three-pronged treatment plan: prevent, abort, rescue;
- Exploration of various treatments, including complementary treatments; and
- Review of the components of an effective wellness plan.
The negatives, however, would make me reluctant to recommend this book to other Migraine sufferers.
First, Dr Bernstein gives only a passing mention to Status Migrainosus (also referred to as Status Migrainous), saying, "... it can be serious. If you get a migraine that lasts more than seventy-two hours (three days), you should seek medical attention, not only to ease your pain but also to ensure you don't become dangerously dehydrated due to vomiting, inability to hold down liquids, or diarrhea" (23). Where is the mention of increased stroke risk? It gets worse: "... 'status migrainosus', a severe migraine that can last over a week. It isn't necessarily dangerous" (66). In fact, the word stroke is not mentioned on the same page as status migrainosus even once in her book.
Second, Dr Bernstein's terminology is not consistent with the International Headache Society's International Classification of Headache Disorders. She uses a number of outdated Migraine terms, including complicated Migraine, ocular/ophthalmic Migraine, basilar Migraine and Migraine equivalent. Her brief descriptions of the various Migraine types also do not match up with the IHS's classification described in detail on MyMigraineConnection.
Third, she overemphasizes the risk of addiction to pain medications, while underemphasizing the risk of Medication Overuse Headache (MOH). In fact, she refers to MOH as rebound headache, another outdated term. She also does not draw a clear distinction between addiction and MOH. Since many Migraineurs end up in MOH cycles, the lack of a clear explanation of this serious problem is worrisome.


Interesting, MJ. I have also been very troubled by the innacuracies in the book, though I have not finished it yet and have been trying to give it the benefit of the doubt. There were numerous points where she downplays dangers. The status migrainous point is one, also right at the beginning in her "myth busting" she states that no one ever died from a migraine attack - well, what of migrainous stroke, then? It is dangerous for a MD and director of a headache center, who will get a great deal of credibility out of her status, to make incorrect points like these.
I do think that her description of the Migraine brain is useful, the phrase she uses is "a high maintenance brain" which I really like. It is helpful for Migraineurs and others to really understand that our brains are different and must be cared for, that our lives must be kept regular to regulate our brains. I also think she has a number of worksheets and tools which are helpful. Now, could those things have been done in a more accurate and well written book? Of course. Is the book worth buying? I don't know. If you're only going to buy one book on managing your life with Migraine, this is definitely not the one. I agree that Teri's book is better!
Megs, thanks for your comments. I agree there are some real positives to the book, including her references to the "Migraine Brain" and "high-maintenance brain". But I am troubled by her use of outdated terms. I didn't mention this in the review, but I think it's very telling that the physicians she consulted with for this book (mentioned in the acknowledgements at the end) aren't any of the names we usually hear about in the research/treatment of Migraine (Lipton, Krusz, Young, etc).
I will be interested to hear your opinion once you've finished the book.
Be well,
MJ