Asthmatics With Migraines at 'Increased Risk' for Developing Chronic Migraine

B.S. Dietetics, Dietitian, Health Professional

There is arguably nothing worse than seeing your child in pain. Nothing. It is a frustrating and heart-wrenching feeling, especially when you are helpless to do anything about it.

If you’ve been following my posts then you know that my twins both have asthma. Asthma is tough enough to deal with but now one of the girls, Ella, has also been diagnosed with chronic migraine. I have to say, it feels like she’s been dealt a bad hand. She’s had so many health issues to deal with, and now this? Why?

It turns out that having asthma may actually increase your risk of developing chronic migraineAccording to a 2015 study in the journal Headache, asthma and migraine are “comorbid chronic disorders,” which means “existing simultaneously with and usually independently of another medical condition.” Both are episodic attacks that most likely involve inflammatory and neurological mechanisms. The study examined the hypothesis that in people who have episodic migraine, asthma is a risk factor for their migraine attacks developing into chronic migraines.

Researchers studied 4,446 individuals with episodic migraine, 746 with asthma, who were enrolled in the American Migraine Prevalence and Prevention (AMPP) study in both 2008 and 2009. They added a Respiratory Symptom Severity Score (RSSS) to assess asthma severity and assessed the influence of asthma on the clinical course of episodic migraine, which typically starts before migraines become more frequent, i.e., “chronic.” The study’s primary outcome measure was chronic migraine, defined as 15 or more headache days per month.

What they found was that patients with asthma were at about double the risk for developing chronic migraine. But, even more interesting, those asthma patients who reported higher RSSS scores had an even higher risk of going on to develop chronic migraine.

“Asthma is associated with an increased risk of new onset [chronic migraine] [one] year later among individuals with EM, with the highest risk being among those with the greatest number of respiratory symptoms,” study authors found.

Researchers believe that one of the common factors in both asthma and migraine that may contribute to this link is inflammation. Asthma can be caused by irritation of smooth muscle in the airways and inflammation of the airway linings, while in migraine there's often inflammation of blood vessels.

“The exact mechanisms underlying this association are unknown, but could suggest mast cell degranulation, autonomic dysfunction, or shared genetic or environmental factors,” authors said in the study.

If you or your child has asthma, it is important to know typical migraine symptoms.

Migraine symptoms include:

  • Stiff neck
  • Mood changes
  • Auras
  • Pain on one or both sides of the head
  • Nausea and vomiting
  • Sensitivity to light, sounds, smells or touch
  • Feeling dizzy or light headed
  • Blurred vision

Migraine medications fall into two categories: abortive and preventative. Abortive medications (like triptans or ergots) are given once an attack has started. Preventative medications (like betablockers, some antidepressants, or seizure medications) are often used in patients who have frequent, severe, or long-lasting migraines, or migraines that don’t respond to treatment.

If you or your child has a new headache that is severe, different than a “run of the mill” headache, or is seen in combination with the above symptoms, it is important that he or she is evaluated by their pediatrician or your primary care provider.

Treating both asthma and migraine can be a process of trial by error to get the right medications and dosage for each individual. Thankfully there are treatments that work for most people and can greatly improve the quality of life of the patient. For more information about migraine, check out Health Central’s Migraine site.

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Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).