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Four Things Migraine Sufferers Wish You Knew—Commentary

01/16/19 Stephen Silberstein, MD, Professor of Neurology and Director, Headache Center, Sidney Kimmel Medical College at Thomas Jefferson University

It can surprise people to learn that many neurologists suffer from migraines.

It is, after all, an often-debilitating disease that comes in unexpected episodes. And yet many healthcare professionals who live with migraines (myself included) have dedicated their careers to treating them.

As someone who sees hundreds of migraine patients each year, I know that a key point of frustration among this group is the lack of broad understanding about migraines. Although more than 12 percent of Americans suffer from migraines, there is a tremendous amount of unsubstantiated, conflicting, or simply incorrect information that has led to widespread misconceptions about the disease.

To provide clarity around migraines, here are four important things the general public should know.

1. Migraines run in the family

While a family presence doesn’t guarantee someone will suffer migraines, there is a genetic predisposition associated with increased brain sensitivity, which often results in the passing on of migraines from one generation to the next. While behavior can trigger individual episodes, migraine is a hereditary disease which is most effectively diagnosed and managed through medical-based treatment options guided by a qualified physician.

2. A migraine is more than a headache

Migraine is a disorder of the brain which can cause severe physical symptoms during episodes. Migraine episodes affect the sufferer’s autonomic nervous system, which controls many of the involuntary functions of the body. That is why migraine sufferers often have symptoms beyond intense head pain, including nausea, dizziness, vomiting, sensitivity to light, gastrointestinal distress, vertigo, and even paralysis in parts of the body.

Yet not all migraines produce these symptoms, which is why many people mistake a migraine for a sinus headache. If a headache presents in the sinus area without fever or congestion, it is likely a migraine. Similarly, mild migraine headaches are often thought to be tension headaches and therefore not treated properly or early enough.

3. Migraines have no gender bias

While there is some perception that migraines are a disease that only affect women, there is no truth to that assertion. Migraines are a disorder of men, women, and children. It is important to understand that migraines are a life-altering disease that can affect anyone. Only when we understand the scope and severity of the problem can we take the appropriate clinical steps to treat the disease.

4. There’s no silver bullet for migraines

Most migraine sufferers are on a lifelong journey to understand their triggers and find the right combination of routine, diet, and clinical treatments that are the most likely means of controlling migraine attacks. Each person is different and the unfortunate reality is there is no one thing that works for all patients.

That’s why many patients seeking relief turn to alternative and emerging therapies. Acupuncture is effective for some patients, but it can be expensive and often patients can achieve similar results on their own with meditation, yoga, and exercise. Supplements also tout preventative qualities, but they are unregulated and studies have shown that many supplements don’t clearly label ingredients that may be unsafe to consume. Botox works for some migraine sufferers and is FDA approved, but it is only used for patients who have symptoms more than 15 days a month (known as chronic migraine sufferers).

One promising new treatment for the prevention of migraines is called calcitonin gene related peptide (CGRP) antagonist. These drugs are antibodies designed to counteract the effect of the CGRP chemical that comes out of nerve endings in the body – causing migraines.

Understanding drives action

Migraines are disabling. They interfere with people’s social lives, their ability to go to work, and in many cases their ability to live a “normal” life. Making matters worse, migraines are often misunderstood or underestimated by the general public—and even by some physicians. It’s critical that a migraine sufferer’s family, peers, and healthcare providers take migraines seriously and provide needed support.