Talk:Migraine/Archive 3

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Images

I feel this article is heavy on images, especially the ones related to headaches. This is not a CNN article that needs to entice readers with headline pictures nor is it a textbook. The image of a woman rubbing her head adds nothing to the understanding. I have removed it. Moreover, this is the entry for Migraine, not headache. Headache related images should be under 'Headache'. — Preceding unsigned comment added by198.202.68.49 (talk) 19:53, 20 December 2011 (UTC)

Please get consensus first. Thanks. --Doc James (talk ·contribs · email) 20:56, 20 December 2011 (UTC)
The person who took the image at the top (self-portrait) says she was suffering from a 6-day migraine headache. ([1]). Anyway I think the image is nice and contributes educational value. It communicates "migraines may involve very very painful headaches", which is a basic and important fact about migraines.
Here are more pictures related to migraines, but none look worth adding to me.--Steve (talk) 22:08, 20 December 2011 (UTC)
I hate the ugly brown photo of the woman holding her head. If it must be in WP, put it in an article on demonic images or horror photography, not here. It may be cathartic for her to inflict it on the rest of the world, but why do we have to be her scapegoats? However, I have learned that resisting anything any strong-willed editor likes is futile, so I'll just add this creepy picture to my Adblock Plus blacklist and go on my way.--Jim10701 (talk) 05:10, 23 February 2012 (UTC)

December 2008

The cause that produces my migraine seems to be omitted everywhere: About 15 hours+ after exposure to diesel fumes I get migraines which often also include vomiting and diarrhoea. The problem is that most research looks into shorter periods, like 3 or 4 hours. Most people do not make the connection that diesel fumes can cause these symptoms, and with such a delay. 121.209.49.22 (talk) 03:23, 6 December 2008 (UTC)

Don't forget about when you get hit in the head too, Steve (talk) 13:16, 18 December 2008 (UTC)

I agree that the article needs to be divided, you shouldn't have to read through so many paragraphs.Radical man 7(talk) 22:14, 15 February 2009 (UTC)

Vague stuff.

Neural theory

When certain nerves or an area in the brain stem become irritated, a migraine begins. In response to the irritation, the body releases chemicals which cause inflammation of the blood vessels. These chemicals cause further irritation of the nerves and blood vessels and results in pain. Substance P is one of the substances released with first irritation. Pain then increases because substance P aids in sending pain signals to the brain.

Which nerves?, what area of the brain stem?(a diagram would be helpfull!), what chemical?, from where? ...not a complaint, believe your work is important, Thanks.

Temporal artery involvement, quality of sources

The standard story of migraine has it that an expansion of the temporal artery causes the pain (see e.g.[2]). Our article states twice "The vascular theory of migraines is now seen as secondary to brain dysfunction", citing both times a paperback that is advertised on Amazon with "GET RELIEF FROM MIGRAINES NOW WITH A NEW, BREAKTHROUGH TREATMENT!". That same book is cited six more times in the article. I have three concerns:

  • "is now seen" are weasel words and should be avoided
  • we should prefer peer-reviewed sources in scientific topics like this
  • the meaning of the word "secondary" in the sentence "The vascular theory of migraines is now seen as secondary to brain dysfunction" is unclear in an important way. Are we claiming that
    • expansion of arteries is not involved at all in migraine, or that
    • expansion of arteries is seen in migraines but is not the main cause of the pain, or that
    • expansion of arteries is the main cause of pain in migraines, but the ultimate cause of this expansion is brain dysfunction?

AxelBoldt (talk) 16:39, 10 March 2009 (UTC)

Basic artery questions

This article skirts two important basic questions about the cerebral arteries:

  • 1. Do most people have sensation in/near arteries in the brain?
  • 2. Do most people have voluntary(ish) control over bloodflow in arteries of the brain?
As an aside, I should say that though I don't suffer migraines,* as a child I noticed that MSG in food caused a short-term, distinctive "line" headache on the left side (which corresponds closely to the pericallosal artery), and I since noticed that direct mental attempts to expand the anterior cerebral artery of which this is a branch (for antidepressant effect) can cause a very similar pain, and for good measure I should mention that I suspect much of the "emotion" of shame to be a purely physical sensation of vasoconstriction in the anterior cerebral artery or nearby (and one way to 'find' it). That's my prejudice, but I'm finding it oddly difficult to think of good ways to search for such topics in the literature. Wnt (talk) 17:03, 26 March 2009 (UTC)
(Exception: fooling around with arteries once gave me a striking 'ocular migraine' on the right side of the visual field that lasted half an hour... proceed with caution ;) )

This entire article is flagrantly wrong.

This article devotes no more than 137 words to the proposition of a migraine without a headache, and the entire rest of the article fails to differentiate between "migraine" and "migraine headache". The headache merely follows the migraine, and it need not. The migraine itself is a simple partial seizure, a word this article does not even mention once. The article only devotes a single sentence to noting that migraine is highly comorbid with epilepsy, which would be because they are essentially the same condition at the neurological level, the main difference being location of the seizure.

I can only conclude that most of the contributors to this article largely have absolutely no idea what they're talking about and are under the mistaken impression that a migraine fundamentally is a form of headache, which is not true.--70.131.119.35 (talk) 03:46, 17 April 2009 (UTC)

I'm not sure where your basis for the article being wrong comes from. Where are your sources? While migraine is related to the epilepsy family of disorders, and can occur in CONJUNCTION with seizure activity, it is not in and of itself a "simple partial seizure". None of the current literature credits migraine as a seizure of any sort (unless I have missed some), because the fundamental root cause of migraine is neither known nor understood at this time, while epilepsy stems from over-active electrical outbursts in the brain. Migraine, on the other hand, is an episode triggered by an event, leading to neuronal depolarization of the brain and subsequent chemical reactions that cause the physical symptoms of the attack. Not everyone who has migraine has seizures, and not everyone who has seizures has migraines. Migraine hasn't been proven to be a seizure of any type which is why stating your sources might lend credibility to your statements. If I am having seizures-as-migraine, then my migraine specialist has never mentioned it! Plus, there is the added problem of anti-seizure medications not working for many sufferers. You might as well, at that point, call migraine a heart disease too as there is evidence of more heart attacks seen in many migrainuers, as well as some results of PFO studies in which closure of the hole has permanently resolved migraines for the subjects.

Unfortunately much of the current migraine literature does not differentiate between "headache" and "migraine" simply because the head pain is the number one identifying feature of the disorder. Doctors that should know better won't differentiate, but the educated patient will understand what one is getting at. Personally, I agree with you that a migraine is a migraine is a migraine, head pain or not, and for exposure's sake getting the terms correct is a benefit for those seeking help or advice on dealing with them.LeeloosGotAGun (talk) 22:22, 25 April 2009 (UTC)

I think this is a very valuable article. It discusses a lot of my issues such as weather fronts (hate those Alberta Clippers), and something I just had which is a new manifestation for me -- vertigo with numbness although I'm not having actual pain. I agree: name your sources.

4.249.3.20 (talk) 19:14, 6 November 2009 (UTC)

To the person who declares that the article is "flagrantly wrong," I have to respond that at least a part of your argument, that "The headache merely follows the migraine," is itself flagrantly wrong. Migraine is a medical condition, not an isolated event, which your wording seems to imply, and headache is a symptom of migraine that can and often does occur simultaneously with other symptoms -- meaning that it does not "merely follow" a migraine attack, but is an aspect of it. While you're right that the article would be erroneous to equate migraine with, specifically, a migraine headache (which the article does not seem to do) you are equally wrong to equate it with seizures-- a relevant topic which the article should address, but certainly not "essentially the same condition." I speak both from personal experience as a migraine sufferer, and as someone who has done a lot of research, from the Oliver Sacks book and other sources. Minaker (talk) 04:29, 14 January 2010 (UTC)

Migraine, a commentary ...

"... causes the pain when it enters your scull. BSi 090802" (Rest removed)

Uh, that you for that, uhm... whatever it was. Unsigned and with spelling errors, at that. - Ageekgal (talk) 23:29, 8 September 2009 (UTC)

Produce reliable references, please. Your claims are unfounded and completely inaccurate. Migraine is a neurological dysfunction, not a result of viral infection, though the two may be comorbid. Comorbid doesn't mean they cause one another, it means they simply exist in the same body at the same time and one problem may aggravate the other. I'd love to cry troll, here. I'm pretty sure many in the migraine community would call your foul as well. LeeloosGotAGun (talk) 04:01, 16 September 2009 (UTC)

Agree, produce reliable references. You have only anecdotal evidence. It is false in a number of cases I know about including my own.

4.249.3.20 (talk) 19:14, 6 November 2009 (UTC)

It's an interesting hypothesis. As LeeloosGotAGun correctly pointed out, comorbidity does not necessarily indicate a causal relationship. Anecdotal evidence is of very limited value in itself, but can sometimes provide valuable insights into areas which might warrant further research. Perhaps our anonymous editor could elaborate on their hypothesis/ theory? Does this editor have a medical background? Has s/he discussed this with others? Of course original research is not for inclusion in Wikipedia articles, but I don't think there's any rule against mentioning it on talk pages. Contains Mild Peril (talk) 02:10, 7 November 2009 (UTC)

I don't get it

Perhaps the folowing sentence (located in the lead section) could be reworded to be easier to understand for laypersons (me included)?

The cause of migraine headache is idiopathic; the accepted theory is a disorder of the serotonergic control system, as PET scan has demonstrated the aura coincides with diffusion of cortical depression consequent to increased blood flow (up to 300% greater than baseline).

What I think this means is: 1) The cause of migraine is unknown. 2)There is a theory that says it is somehow (how?) connected with serotonine.3) PET scans have demonstrated that the visual aura experienced by some migraine sufferers coincides with a spreading reduction in brainactivity which somehow (how?) leads to increased blood flow.

Could someone more knowledgable on the subject please confirm I have understood correctly? Thank youIneverheardofhim (talk) 15:17, 23 November 2009 (UTC)

Fixed Doc James (talk ·contribs · email) 00:08, 2 December 2009 (UTC)
Ah, thank you Doc James Ineverheardofhim (talk) 09:58, 17 December 2009 (UTC)

"relaxation, biofeedback and cognitive therapy ... are of considerable value."

... The empirical support for three behavioral treatments (relaxation, biofeedback and cognitive therapy) for managing migraine headaches in children and adults is reviewed. Meta-analyses and evidence-based reports show that these approaches are of considerable value, they appear to work equally well when applied individually, in groups or in limited contact formats. Meta-analyses comparing behavioral and prophylactic medication show equivalent results. However, outcomes are optimized when these treatments are combined. ...

PMID 15853538 —Preceding unsigned comment added by66.167.61.210 (talk) 23:54, 1 December 2009 (UTC)

Feel free to summarize and add to Wikipedia.Doc James (talk ·contribs · email) 00:07, 2 December 2009 (UTC)

Ginkgo Biloba

Ginkgo diminished the number of my migraine attacks from one-two a week to one a month, also decreased their strenght. I have been told by my neurologist that this often helps migraine sufferers, what about adding it to the article under herbal treatment? Canabis helps too, I confirm that :D —Preceding unsigned comment added by158.194.185.138 (talk) 19:53, 6 December 2009 (UTC)

We would need citable sources to add those to the article. Do you know of any suitable published references? Contains Mild Peril (talk) 21:13, 7 December 2009 (UTC)


I have found two interesting references for migraine and cannabis treatment: this one is from the medical marijuana wikipedia articlehttp://www.freedomtoexhale.com/clinical.pdf and this one is actually cited in the previous document: http://www.drugpolicy.org/docUploads/hemp_for_headache.pdf if someone can review and add the corresponding treatment research from those papers that would be great. —Preceding unsigned comment added by 99.237.252.214(talk) 01:36, 23 March 2011 (UTC)

Classic migraine

The page mentions classic migraine briefly, but never defines it. I'd correct this myself, but I'm having the darnest trouble finding where the terms classic, common, MA and MO were originally defined.--MijinLaw (talk) 13:09, 21 December 2009 (UTC)

BOTOX FOR MIGRAINE

Botox for migraine is not mentioned. While not FDA approved it is being studied and showes great promise. It should be mentioned. The article, in its entirety, seems unorganized and not entirely scientific but subjective. —Preceding unsigned comment added by 66.103.116.226(talk) 23:53, 30 January 2010 (UTC)

You'll notice that the entire huge section on migraine prevention was split into a separate article, Prevention of migraines. You can find information about botox there. I'm sorry that you didn't see the existence of this article, maybe that means we should somehow make it clearer. Maybe an navigation template? I think there are enough migraine articles to warrent a migraine navigation template, what do other people think? Articles would be:
As for your other comments: I can see parts of the article that are subjective but not too many luckily. It needs improvement on organization, it actually is for the most part pretty organized yet somehow doesn't come across that way! Also, don't be afraid to work on it yourself! --Steve (talk) 00:42, 31 January 2010 (UTC)
    • I agree, I think a navigation template or similar would be a good idea for the topics you outlined. RickO5 (talk) 17:07, 11 July 2011 (UTC)

MSG

Here is a 2009 review that discusses MSG as a trigger for migraines PMID 19454881 Sun-Edelstein C, Mauskop A (2009). "Foods and supplements in the management of migraine headaches". Clin J Pain. 25 (5): 446–52. doi:10.1097/AJP.0b013e31819a6f65. PMID 19454881. {{cite journal}}: Unknown parameter |month= ignored (help) Doc James(talk · contribs · email) 20:25, 1 February 2010 (UTC)

Others however seem to disagree. Will look into this more when I have time.Doc James (talk · contribs · email) 20:32, 1 February 2010 (UTC)

Angor animi

A few moments ago, I informed the authors of Angor animi that it is not solely a symptom of vascular dysfunction (angina), but also of classical migraine. Angor animi appears to be an 'orphan' article. It is important, I feel, that those who experience it (a certainty of imminent death) know it is harmless. Perhaps this article on migraine could mention it? Thanks very much!

Geologist (talk) 18:57, 24 February 2010 (UTC) Migraineur

I do not see how it is related? Do you have a ref?--Doc James (talk · contribs · email) 08:32, 1 March 2010 (UTC)

Neural & Unified Theories supported by study showing magnesium (identified as helpful by many migraine sufferers and treating physicians) inhibits release of neurogenic inflammatory cytokines such as Substance P

PMID 1384353

Weglicki WB, Phillips TM.

Pathobiology of magnesium deficiency: a cytokine/neurogenic inflammation hypothesis.

Am J Physiol. 1992 Sep;263(3 Pt 2):R734-7. Department of Medicine, George Washington University Medical Center, Washington, DC 20037.

During the progression of Mg deficiency in a rodent model, we have observed dramatic increases in serum levels of inflammatory cytokines [interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha)] after 3 wk on a Mg-deficient diet. Sequential analyses of these cytokine changes in the serum of rats revealed an initial rise at day 12, followed by a major elevation in all three cytokine levels by day 21. Of greater interest was an early peak in the serum level of the neuropeptide substance P after only 5 days on the diet. This "neuronal" tachykinin is thought to be released from neural tissues, and it is known to stimulate production of certain cytokines, including IL-1, IL-6, and TNF-alpha. In addition, there was a concomitant increase in histamine levels, which may have resulted from stimulation and degranulation of mast cells by substance P. Thus we hypothesize that the release of substance P may be the earliest pathophysiological event leading to stimulation of the inflammatory cytokines, which may then stimulate the free radical mechanisms of injury previously confirmed by our work. —Preceding unsigned comment added byOcdcntx (talk • contribs) 18:55, 28 February 2010 (UTC)

Neural & Unified Thories supported -- drugs inhibiting 'neurogenic' inflammation

PMID 18545913

Frediani F, Villani V, Casucci G.

Peripheral mechanism of action of antimigraine prophylactic drugs.

Neurol Sci. 2008 May;29 Suppl 1:S127-30.

Neurological Department and Headache Center, Policlinico S. Pietro, via Forlanini 15, 24036 Ponte San Pietro (BG), Italy. fabio_frediani@yahoo.it

Migraine is a visceral pain. According to current theories, activation of trigeminocervical nerve endings releases calcitonin gene-related peptide and substance P, inducing vasodilation and plasma protein extravasation, leading to 'neurogenic' inflammation. Activation of the trigeminovascular system is followed by sensitisation of trigeminocervical fibres, maintaining a condition of hypersensitivity to non-noxious stimuli that support persistent pain during migraine attack. Other neurotransmitters (nitric oxide, bradykinins, 5-HT, etc.) play a role in regulating this complex mechanism. In this brief review, we consider the effect of drugs that, acting on the different transmitters involving in pain perception, can stop or inhibit these pathogenetic mechanisms. —Precedingunsigned comment added by Ocdcntx (talk •contribs) 23:12, 28 February 2010 (UTC)

Just a note about Auras...

The type of Aura that I experience (and have for some time) doesn't match the descriptions mentioned there. Instead of a true tunnel vision, I get what looks like a "flying through stars" effect everywhere I look. The 'stars' themselves are darker than the surrounding area, and fly towards my center vision, but don't quite reach it. I don't know if this is worth adding to the article, as it lacks appropriate scientific terminology, but because some migraine sufferers are likely in my boat (where their type of aura is not represented) perhaps a slightly ambiguous statement like "Other types of auras have been known to occur and this is by no means an exhaustive list." would be appropriate?

I didn't want to edit that in without hearing an opinion on it, though. —Precedingunsigned comment added by 24.36.150.225 (talk) 12:18, 17 March 2010 (UTC)

Removed statement

I removed a flaky statement claiming hypothyroidism and migraine can be "caused" by anxiety. The first reference was a link to a huge page about military disibility claims or something, but which seemed below standard as a source for a medical article. The second was a journal article with only one author, which has no free access. I think such a bold claim needs much stronger evidence, which can be publicly verified. At this time most theories regarding migraine seem that - theories. —Preceding unsigned comment added by 94.197.7.94 (talk) 16:19, 7 April 2010 (UTC)

Classification

I added the POV tag to the statement calling the ICHD classification arbitrary and unsupported; the only reference given for this is the ICHD itself, which sounds tendentious. Do we have a separate reference for the lack of scientific suppport for the classification? If not, we ought to remove the sentence. Docben (talk) 15:55, 20 January 2012 (UTC)

Migraineurs

This word was just replaced by "people with migraines" with the edit summary: "Migraineurs" is not a word; furthermore, using it is an act of labeling an entire person with a disease. I changed that to "people with migraines." According to the OED it is a word:

migraineur, n. A person who suffers from migraine.
1970 O. SACKS Migraine 25 The diet of the migraineur must be sparse and ascetic. 1971 Listener 15 Apr. 480/3 Classical migraine is (pace G. B. Shaw) as uncommon among migraineurs as ‘normal’ vision among the rest of us. 1989 Pharmaceut. Jrnl. 16 Sept. 336/2 Some migraineurs can have an attack triggered by dietary amines. 1994 Arch. Neurol. (Chicago) 51 1258/2 Migraineurs have noted that their varicose veins constricted and ‘disappeared’ for hours.

Does it matter? I've replaced it with "people who suffer from migraine" per OED. It still leaves four instance of migraineur in the article. Anthony (talk) 00:49, 1 August 2010 (UTC)

Doesn't matter much. Actually, one nice thing is that the edit replaces an obscure English word with common English words, which is good for people reading the article who don't speak English well. The article needs much more of that actually. For example, "highly efficacious prophylactic treatments" should be replaced by "very effective preventive treatments", etc. etc. :-) --Steve (talk) 01:31, 1 August 2010 (UTC)
Yes. But I think I might just delete migraineur, for now. Anthony (talk) 01:47, 1 August 2010 (UTC)

New migraine template

As discussed above, I made a migraine template: See {{Migraine}}. I just kept it to the most central articles. The goal is that people interested in prevention of migraines, for example, won't overlook that there's a whole article on it. Therefore it's important that it be right at the top, not one of those bottom navigation templates that most readers would miss. I used a sidebar-format. OK?--Steve (talk) 03:16, 1 August 2010 (UTC)

Nice. Can the heading be "Wikipedia migraine articles" or "Articles related to migraine" or similar? Whatever, well done!Anthony (talk) 04:07, 1 August 2010 (UTC)

Compazine for Migraine Management

Am I mistaken that dopamine antagonists such as Compazine are often used to treat migraines? Compazine is the first line treatment for migraines at the US hospital near me. Surely this isn't an isolated case. If Compazine is a common treatment, I think it should be mentioned in the Management section. —Preceding unsigned comment added by 71.101.187.191 (talk) 01:19, 11 August 2010 (UTC)

Migraine Triggers

http://www.healthcentral.com/migraine/triggers.html —Preceding unsigned comment added by Ocdncntx (talk • contribs) 18:39, 22 November 2010 (UTC)

Good sources (*.org & *.gov)

   * www.americanheadachesociety.org -- National Headache Foundation
   * www.ahsnet.org -- American Headache Society
   * www.achenet.org -- American Council for Headache Education
   * www.aan.com -- American Academy of Neurology
   * www.ninds.nih.gov -- National Institute of Neurological Disorders and Stroke
   * www.clinicaltrials.gov -- Find clinical trials  —Preceding unsigned comment added by Ocdncntx (talk • contribs) 18:42, 22 November 2010 (UTC)

Here's another http://www.drugpolicy.org/docUploads/hemp_for_headache.pdf —Precedingunsigned comment added by 99.237.252.214 (talk) 01:38, 23 March 2011 (UTC)

Migraine or headache in children correlates with higher relative humidity and with rain.

Migraine or headache in children correlates with higher relative humidity and with rain.


Connelly, Mark, PhD; Miller, Todd, BA; Gerry, Gerry, MD; Bickel, Jennifer, MD.

Electronic Momentary Assessment of Weather Changes as a Trigger of Headache in Children.

Headache, 2009.


Cf.

It's true: Humidity, rain linked to kids' headaches NEW YORK | Fri Jan 22, 2010 http://www.reuters.com/article/idUSTRE60L5Q320100122

...

In a study of 25 children and teenagers with migraines or chronic tension-type headaches, researchers found that symptoms tended to flare up on days when it rained or when humidity was higher than normal.

Overall, study participants were nearly three times more likely to have a headache when it was raining or humidity was higher than average, compared with drier conditions, according to findings published in the journal Headache.

...

Overall, the researchers found that during periods of rain, kids in their study had a 59 percent probability of reporting headache symptoms. That compared with a 21 percent probability at rain-free times.

Similarly, the odds of headache symptoms were 58 percent when humidity was higher than average -- versus 22 percent when humidity levels were average. —Preceding unsigned comment added by Ocdncntx (talk • contribs) 18:52, 22 November 2010 (UTC)

good sleep habits reduce both the number and intensity of migraine headaches

Calhoun AH, Ford S.

Behavioral sleep modification may revert transformed migraine to episodic migraine.

Headache. 2007 Sep;47(8):1178-83. PMID 17883522

Department of Neurology, University of North Carolina, Chapel Hill, NC 27599, USA.

Abstract

BACKGROUND: Sleep problems have been linked with headaches for more than a century, but whether the headaches are the cause or the result of the disrupted sleep is unknown.

OBJECTIVES: We previously reported that nonrestorative sleep and poor sleep habits are almost universal in a referral population of women with transformed migraine (TM). Since cognitive behavioral therapy is effective in improving sleep quality in individuals with poor sleep hygiene, we designed a randomized, placebo-controlled study to assess the impact of such treatment on TM. We hypothesized that behavioral sleep modification (BSM) would be associated with improvement in headache frequency and intensity and with reversion to episodic migraine.

METHODS: Subjects were 43 women with TM referred to an academic headache center. After obtaining informed consent, patients were randomized to receive either behavioral sleep instructions or placebo behavioral instructions in addition to usual medical care. Subjects recorded headaches in standardized diaries. The first postintervention visit was scheduled at 6 weeks. At that visit, the blind was broken and all subjects received BSM instructions. A final visit was scheduled 6 weeks later.

RESULTS: Compared to the placebo behavioral group, the BSM group reported statistically significant reduction in headache frequency [F (1, 33 = 12.42, P=.001)] and headache intensity [F(1, 33 = 14.39, P= .01)]. They were more likely to revert to episodic migraine chi2 (2, n = 43) = 7.06, P= .029. No member of the control group reverted to episodic migraine by the first postintervention visit. By the final visit, 48.5% of those who had received BSM instructions had reverted to episodic migraine.

CONCLUSIONS: In this pilot study of women with TM, we found that a targeted behavioral sleep invention was associated with improvement in headache frequency, headache index, and with reversion to episodic migraine. —Precedingunsigned comment added by Ocdncntx (talk •contribs) 19:00, 22 November 2010 (UTC)

Natural treatments for migraine from nih

"Natural treatments for migraine include riboflavin (vitamin B2), magnesium, coenzyme Q10, and butterbur.
Non-drug therapy for migraine includes biofeedback and relaxation training, both of which help individuals cope with or control the development of pain and the body's response to stress.
Lifestyle changes that reduce or prevent migraine attacks in some individuals include exercising, avoiding food and beverages that trigger headaches, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. Obesity increases the risk of developing chronic daily headache, so a weight loss program is recommended for obese individuals."
http://www.ninds.nih.gov/disorders/headache/detail_headache.htm —Precedingunsigned comment added by Ocdncntx (talk •contribs) 19:33, 22 November 2010 (UTC)

Chronic headache and potentially modifiable risk factors: screening and behavioral management of sleep disorders. PMID 18184283

Chronic headache and potentially modifiable risk factors: screening and behavioral management of sleep disorders.

Rains JC.

Center for Sleep Evaluation at Elliot Hospital, Manchester, NH 03103-3599, USA.

Headache. 2008 Jan;48(1):32-9. PMID 18184283

Abstract

Sleep-related variables have been identified among risk factors for frequent and severe headache conditions. It has been postulated that migraine, chronic daily headache, and perhaps other forms of chronic headache are progressive disorders. Thus, sleep and other modifiable risk factors may be clinical targets for prevention of headache progression or chronification. The present paper is part of the special series of papers entitled "Chronification of Headache" describing the empirical evidence, future research directions, proposed mechanisms, and risk factors implicated in headache chronification as well as several papers addressing individual risk factors (ie, sleep disorders, medication overuse, psychiatric disorders, stress, obesity). Understanding the link between risk factors and headache may yield novel preventative and therapeutic approaches in the management of headache. The present paper in the special series reviews epidemiological research as a means of quantifying the relationship between chronic headache and sleep disorders (sleep-disordered breathing, insomnia, circadian rhythm disorders, parasomnias) discusses screening for early detection and treatment of more severe and prevalent sleep disorders, and discusses fundamental sleep regulation strategies aimed at headache prevention for at-risk individuals. —Preceding unsigned comment added by Ocdncntx (talk •contribs) 19:36, 22 November 2010 (UTC)

Optimizing circadian cycles and behavioral insomnia treatment in migraine.

Optimizing circadian cycles and behavioral insomnia treatment in migraine.

Rains JC. Curr Pain Headache Rep. 2008 Jun;12(3):213-9. PMID 18796272

Center for Sleep Evaluation, Elliot Hospital, Manchester, NH 03103, USA. jrains@elliot-hs.org

Abstract

Sleep regulation may play a key role in headache management for individuals with migraine. At least among individuals with a predisposition to headache, episodes may be provoked by sleep deprivation or excess, as well as by sleep disorders. Chronobiological patterns have been identified in some forms of headache, including migraine. Insomnia is the most common sleep disorder in headache clinic populations, observed in half to two thirds of migraineurs. Recent evidence suggests migraine may improve with regulation of sleep. Because sleep represents a potentially modifiable vulnerability to headache, practitioners may wish to consider strategies that restore sleep homeostasis.Behavioral strategies are effective for regulation of sleep and may be abbreviated for headache medical practice settings. This article discusses the nature and prevalence of sleep complaints in migraineurs, conceptualization, and behavioral management of insomnia in the headache practice setting. —Preceding unsigned comment added byOcdncntx (talk • contribs) 19:38, 22 November 2010 (UTC)

Not sure what this text is being used for?

Should this stuff be combined as internal links or are these meant to be external links?--Doc James (talk · contribs · email) 00:25, 4 December 2010 (UTC)

==References==

Migraine triggers

  • Federation of American Societies for Experimental Biology [FASEB] [1995]. Analysis of adverse reactions to monosodium glutamate (MSG). Bethesda, MD: Life Sciences Research Office, FASEB.
  • Pashley, H. (2009). About Migraine Triggers. [3]
  • Radnitz, C. L. (1990). Food-triggered migraine: a critical review. Annals of Behavioral Medicine, 12, 51–65.
  • Ravishankar, K (2006). 'Hair wash' or 'Head bath' triggering migraine - observations in 94 Indian patients". Cephalagia 26 (11): 1330–1334. ISSN 0333-1024.

Treatment

Triptans

  • Cohen JA, Beall D, Beck A, et al. Sumatriptan treatment for migraine in a health maintenenace organization: economic, humanistic, and clinical outcomes. Clin Ther 1999;21:190–205.
  • Adelman JU, Sharfman M, Johnson R, et al. Impact of oral sumatriptan on workplace productivity, health-related quality of life, healthcare use, and patient satisfaction with medication in nurses with migraine. Am J Manag Care 1996;2:1407–1416.
  • Cohen JA, Beall DG, Miller DW, Beck A, Pait G, Clements BD. Subcutaneous sumatriptan for the treatment of migraine: humanistic, economic, and clinical consequences. Fam Med 1996;28:171–177.
  • Jhingran P, Cady RK, Rubino J, Miller D, Grice RB, Gutterman DL. Improvements in health-related quality of life with sumatriptan treatment for migraine. J Med Econ 1996;42:36–42.
  • Solomon GD, Nielsen K, Miller D. The effects of sumatriptan on migraine: health-related quality of life. Med Interface1995;June:134–141.
  • Solomon GD, Skobieranda FG, Genzen JR. Quality of life assessment among migraine patients treated with sumatriptan. Headache1995;35:449–454.
  • Santanello NC, Polis AB, Hartmaier SL, Kramer MS, Block GA, Silberstein SD. Improvement in migrainespecific quality of life in a clinical trial of rizatriptan. Cephalalgia 1997;17:867–872.
  • Caro JJ, Getsios D. Pharmacoeconomic evidence and considerations for triptan treatment of migraine. Expert Opin Pharmacother2002;3:237–248.
  • Lofland JH, Johnson NE, Batenhorst AS, Nash DB. Changes in resource use and outcomes for patients with migraine treated with sumatriptan: a managed care perspective. Arch Intern Med 1999;159: 857–863.
  • Cady RC, Ryan R, Jhingran P, O’Quinn S, Pait DG. Sumatriptan injection reduces productivity loss during a migraine attack. Arch Intern Med 1998;158: 1013–1018.
  • Litaker DG, Solomon GD, Genzen JR. Impact of sumatriptan on clinic utilization and costs of care in migraineurs. Headache1996;36:538–541.
  • Greiner DL, Addy SN. Sumatriptan use in a large group-model health maintenance organization. Am J Health Syst Pharm1996;53:633–638.
  • Lofland JH, Kim SS, Batenhorst AS, et al. Cost-effectiveness and cost-benefit of sumatriptan in patients with migraine. Mayo Clin Proc 2001;76:1093–1101.
  • Biddle AK, Shih YC, Kwong WJ. Cost-benefit analysis of sumatriptan tablets versus usual therapy for treatment of migraine. Pharmacotherapy 2000;20: 1356–1364.
  • Caro JJ, Getsios D, Raggio G, Caro G, Black L. Treatment of migraine in Canada with naratriptan: a cost effectiveness analysis. Headache2001;41:456–464.

General

Economic impact

  • Edmeads J, Mackell JA. The economic impact of migraine: an analysis of direct and indirect costs. Headache 2002;42:501–509.
  • Gerth WC, Carides GW, Dasbach EJ, Visser WH, Santanello NC. The multinational impact of migraine symptoms on healthcare utilisation and work loss. Pharmacoeconomics 2001;19:197–206.
  • Hu XH, Markson LE, Lipton RB, Stewart WF, Berger ML. Burden of migraine in the United States: disability and economic costs. Arch Intern Med 1999;159:813–818.
  • Osterhaus JT, Gutterman DL, Plachetka JR. Healthcare resource and low labour costs of migraine headaches in the US. Pharmacoeconomics1992;2:2–11.

Clinical picture

  • Blau JN. Classical migraine: symptoms between visual aura and headache onset. Lancet 1992;340:355-6.
  • Silberstein SD: Migraine symptoms: Results of a survey of self-reported migraineurs. Headache 1995;35:387-96.
  • Silberstein SD, Saper JR, Freitag F. Migraine: Diagnosis and treatment. In: Silberstein SD, Lipton RB, Dalessio DJ, eds. Wolff's headache and other head pain. 7th ed. New York: Oxford University Press, 2001:121–237.

Do migraines cause dizziness or vertigo?

Do migraines cause dizziness or vertigo? Many websites I have run across don't mention these symptoms, and this article (at least today's revision) doesn't either. But these sources do say that migraines can cause them:

  • Migraine Associated Vertigo (MAV), Timothy C. Hain, MD Page last modified: January 4, 2010
http://www.dizziness-and-balance.com/disorders/central/migraine/mav.html
  • Migraine-Associated Vertigo, Aaron G Benson, MD,and Davin W Chark, MD

http://emedicine.medscape.com/article/884136-overview

  • Dizziness - Causes By Mayo Clinic staff
http://www.mayoclinic.com/health/dizziness/DS00435/DSECTION=causes
  • Vestibular Migraine
http://www.vestibular.org/vestibular-disorders/specific-disorders/vestibular-migraine.php

So here's my questions: Should we add this a symptom of migraines? Or should we put this in a care "Rare symptom" category? Or is it so rare to be caused by migraines that we should leave it out? I look forward to your thoughts RK (talk) 04:20, 6 December 2010 (UTC)

Triggers

I have removed this primary research:

====Weather====

Several studies have found some migraines are triggered by changes in the weather. One study noted 62% of the subjects thought weather was a factor but only 51% were sensitive to weather changes.[1] Among those whose migraines did occur during a change in weather, the subjects often picked a weather change other than the actual weather data recorded. Most likely to trigger a migraine were, in order:

  1. Temperature mixed with humidity. High humidity plus high or low temperature was the biggest cause.
  2. Significant changes in weather
  3. Changes in barometric pressure

Another study examined the effects of warm chinook winds on migraines, with many patients reporting increased incidence of migraines immediately before and/or during the chinook winds. The number of people reporting migrainous episodes during the chinook winds was higher on high-wind chinook days. The probable cause was thought to be an increase in positive ions in the air.[2]

It is based on a questionaire given to 77 people asking them what wheather triggered there migrains and the other was a look at 79 people. We need review articles.Doc James (talk ·contribs · email) 06:04, 16 December 2010 (UTC)

I hope someone finds the review article you are seeking, because I know from 30 years of personal experience that weather is the #1 trigger for my migraines. I don't know precisely what environmental element it is (I suspect temperature changes and pollens) but I experience probably 3X migraine frequency in Spring and Autumn, as opposed to Summer and Winter. ZincOrbie (talk) 19:28, 9 September 2011 (UTC)

There is a definite correlation between migraine and weather. I live in India. During 4-5 cooler months here I had almost nil migraine attacks. Soon, at the onset of summer, I am getting recurring migraines, with at least 3 severe attacks in span of one month. Regards. — Preceding unsigned comment added by122.174.85.159 (talk) 15:43, 9 March 2012 (UTC)

epidemiology

This section says geographical variation is low yet the attached map seems to scream the opposite with a 45/245 ? per 100k ratio between europe and africa for instance --Tumadoireacht (talk) 12:04, 18 December 2010 (UTC)

Agree and removed that text unless a ref can be found. Doc James (talk · contribs · email) 12:08, 18 December 2010 (UTC)

Three sided square?

It would be helpful to find a clearer description than "three sided square" in the sentence "This is followed by a growing into a larger object such as a three sided square with the zig-zag line interfering with vision." Tashiro (talk) 20:19, 2 February 2011 (UTC)

Menstruation

I have tracked my bi-monthly migraines for 10 years and they appear to coincide with the menstrual cycle. I get a "bad" migraine with menstruation and a "mild" attack two weeks later. Any evidence in the literature to support this observation? Pandorama(talk) 11:09, 6 April 2011 (UTC)

Yes, there is. Many women experience what is referred to as Pure Menstrual Migraine or Menstrual Related Migraine. PMM occurs for a few days before flow, directly during menstruation, up to a few days beforehand, whereas MRM may occur during ovulation (which may be your two weeks later attack), or they may happen anytime a hormonal shift occurs. Please see http://migraine.com/migraine-types/menstrual-migraine/or google the terms. LeeloosGotAGun (talk) 01:39, 24 June 2011 (UTC)

Migraine triggers

I was a little shocked when reading this article about the causes of migraine, infact there arnt any according to this. I know that alcolic beverages inc. wine definately trigger my migraines. Eye Strain from computer use, too much and too little sleep, excessive stress, florescent light or long term exposure to the sun are also triggers amongt other things - someone needs to start to make a more comprehensive list.190.212.67.188 (talk) 22:58, 9 April 2011 (UTC)

Yes...I think the article takes too skeptical a view on migraine triggers, in the section Migraine#Triggers. For example, it says "A minority of migraines may be induced by triggers", i.e. less than half, which is indeed whatthe citation says, but on the other hand this reference says "There is a considerable amount of clinical data to suggest that most migraine attacks, despite their seemingly spontaneous nature, are triggered by a variety of endogenous and exogenous factors.[1,2]". (Note the word most, i.e. more than half.) Why do we accept the first reference but not the second? Also, the section says "The most common triggers quoted are stress, hunger, and fatigue; however, these equally contribute to tension headaches.[21]" The word "however" is baffling to me...how does the second half of the sentence undermine the first half?? I want to change it to, "The most common triggers quoted for migraines are the same as for tension headaches: Stress, hunger, and fatigue.[21]" or something like that. And while the section correctly reports that MSG and tyramine are not important triggers, it doesn't mention others that I think are more robustly known to cause migraines -- menstrual cycle, alcohol, stress, etc. Another sentence is, "A 2009 review found little evidence to corroborate the environmental triggers reported." This is misleading because "environmental triggers" sounds very general, when in fact the article is using the word "environment" to mean "indoor and outdoor environment", things like weather, light, etc. Also, when no well-controlled studies have been done on something, the article should present this as "it's unknown" rather than insinuating (through tone and wording) that "it's likely to be false". --Steve (talk) 00:09, 10 April 2011 (UTC)

I agree, Sbyrnes. Every article on migraine triggers I have ever read states everything to the contrary that this particular section states. A migraine MUST be precipitated by a trigger event, they don't "just happen". On many migraine sites, such as migraine.com, headaches.org, etc, there will be articles listing many specific triggers for individuals with migraine, which are the ones you listed above, including others. Weather is certainly a trigger for many individuals, but sometimes research misses the fact that some migraineurs must have what is called "stackable" triggers before they will go into an attack: http://migraine.com/blog/migraine-management-essential-trigger-management/ . That is, a drop in barometric pressure might not trigger a migraine outright (even though the patient has been taught and figured out they get a migraine during a pressure drop, but, maaaaaaybe not always), but a pressure drop, plus a glass of wine, and maybe the stress of a looming deadline all come together to overwhelm the nervous system and triggers an attack. I don't think these studies are accounting for that phenomenon, nor do I think they would be able to replicate the exact stimuli, since triggers are slippery in and of themselves.LeeloosGotAGun (talk) 02:17, 24 June 2011 (UTC)

We need to look at the scientific literature (preferably reviews published in the last 3-5 years) rather than blogs. The scientific literature is skeptical of triggers as they are not migraine specific. The cause of migraines remains unknown. One would need to get the above hypothesis studied and published by a review before we should consider including it here. Doc James (talk · contribs ·email) 02:37, 24 June 2011 (UTC)
I actually read the (english-language) reviews cited in the section, and my general impression was that triggering is widely accepted as a real phenomenon in the recent scientific literature. Anyway, I reworded the section as I suggested above. I'm happy to discuss with you specific conclusions and statements in specific review articles in detail to iron out the best wording, if you think what I wrote gives an impression that disagrees with the citations. :-) I already wrote above why I thought that the previous wording was not a fair reflection of the citations.
You write "The scientific literature is skeptical of triggers as they are not migraine specific." I couldn't find anything like that in the quoted references. Which article(s) are you referring to? If you're thinking of articles not currently in the references, we should of course cite them!! Thanks, :-) --Steve (talk) 15:24, 24 June 2011 (UTC)
Yes I agree different reviews come up with different numbers of migraines influenced by triggers. Have posted below one of the concerns I had with the change in text. AS long as we keep things based on recent review articles I am happy. Doc James (talk · contribs ·email) 15:39, 24 June 2011 (UTC)

OK here are some specific concerns and suggestions one by one:

1. "The most common triggers quoted are stress, hunger, and fatigue; however, these equally contribute to tension headaches." The implication of the wording is that the second half of the sentence undermines the first half, e.g. "because stress also contributes to tension headaches, one can question whether they're really migraine triggers." The citation does not support this implication. It says that the same factors trigger both migraines and other headaches, but it does not say that this implies that they might not really trigger migraines. (Another thing: The reference does not say these three factors are the "most common triggers", only that they are "common triggers".) Therefore I suggest changing the wording to "Common triggers quoted are stress, hunger, and fatigue (these same factors also contribute to tension headaches)." or something like that.
2. "A 2009 review found little evidence to corroborate the environmental triggers reported." This is literally accurate, but has three misleading connotations. First, "environmental triggers" sounds very general, but actually means "indoor and outdoor environment" in the context of the article (and not, say, diet or stress). Second, "found little evidence to corroborate" sounds in everyday speech like there was evidence against all of the triggers, but what is meant is "no good studies have been done so we don't know either way". Third, they did find some reliable studies, and these studies often supported the triggering hypothesis, not just opposed. See Table 1. Importantly, in the "Conclusions" section they suggest some prudent measures to avoid certain (presumed) triggers, a very different conclusion than you would think from the wikipedia description. They do not reach a general conclusion that we should view all triggers with skepticism, only that patients overestimate meteorological triggers specifically and that in general more work ought to be done. Therefore I suggest rewording: "In a 2009 review of potential triggers in the indoor and outdoor environment, the authors concluded that more rigorous scientific studies are needed, but nevertheless suggested that migraineurs take some preventative measures related to indoor air quality and lighting."
3. "A 2005 literature review found that the available information about dietary trigger relies mostly on subjective assessments." Again, this is literally true but the tone (as interpreted by a non-expert using everyday speech) is that this constitutes positive evidence against dietary triggers. I suggest rewording: "A 2005 literature review on dietary triggers found that the available scientific studies, mostly relying on subjective assessments, were not rigorous enough to prove or disprove any particular triggers". I don't speak German so I can't actually check this reference. :-(

What do you think of these three changes? --Steve (talk) 21:34, 24 June 2011 (UTC)

Yes agree and have made those changes.Doc James (talk ·contribs · email) 22:03, 24 June 2011 (UTC)

I still find it astonishing that the article has so little to say about dietary and other triggers. Many of my friends, most of my family and I suffer from migraines and know from our own experience that ours can be set off variously by coffee, chocolate, cheese, blue cheese, onions, cigarette smoke, the smell of glue or paint, fluorescent lighting, and so on. Even if the results of the 2005 study are inconclusive, could it not at least be mentioned that many people's experience leads them to believe that certain foods and environmental conditions act as triggers, with some of the commonest of these listed?Costesseyboy (talk) 00:59, 6 March 2012 (UTC)

Menstration

The ref does not support "The most important trigger is often the menstrual cycle: For many women, most or even all of their migraines occur within a few days of menstruation (this is classified as "menstrual migraine"). pmid14979299"" Doc James (talk ·contribs · email) 15:29, 24 June 2011 (UTC)

I suppose a better link would be [4], which includes the Appendix. Anyway, It says "Migraine without aura often has a strict menstrual relationship." By strict menstrual relationship they mean A1.1.1, "Pure menstrual migraine without aura", where the migraines exclusively occur during menstruation. I think for those people it's fair to say that menstruation is "the most important trigger" and that "all of their migraines occur within a few days of menstruation". There's also the A1.1.2 people, for whom attacks occur during most (2 out of 3) menstrual cycles but other times too. Maybe "most of their migraines" is not right, it should be "many".
So how's this? "For some women, the most important trigger is the menstrual cycle: Many or even all of their migraines occur within a few days of menstruation (this is classified as "menstrual migraine"). (Plus changing the PDF reference link.) Is that better? --Steve (talk) 20:28, 24 June 2011 (UTC)


I have added a couple of review articles following up on the significance of menstruation. Saying that menstruation is the most important factor for women with menstrual migraines is circular as the definition of menstrual migraines depends on them being due to menstruation. So I guess what I am saying is do we have a number from a review that illustrates what proportion of migraines in women are menstrual migraines?Doc James (talk · contribs ·email) 20:41, 24 June 2011 (UTC)
I see a primary study on the ICHD classification page but would prefer if we could find results from a review articleDoc James (talk · contribs ·email) 20:43, 24 June 2011 (UTC)

Possibly more details related to "Migraine Surgery" section's first sentence?

First sentence of that section:

"Migraine surgery is a field that shows a great deal of promise, particularly in those who suffer more frequent attacks, and in those who have not had an adequate response to prophylactic medications."


Is it possible that this section could include a brief explanation of why (or how) surgery shows a "great deal of promise"?

The reason why I ask is because I was skimming this article for info, and this caught my eye. But I would have liked to know (with less research on my part) if this could be taken seriously. Basically asking for an easier way to know if this is true.--Acuddlyheadcrab (talk) 07:19, 7 September 2011 (UTC)

Current clinical data support the use of fever-few, butterbur, magnesium, and riboflavin in migraine prophylaxis

A review has concluded that "[c]urrent clinical data support the use of fever-few, butterbur, magnesium, and riboflavin in migraine prophylaxis." PMID 15264611 Rios J, Passe MM.

Evidenced-based use of botanicals, minerals, and vitamins in the prophylactic treatment of migraines.

J Am Acad Nurse Pract. 2004 Jun;16(6):251-6. PMID 15264611

Source: University of Texas at Austin School of Nursing, USA. janie_rios01@yahoo.com

Abstract

PURPOSE:

To analyze evidence-based information about alternative prophylactic pharmacological migraine treatments utilizing feverfew, butter-bur, magnesium, and riboflavin and to discuss the mechanism of action, dosage recommendations, side effects, and contraindications for each treatment.

DATA SOURCES:

Data obtained via electronic databases and professional medical references.

CONCLUSIONS:

Current clinical data support the use of fever-few, butterbur, magnesium, and riboflavin in migraine prophylaxis; however, studies are limited but promising regarding the participants' perceived relief. Studies with rigorous methodologies and larger sample sizes are needed to further support the safe and effective use of these treatments.

IMPLICATIONS FOR PRACTICE:

With increased patient access to information regarding alternative migraine treatments, nurse practitioners (NPs) and other health care providers must be knowledgeable about evidence-based data regarding these alternative treatments to appropriately offer safe patient care.

PMID 15264611 — Preceding unsigned comment added by Ocdncntx(talk • contribs) 20:48, 22 September 2011 (UTC)

Related orphaned page

Via a Google search, I found the following wikipage which is currently orphaned: http://en.wikipedia.org/wiki/Mixed_tension_migraine

The information it contains looks like it might be related to one or all of the following pages: http://en.wikipedia.org/wiki/Migraine; http://en.wikipedia.org/wiki/Headache; http://en.wikipedia.org/wiki/Tension_headache.

Just thought to let someone know as I'm not yet comfortable making changes on wiki myself (sorry!) and it looks like an orphaned page could be removed (yay!). :) 

07:07, 8 April 2012 (UTC) Fae  — Preceding unsigned comment added by 210.49.168.154 (talk) 20:57, 26 December 2011 (UTC)

What about "complex migraines", also known as "variant migraines"?

I was confused to find nothing on the page about migraines whose symptoms are out of order or include unusual extra symptoms like hemiparesis/weakness, loss of vision, or difficulty speaking. The confusion between how such a complex migraine presents itself with the symptoms of a stroke can be terrifying to someone experiencing them. Might be worth a citation or two. Starters:

Before commenting, please review the archives

Before commenting, please review the archives as numerous topics have been previously discussed. If necessary, reference the appropriate archived discussion.

So; how do we review the archives / reference an archived discussion? Ocdnctx (talk) 13:15, 12 November 2011 (UTC)

Classification ?arbitrary

I added the POV tag to the statement calling the ICHD classification arbitrary and unsupported; the only reference given for this is the ICHD itself, which sounds tendentious. Do we have a separate reference for the lack of scientific suppport for the classification? If not, we ought to remove the sentence. 07:07, 8 April 2012 (UTC) — Preceding unsigned comment added by Docben (talk • contribs) 12:58, 20 January 2012 (UTC)

Classification; ?NPOV

I added the POV tag to the statement calling the ICHD classification arbitrary and unsupported; the only reference given for this is the ICHD itself, which sounds tendentious. Do we have a separate reference for the lack of scientific suppport for the classification? If not, we ought to remove the sentence. 07:07, 8 April 2012 (UTC) — Preceding unsigned comment added by Docben (talk • contribs) 15:53, 20 January 2012 (UTC)

Prevention

I have just segregated the individual therapies discussed in 'prevention'. I have also cut-out alot of detail from the 'prevention' section of this article and have moved it all to the main "migraine prevention' article. The prevention section here is now much shorter. Comments? Puhlaa (talk) 16:19, 8 April 2012 (UTC)

Have combined some together. We try to avoid one sentence paragraphs. Everything in this article should be support by reviews. --Doc James (talk · contribs · email) 18:13, 8 April 2012 (UTC)

A couple new reviews

Doc James (talk · contribs · email) 11:40, 24 April 2012 (UTC)

Percentage of auras.

I have just read a little bit of this article, and one spot says 1/3 of people experience auras (33%), another says a "small" percentage, and another 15%. This needs to be sorted out. If there is debate, it should be clarified, and not having disparate numbers across the article. It makes me not trust the article seeing unexplained ambiguity like this.

Peace and Passion ☮  ("I'm listening....") 17:39, 9 May 2012 (UTC)
I have not gotten to a comprehensive update yet. But will take care of this now. I would not completely trust this article as it stand now either. --Doc James (talk · contribs · email) 19:08, 9 May 2012 (UTC)

Triggers Section Needs Work

The Triggers section needs some attention from someone with access to WP:MEDRS-quality journal articles. It's out-of-date and also missing a lot of relevant information. In surveying the various migraine/headache websites, there is not a lot of evidence-based info on migraine triggers available to the general public, so this would be a valuable and unique contribution. I will try and get temporary access to journals beyond free-text, but if there is someone else who would like to help out that would be great. --Nicely0Done (talk) 16:45, 17 June 2012 (UTC)

Have removed the primary research which was added Doc James (talk · contribs · email) 05:02, 20 June 2012 (UTC)

neurological vs. vascular

I read the archive and considering the energy expended discussing the use of disease vs. disorder, I wanted to discuss this before making an edit.

In the first paragraph we have this statement: "Although some believe it to be a neurological disorder, there is no evidence to confirm this theory.[1]"

While the second paragraph has this statement: " ... symptoms are generally aggravated by routine activity.[5][6]"

Please Note: [6] states " ... Researchers believe that migraine is the result of fundamental neurological abnormalities caused by genetic mutations at work in the brain."

Other places in the article state:

" ... An aura comprises focal neurological phenomena that precede or accompany the attack. "
" ... It has been estimated to be the most costly neurological disorder in the European Community, costing more than €27 billion per year."

So my suggestion is to remove black and white statements such as the one stating "Although some believe it to be a neurological disorder, there is no evidence to confirm this theory.[1]" Siting a single source (which by the way, you have to pay for to read) which may be of the opinion that there is no evidence of a neurological disorder, does not mean that there is, in fact, no evidence. I believe that the other researchers that tend toward a neurological basis would beg to differ.

As a matter of fact, in the abstract for the referenced article, it says " ... A debate is presented that examines whether it is the blood vessel or the brain that determines the essence of migraine." Seems like that debate was boiled down to a one-sided conclusion.

I think we should stick to what is known, and be clearly referenced, on both sides of the argument, without coming to our own conclusions. So I suggest either removing the statement from the opening of the article, or at least move it down to the Pathophysiology section, where it can be discussed. Bobsd (talk) 22:17, 18 June 2012 (UTC)

I could not find in the ref provided the statement that their is no evidence it is a neurological disorder. I did however find a 2010 review which states it is a neurovasuclar disorder.Doc James (talk · contribs · email) (please reply on my talk page) 03:25, 25 June 2012 (UTC)

--- There are many researchers who think the vascular theory of migraines is done. For example: http://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2813%2970051-6/fulltext http://brain.oxfordjournals.org/content/132/1/6.full — Preceding unsigned comment added by 209.6.200.115 (talk) 21:47, 2 November 2013 (UTC)

WP:MEDRS

This page needs to follow WP:MEDRS. Some reviews below...

Doc James (talk ·contribs ·email) 23:23, 3 December 2010 (UTC)

  • Gilmore, B (2011 Feb 1). "Treatment of acute migraine headache". American family physician. 83 (3): 271–80. PMID 21302868. {{cite journal}}: Check date values in: |date= (help); Unknown parameter |coauthors= ignored (|author= suggested) (help)

Doc James (talk · contribs · email) (please reply on my talk page) 11:36, 7 July 2012 (UTC)

MSG

The 1991 source about MSG being a trigger is too old to be used, per MEDRS. Please use sources that qualify for MEDRS before re-adding. Yobol (talk) 16:36, 8 July 2012 (UTC)

Agree. Doc James (talk · contribs · email) (please reply on my talk page) 00:10, 9 July 2012 (UTC)


Moved from main area

Doc James (talk · contribs · email) (please reply on my talk page) 18:00, 11 July 2012 (UTC)

GA Review

GA toolbox
Reviewing
This review is transcluded from Talk:Migraine/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: MathewTownsend (talk · contribs) 19:58, 28 August 2012 (UTC)

  • I'll review this! Reading it answered one of my long-standing questions. MathewTownsend (talk) 19:58, 28 August 2012 (UTC)
review
  • more than 10%; 90 percent - should  % or percent consistently - the article is inconsistent in this respect.
Done Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:00, 30 August 2012 (UTC)
  • Overall the article is very interesting but a little hard to follow. I assume that the sections are following a formula for medical articles. I have some comments that may or may not be relevant.
Follows WP:MEDMOS yes Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:01, 30 August 2012 (UTC)
  • neurovascular disorder - what is this (perhaps the explanation is too technical for this article)
a disorder that involves nerves and blood vessels Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:53, 30 August 2012 (UTC)
This is another presumed presentation of migraine headaches along with cyclical vomiting syndrome. I guess we could move it to the section on diagnosis as it really is uncommon. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:51, 30 August 2012 (UTC)
Added further details Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:55, 17 September 2012 (UTC)
  • "They do run in families in about two-thirds of cases" - doesn't seem like encyclopedic language
Fixed Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:55, 17 September 2012 (UTC)
  • "Migraines may be induced by triggers, with some reporting it as an influence in a minority of cases[5] and others the majority." - some people or some research review articles?
Both. Doc James (talk · contribs · email) (if I write on your page reply on mine) 11:04, 30 August 2012 (UTC)
  • "spreading depression of Leão" - what is Leão?
Someones name Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:48, 30 August 2012 (UTC)
  • "Trepanation, the deliberate drilling of holes into a skull, was practiced as early as 7,000 BCE." - what is the relevance, as it's only mentioned at the end of the paragraph that William Harvey recommended it as a treatment in the 17th century. - the image, though nice, seems irrelevant and off topic -
This is a discussion of the early treatments of migraine headaches. We could go into more depth. Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:50, 30 August 2012 (UTC)
  • Why is the "Research" section so sparse? Is that all that's being researched? Shouldn't possible treatments be under "Management"/Treatment?
I never put possible treatments under treatment. These are typically not available. Yes more research is being done but it is only a GA and research is not really my area of interest. I am more interested in what is done now :-) Doc James (talk · contribs · email) (if I write on your page reply on mine) 10:45, 30 August 2012 (UTC)
  • Under diagnosis, it says that if a person has two attacks (or more) with aura, it is diagnosed as migraine. Then it says "If someone experiences two of the following: photophobia, nausea, or inability to work / study for a day the diagnosis is more likely.[57] In those with four out of five of the following: pulsating headache, duration of 4–72 hours, pain on one side of the head, nausea, or symptoms that interfere with the person's life, the probability that this is a migraine is 92%.[11] In those with less than three of these symptoms the probability is 17%." - what is the "ultimate" test of what a migraine is? (or whether a person is correctly diagnosed?)
The IHS criteria are the ultimate method of diagnosis. Doc James (talk · contribs · email) (if I write on your page reply on mine) 07:55, 17 September 2012 (UTC)

MathewTownsend (talk) 21:37, 29 August 2012 (UTC)

GA review-see WP:WIAGA for criteria (and here for what they are not)

  1. Is it reasonably well written?
    a. prose: clear and concise, respects copyright laws, correct spelling and grammar:
    b. complies with MoS for lead, layout, words to watch, fiction, and list incorporation:
  2. Is it factually accurate and verifiable?
    a. provides references to all sources in the section(s) dedicated to footnotes/citations according to the guide to layout:
    b. provides in-line citations from reliable sources where necessary:
    c. no original research:
  3. Is it broad in its coverage?
    a. it addresses the main aspects of the topic:
    b. it remains focused and does not go into unnecessary detail (see summary style):
  4. Does it follow the neutral point of view policy.
    fair representation without bias:
  5. Is it stable?
    no edit wars, etc:
  6. Does it contain images to illustrate the topic?
    a. images are copyright tagged, and non-free images have fair use rationales:
    b. images are provided where possible and appropriate, with suitable captions:
  7. Overall:
    Pass or Fail:
  • Congratulations on a very informative article. (I've made a few edits that you're free to change.[5]) MathewTownsend (talk) 18:40, 2 September 2012 (UTC)
Many thanks. I will try to address any remaining when I get home. Doc James (talk · contribs · email) (if I write on your page reply on mine) 20:12, 2 September 2012 (UTC)

Illustrations of visual migraine aura

Example of a scintillating scotoma aura with each dot or line flickering.

The reference Exploring the visual hallucinations of migraine aura by Schott accurately depicts the phosphene (expanding fortification spectrum) and featureless (not black) trailing scotoma. But the illustrations showing a brown and yellow Roman building with a dark area or fortification spectrum with no scotoma are inaccurate. The illustration of the phosphene against an ocean background is more accurate than the Roman building illustration. The phosphene appears as a bright (not dark) flickering patch that totally replaces the details of an expanding area of the background image. Greensburger (talk) 06:37, 22 October 2012 (UTC)

That image is blurry. We need a better one. It does not look like the ones in the ref you link [6] We could use the images in this document as they are from 1902. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:55, 22 October 2012 (UTC)

Migrainous delirium and hallucinations

A while back, I had included information on this phenomenon. It was properly cited (using books by Oliver Sacks as source material). It was relevant and valid information, and need not have been removed. That is all. — Preceding unsigned comment added by 67.83.213.205 (talk) 07:25, 20 November 2012 (UTC)

Sure issues are 1) no page numbers where given. While these phenomenon may occur, that they occur commonly is not supported 2) we do not typically use the popular press for medical content per WP:MEDRS Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:43, 23 November 2012 (UTC)
An aura by the way is a type of hallucination and we already discuss this in depth and state just how common it is. If it does state that delirium is common please state what page in what ref this is on as I may have missed it. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:48, 24 November 2012 (UTC)
Agree that the article already has hallucination (aura) covered with appropriate balance. DSM-IV's long list of causes of delirium does not include migraine. -- Scray (talk) 16:28, 24 November 2012 (UTC)
This reference states "Acute confusional migraine occurs almost exclusively in children and adolescents and is characterized by confused behavior occurring as a prodrome to the migraine headache." However it doesn't say if this symptom is "common". Axl ¤ [Talk] 11:17, 24 November 2012 (UTC)
Agree. Moreover, it is important to avoid any implication that persons with migraine have a high incidence of thought disorder, because systematic review has shown that is not the case in children, for example (PMID 20603260). -- Scray (talk) 16:28, 24 November 2012 (UTC)
The Oliver Sacks book Migraine should not be used as a source for medical information for this article. That book is a 1999 popular-press book; we're looking for recent (last 2-3 years ideally) peer-reviewed review articles and systematic reviews, or statement by national medical organizations, or similar. Please see WP:MEDRS. Zad68 03:44, 25 November 2012 (UTC)

Hello. Regarding the Oliver Sacks books being legitimate sources, my brother (the guy insisting that the Sacks books are legit) is highly biased. I suffer from chronic, severe migraine, and the worst ones are accompanied by hallucinations that go far beyond the mere visual misperceptions associated with aura. In both my brother's and my own opinion, the Sacks books feel like a validation of my experience. So my brother feels like he's protecting me and that Doc James is a bully. Once the situation has been framed in his mind in such a way, he will never back down.

Problem is, my brother is a confessed Internet addict who, by his own admission and our personal agreement with each other, has no business editing Wikipedia. Is there any way to ban or block him from doing so by using IP address alone? I don't use Wikipedia myself (except to read it) so if there's another page, place, or way to make this request, I'm gonna be lost. — Preceding unsigned comment added by 67.83.213.205 (talk) 11:19, 25 November 2012 (UTC)

Hi, I agree with everything my brother just said above, and agree that blocking me from Wikipedia might be for my own good. The only thing I disagree about is that Doc James is just a bully and a jerk.

environmental influence

The sources for this section must be out of date. Weather is such a well known trigger for migraine that the Accuweather website has a special tab for it. It is extremely accurate in my case; years ago I identified the Alberta Clipper weather front as one of my triggers. 71.163.114.49 (talk) 13:23, 24 January 2013 (UTC)

It is very uptodate. There is poor evidence to support the correlation you mention. This from Sept 2012 http://www.neurology.org/content/early/2013/01/23/WNL.0b013e31827f0f10.abstract which of course is a primary source and not suitable here but interesting none the less. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:35, 24 January 2013 (UTC)
While I realize the triggers are very varied and depend on a combination of factors I am slightly rattled that air pollution is never really considered. I get migraines from exposure to diesel fumes; the onset is about 15 hours. Diesel fumes (with their dioxin content) should probably not be excluded from research and studies. With vomiting and diarrhea, no medication can be taken. 58.174.224.5 (talk) 02:21, 10 April 2015 (UTC)
WP:Talk is no place to discuss our own experiences or maladies. Without reliable sources, our personal experiences are not germane. with reliable sources, our personal experiences are not needed. -- Scray (talk) 10:11, 10 April 2015 (UTC)

Lightning

Please stop deleting the Meeja.com.au entry on lightning as a trigger. Wiki guidelines state that ideal sources for such content includes general or systematic reviews published in reputable medical journals. You cannot link to the review article on this research by the University of Cincinnati without a subscription. Therefore, the outlet in question has used a Eurekalert report as a basis for the article, which is universally accepted as a reliable source. Just Undoing references does not help. If you must, find another source to replace it - there have been hundreds published today using the same Eurekalert report as a basis for information.

The popular press is not a reliable source for medical content. Link to the ref is here [7] Doc James (talk · contribs · email) (if I write on your page reply on mine) 00:29, 25 January 2013 (UTC)
It is a popular press cite of a primary study - exactly the kind of thing WP:MEDRS tells us not to use. See the section above this one. If you want to avoid a block you should self revert right now. Zad68 00:34, 25 January 2013 (UTC)
I just reverted this content because the source provided is a website and does not meet WP:MEDRS. The website says: "University of Cincinnati researchers are reporting the results of the first study to find that lightning may affect the onset of headache and migraines.", thus the website is discussing a primary study, which is also not ordinarily suitable for inclusion in medical articles. Puhlaa (talk) 01:07, 25 January 2013 (UTC)
  1. ^ Prince PB, Rapoport AM, Sheftell FD, Tepper SJ, Bigal ME (2004). "The effect of weather on headache". Headache. 44 (6): 596–602. doi:10.1111/j.1526-4610.2004.446008.x. PMID 15186304. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
  2. ^ Cooke LJ, Rose MS, Becker WJ (2000). "Chinook winds and migraine headache". Neurology. 54 (2): 302–7. PMID 10668687. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
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