Discover and read the best of Twitter Threads about #migraine
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10 commonly asked questions about migraine answered
1. Is migraine hereditary?
Migraine is hereditary, so if one or both of your parents have it, there is a 50-75% chance you will too. However, in many patients, there is no family history of migraine.
#MedTwitter #migraine twitter.com/i/web/status/1…
1. Is migraine hereditary?
Migraine is hereditary, so if one or both of your parents have it, there is a 50-75% chance you will too. However, in many patients, there is no family history of migraine.
#MedTwitter #migraine twitter.com/i/web/status/1…
2. Can children get migraine?
Ans: Yes. Migraine occurs in about 3% of preschool children, 4-11% of elementary school-aged children, and 8-15% of high school-aged children. Incidence of migraine increases in adolescence.
Ans: Yes. Migraine occurs in about 3% of preschool children, 4-11% of elementary school-aged children, and 8-15% of high school-aged children. Incidence of migraine increases in adolescence.
3. What are the common symptoms of migraine?
Ans: Headache, nausea, vomiting, intolerance to bright lights and noise.
Some people can have flashes of light, zigzag lines or blurred vision prior to onset of headache (called as visual aura).
Ans: Headache, nausea, vomiting, intolerance to bright lights and noise.
Some people can have flashes of light, zigzag lines or blurred vision prior to onset of headache (called as visual aura).
If you or a loved one suffers from migraines, you are going to want to settle in for this thread going over the outcomes of a recently published study. 🧵(1/15) #migraine #neurotwitter
Migraine patients report sleep problems. But how much of that is due to pain or other factors going on with this neurological disease? (2/15)
These researchers wanted to see if the effects of a ketogenic diet could modify sleep issues in patients with migraines and to clarify whether those changes came from the ketogenic diet's effects on headache symptoms. (3/15)
Started treatment for toxoplasmosis 3 days ago. serious herx, suggesting major die-offs (fingers crossed). The odd (and frightening) part is the feeling of "being able to feel" optic nerve/pre-frontal cortex and the formications/pressure/sensations tripled from baseline. 1/n
This was something that really started for me (or at least got a lot worse) after the 2nd covid vaccine. Toxoplasmosis is known to affect the brain and eyes and is a major risk in immunocompromised. I can tell something is going on in there. 2/n
Sure wish I had an infectious disease specialist in my pocket! I am on the Buhner protocol stephenharrodbuhner.com/wp-content/upl… as the western medical approach was way to toxic for my comfort. 3/n
Tina dreaded those 3 days every month
1. 32-year old Tina was happy & cheerful for 27-28 days every month, however, she feared facing the remaining 3-4 days. She hopelessly wished that those days never ever came, but that was not possible.
#medTwitter #neurotwitter
1. 32-year old Tina was happy & cheerful for 27-28 days every month, however, she feared facing the remaining 3-4 days. She hopelessly wished that those days never ever came, but that was not possible.
#medTwitter #neurotwitter
2. Tina used to get severe headaches that occurred only on 3-4 days every month. These days were 1-2 days prior to her menses or during the first two days of menses. She never experienced headache on other days of the month. She had regular periods and had a 2-year old child too.
3. Headaches were severe with a score of 7-8 on visual analog scale (where 10 is the most severe pain, and 0 is absence of pain). Tina had nausea, vomiting and dizziness associated with headache.
Headaches lasted 24-36 hours and they left her completely incapacitated.
Headaches lasted 24-36 hours and they left her completely incapacitated.
Migraine, a common neurological disorder, may be a metabolic as much as a neurological disease, with the migraine attack serving as a warning signal to increased oxidative stress and/or hypometabolism. (1/21) #neurotwitter #hypometabolism
Despite being primarily studied in terms of neuro-vasculature and neurotransmission, recent research suggests that migraine's pathogenic mechanisms may be linked to metabolism and mitochondrial dysfunction. (2/21) #mitochondria
Magnetic resonance spectroscopy studies have consistently shown decreased ATP levels and abnormal mitochondrial function in migraineurs, suggesting a metabolic component to the disorder. (3/21)
Migraine attacks can get triggered by sleeping less as well as oversleeping
1. 29-yr old presented with features of chronic #Migraine for 8 years. Among the triggers for headache, he mentioned lack of sleep as well as oversleeping (>9 hours/night).
#MedTwitter #Headache #sleep
1. 29-yr old presented with features of chronic #Migraine for 8 years. Among the triggers for headache, he mentioned lack of sleep as well as oversleeping (>9 hours/night).
#MedTwitter #Headache #sleep
2. Lack of sleep is a well-known trigger for migraine attacks.
People with migraine have a higher risk of insomnia and people with insomnia have a higher risk of developing migraine. Those with insomnia also have a higher migraine frequency & severity.
…alofheadacheandpain.biomedcentral.com/articles/10.11…
People with migraine have a higher risk of insomnia and people with insomnia have a higher risk of developing migraine. Those with insomnia also have a higher migraine frequency & severity.
…alofheadacheandpain.biomedcentral.com/articles/10.11…
3. Oversleeping too can trigger migraine attacks. This is often referred to as "weekend migraine". The person wakes up in morning (after sleeping >9 hours) with headaches.
doi.org/10.3390%2Fijms…
doi.org/10.3390%2Fijms…
Woman in whom #migraine #headaches were triggered by financial dependence on husband
1. 35-year old Mahima- "Dr, my husband locks entire cash in a safe and takes the keys to office. I have no back account, so can't use UPI on mobile. I can't even buy a chocolate for my son."
1. 35-year old Mahima- "Dr, my husband locks entire cash in a safe and takes the keys to office. I have no back account, so can't use UPI on mobile. I can't even buy a chocolate for my son."
2. Mahima had been consulting me for three months for frequent headaches, which were suggestive of migraine.
She was properly following my prescription, however, she still used to get 2-3 episodes of #headache every week.
I enquired with her about possible #stressors.
She was properly following my prescription, however, she still used to get 2-3 episodes of #headache every week.
I enquired with her about possible #stressors.
3. She had no interpersonal issues with in-laws or other family members and had no problems in marital life.
She was a housewife and had no source of income. She was dependent on husband for every expense, including buying small gifts for her son and even for emergency expenses.
She was a housewife and had no source of income. She was dependent on husband for every expense, including buying small gifts for her son and even for emergency expenses.
A woman in whom "pain-reliever" became "pain-giver"
1. 35-year old woman, known case of #migraine for 12 years, presented with increased frequency & severity of headaches for past 6 months (#headache occurred every single day in the past 3 months).
#MedTwitter #neurotwitter
1. 35-year old woman, known case of #migraine for 12 years, presented with increased frequency & severity of headaches for past 6 months (#headache occurred every single day in the past 3 months).
#MedTwitter #neurotwitter
2. Headache started early in the morning on awakening, after which she would take pain-relievers (sumatriptan, naproxen or ergotamine), which would relieve her headache for 4-6 hours, only to return by early evening. She would consume 30-40 tablets of pain-relievers every month.
3. She had disturbed sleep and also had features of #anxiety and #depression.
Headache, taking "pain-reliever" tablets, short duration pain relief followed by rebound headaches after 4-6 hours, occurring on daily basis had become a vicious cycle for her.
Headache, taking "pain-reliever" tablets, short duration pain relief followed by rebound headaches after 4-6 hours, occurring on daily basis had become a vicious cycle for her.
Regular #exercise effectively reduces #headache days in patients with #migraine
1. Migraine is a disabling disease that causes repeated episodes of headaches.
Exercise is very effective, however, it is uncommonly prescribed in migraine.
#MedTwitter #neurotwitter
1. Migraine is a disabling disease that causes repeated episodes of headaches.
Exercise is very effective, however, it is uncommonly prescribed in migraine.
#MedTwitter #neurotwitter
2. In a recent research, strength/resistance training reduced monthly migraine days (MMD) by 3.5 days, followed by high-intensity aerobic exercise (3.1 days) and moderate intensity aerobic exercise (2.2 days).
3. All exercise modalities showed higher efficacy compared to placebo.
The reason for strength/resistance training to rank top could be because of targeted muscular strengthening and reconditioning, particularly involving major muscles in the neck, shoulders and upper limbs.
The reason for strength/resistance training to rank top could be because of targeted muscular strengthening and reconditioning, particularly involving major muscles in the neck, shoulders and upper limbs.
1/ I'm approaching my 2 year anniversary of #LongCovid . I thought I would share my journey to recovery. This is not medical advice, just my story. If it helps one person it's worth it. I learned more from Twitter than anywhere else on this journey. #microclots #teamclots #pots
2/ I got COVID November 2020. Night 1 I had the most excruciating headache of my life. It felt as if someone was drilling into my forehead. The headache dissipated after 2 days only to return day 13. Initially I had some minor brain fog, like putting Ice Cream in the fridge etc
3/ I never lost my sense of taste or smell. I had a minor fever/body aches for 24 hours. Day 4, I started having heart rate issues. I would be resting on the couch and get up to walk to the bathroom and my heart rate would jump to 130.
This week’s #MigraineChatAMA invited Qs about the relationship between sleep disorders and #migraine.
Nothing shared is medical advice. Please talk to an HCP before making changes to your migraine treatment. Errors are mine. #MigraineChat /1
Nothing shared is medical advice. Please talk to an HCP before making changes to your migraine treatment. Errors are mine. #MigraineChat /1
What is the relationship between sleep and #migraine? “[T]he exact nature and direction of the association remains enigmatic; migraine may be the result of sleep disruption, but also sleep disruption may trigger migraine,... [cont.]
#MigraineChatAMA /2
#MigraineChatAMA /2
"...or migraine and sleep disruption may be symptoms of an unrelated medical condition, or they might be two intrinsically related phenomena with shared pathophysiological mechanisms.”
…alofheadacheandpain.biomedcentral.com/articles/10.11… #MigraineChatAMA /3
…alofheadacheandpain.biomedcentral.com/articles/10.11… #MigraineChatAMA /3
At an event I did last night, someone asked me to recommend poems of illness, and my mind totally blanked. But of course names popped in my head all day today. A little 🧵 of illness poems I love:
(thinking of #Lyme #MECFS, #longcovid #dysautonomia, #autoimmunedisease, and more)
(thinking of #Lyme #MECFS, #longcovid #dysautonomia, #autoimmunedisease, and more)
An incredible poem about headaches by Emily Dickinson that I bet some #longcovid and #migraine sufferers could connect to. I mean, these lines:
"And then a Plank in Reason, broke,
And I dropped down, and down -"
poetryfoundation.org/poems/45706/i-…
"And then a Plank in Reason, broke,
And I dropped down, and down -"
poetryfoundation.org/poems/45706/i-…
The one that says it *all* about community and connection - John Donne from DEVOTIONS ON EMERGENT OCCASIONS:
No man is an island entire of itself; every man
is a piece of the continent, a part of the main....
any man's death diminishes me,
because I am involved in mankind.
No man is an island entire of itself; every man
is a piece of the continent, a part of the main....
any man's death diminishes me,
because I am involved in mankind.
Things I’ve learned from talking to doctors about fatigue (related to #sjogrens #migraine #dysautonomia ) a thread:
1). Be dramatic. Now is not the time to put a good face and minimize. Say if you’re bedbound, housebound, unable to do a simple errand.
2). Include technical terms like ADLs (activities of daily living) and PEM (post-exertional malaise). “Fatigue” is too vague and many clinicians don’t have the ability to imagine the level of fatigue you are describing.
🎶When the moon in the sky,
rots like a bad pizza pie that's a #migraine🎶
🎶When flashes only you see,
sting your eyes like a bee, that's a migraine🎶
🎶When gentle closing of doors,
like an explosion roars, that's a migraine🎶 (1/4)
rots like a bad pizza pie that's a #migraine🎶
🎶When flashes only you see,
sting your eyes like a bee, that's a migraine🎶
🎶When gentle closing of doors,
like an explosion roars, that's a migraine🎶 (1/4)
🎶When the faintest of smell
sends your stomach to hell, that's a migraine🎶
🎶When your mood takes a dive,
you feel done with your life, that's a migraine🎶
🎶When your head is in pain,
as if hit by a train, that's a migraine🎶 (2/4)
sends your stomach to hell, that's a migraine🎶
🎶When your mood takes a dive,
you feel done with your life, that's a migraine🎶
🎶When your head is in pain,
as if hit by a train, that's a migraine🎶 (2/4)
🎶When the pain is divine,
but half your head feels just fine, that's a migraine🎶
🎶When it feels as if soon,
your eye's plucked out with a spoon,
that's a migraine🎶
🎶When trepanation sounds fine
and you'd get in that line, that's a migraine🎶 (3/4)
but half your head feels just fine, that's a migraine🎶
🎶When it feels as if soon,
your eye's plucked out with a spoon,
that's a migraine🎶
🎶When trepanation sounds fine
and you'd get in that line, that's a migraine🎶 (3/4)
Week 2 #MigraineChatAMA - #migraine types: You had some tough Qs & I don’t have all the answers. Just because I didn’t find them in my search, doesn’t mean they don’t exist. If you have reliable sources of information, please share. Errors are mine. For more info, click links. /1
Types: 2 main types are migraine without aura (MwoA) & migraine with aura (MwA). Under MwA are migraine w/: typical aura*, brainstem aura, hemiplegic & retinal migraine. *Migraine w/typical aura also incls migraine without headache. migraineagain.com/10-types-of-mi…
#MigraineChatAMA /2
#MigraineChatAMA /2
Types, cont: menstrual migraine (MM) is a subtype under either MwoA or MwA. If attacks happen only during menses = pure MM. Migraine attacks during menses and other times = mensturally-related migraine.
MM can be tougher to treat.
healthline.com/health/migrain…
#MigraineChatAMA /3
MM can be tougher to treat.
healthline.com/health/migrain…
#MigraineChatAMA /3
#Peacetime #Reflections
To get a permanent liberation from #migraine, we, as the sufferers, need to be deeply respectful and committed to ourselves at both dimensions - body and mind. 1/7
To get a permanent liberation from #migraine, we, as the sufferers, need to be deeply respectful and committed to ourselves at both dimensions - body and mind. 1/7
What goes into the #gut and #mind determine how intense and lasting would the #pain and #affliction be! A doctor can help only to some extent. #Painkillers are affronts to the body and mind. They stop working anyway after a while. 2/7
As sufferers, we need to own it up. In an utterly devastated and vexed state, we need to turn around with fire in heart and tell ourselves - 'Enough of playing games with myself! Let me take charge of my own inner sacred space, deterge it, make a temple of it - NOW or NEVER' 3/7
1/”You want me to put my needle where??” my fellow asked incredulously. It’s daunting, but it works—image-guided sphenopalatine ganglion blocks
Here’s a #tweetorial about this underutilized but effective procedure! #medtwitter #neurology #headache #migraine #neurotwitter #FOAMed
Here’s a #tweetorial about this underutilized but effective procedure! #medtwitter #neurology #headache #migraine #neurotwitter #FOAMed
2/Sphenopalatine ganglion (SPG) is the largest collection of neurons outside the brain—like a mini brain just for your face. It contains sensory, sympathetic, & parasympathetic nerve fibers. Given this, it’s not surprising that it’s felt to contribute to facial pain syndromes
3/SPG is a meeting point for the sensory nerves from V2 (thus related to trigeminal neuralgia) & the sympathetics and parasympathetics from the greater superficial and deep petrosal nerves, which have been implicated in cluster headache, migraine, & other facial pain syndromes.
Taken me several days to answer this, because migraines have long been a gap in my knowledge
Can't feel too bad though, because the science of #migraines is WAY more complex and uncertain than most would have thought
Here's what's known
Strap in, this will get complicated
/1
Can't feel too bad though, because the science of #migraines is WAY more complex and uncertain than most would have thought
Here's what's known
Strap in, this will get complicated
/1
What is the root cause of migraines? Currently 'TBC', unfortunately.
But evidence suggests it involves neurological, vascular, hormonal and genetic factors are working in concert
Applies to pretty much anything in the brain, it never makes it easy
/2
But evidence suggests it involves neurological, vascular, hormonal and genetic factors are working in concert
Applies to pretty much anything in the brain, it never makes it easy
/2
But if there IS one specific 'root cause' of migraines, most fingers point to Cortical Spreading Depression, CSD
What's that?
It's when a neuron, brain cell, experiences a sudden burst of activity (depolarisation), followed by a period of inactivity, as if it's exhausted
/3
What's that?
It's when a neuron, brain cell, experiences a sudden burst of activity (depolarisation), followed by a period of inactivity, as if it's exhausted
/3
What is a spontaneous spinal CSF leak?
It’s so much more than a headache. It’s extremely debilitating.
When I experienced a CSF leak in 2014, I had to lie down all day every day for several months.
#leakweek2022 #csfleak #spinalCSFleak #SIH #headache
csfleak.uk/living-with-th…
It’s so much more than a headache. It’s extremely debilitating.
When I experienced a CSF leak in 2014, I had to lie down all day every day for several months.
#leakweek2022 #csfleak #spinalCSFleak #SIH #headache
csfleak.uk/living-with-th…
Sometimes people are wrongly diagnosed with postural orthostatic tachycardia syndrome #POTS when it’s actually a spinal CSF leak.
I gave a short talk at the PoTS UK London Masterclass in December 2019
#leakweek2022 #CSFleak #spinalCSFleak #SIH #headache
I gave a short talk at the PoTS UK London Masterclass in December 2019
#leakweek2022 #CSFleak #spinalCSFleak #SIH #headache
I was interviewed for the National Migraine Centre HeadsUp Podcast about my experiences with a spontaneous spinal CSF leak (Series 2, Ep 6) to help educate healthcare professionals & patients
Sometimes a #CSFleak is misdiagnosed as chronic #migraine
#headache #SIH #leakweek2022
Sometimes a #CSFleak is misdiagnosed as chronic #migraine
#headache #SIH #leakweek2022
1/🧵
What’s going on in the 🧠 that causes motion sickness – and what’s the link with #migraine?
A #tweetorial about motion sickness, the importance of matching, and why serotonin matters
#MedTwitter #NeuroTwitter
What’s going on in the 🧠 that causes motion sickness – and what’s the link with #migraine?
A #tweetorial about motion sickness, the importance of matching, and why serotonin matters
#MedTwitter #NeuroTwitter
2/
First, let’s review some structures of the vestibular system that help us sense body movement:
1⃣ Semicircular canals = angular acceleration
2⃣ Otoliths (utricle & saccule) = linear acceleration & head tilt
📷: cell.com/current-biolog…
First, let’s review some structures of the vestibular system that help us sense body movement:
1⃣ Semicircular canals = angular acceleration
2⃣ Otoliths (utricle & saccule) = linear acceleration & head tilt
📷: cell.com/current-biolog…
3/
The 🧠 combines this vestibular input with visual 👀 & proprioceptive input to assess motion
➡️ This is where the importance of matching comes in
...So what happens when the inputs don't match?
The 🧠 combines this vestibular input with visual 👀 & proprioceptive input to assess motion
➡️ This is where the importance of matching comes in
...So what happens when the inputs don't match?
Let’s talk about #topiramate for #migraine. Love it or hate it, you’re probably gonna prescribe it for your patients. Unfortunately, I see a lot folks prescribe it in a way that it is either not effective or causes side effects, leading to the general disdain for the med. A 🧵1/n
This #tweetorial is more for medical providers but patients can learn from it to. Here are some ways to take topiramate that may lead to decrease in frequency and severity of migraine symptoms with less side effects. #MedTwitter #NeuroTwitter #MedEd 2/n
Topiramate one of the cheapest migraine preventives and it is usually covered by insurance. It also often needs to be trialed due to step therapy before other treatments can be prescribed. It’s also an effective med. But only if prescribed right. 3/n
1/12
How does botulinum neurotoxin (BoNT) work to improve chronic migraine? 🤔
⚡️ Spoiler: it's probably not what you think!
A 🧵 about BoNT & #migraine
#MedTwitter #NeuroTwitter #tweetorial
How does botulinum neurotoxin (BoNT) work to improve chronic migraine? 🤔
⚡️ Spoiler: it's probably not what you think!
A 🧵 about BoNT & #migraine
#MedTwitter #NeuroTwitter #tweetorial
2/
Let's start with a definition: what makes a migraine "chronic?"
◾️ Headache occurs at least 1⃣5⃣ days per month
◾️ Of which at least 8⃣ have features of migraine headache
◾️ For 3⃣ months or more
From: Int'l Classification of Headache Disorders ichd-3.org/1-migraine/1-3…
Let's start with a definition: what makes a migraine "chronic?"
◾️ Headache occurs at least 1⃣5⃣ days per month
◾️ Of which at least 8⃣ have features of migraine headache
◾️ For 3⃣ months or more
From: Int'l Classification of Headache Disorders ichd-3.org/1-migraine/1-3…
3/
And a bit of history: botulinum neurotoxin (BoNT) came to be studied for chronic migraine after anecdotes suggested that BoNT injections to treat wrinkles also helped with headaches!
And a bit of history: botulinum neurotoxin (BoNT) came to be studied for chronic migraine after anecdotes suggested that BoNT injections to treat wrinkles also helped with headaches!
Something I learned recently is there are 3 different types of photophobia associated with #migraine.
Type 1 is when light worsens migraine headache pain. This is due to the receptors in the eye then going to the thalamus and being transmitted out to the trigeminal nerves 1/4
Type 1 is when light worsens migraine headache pain. This is due to the receptors in the eye then going to the thalamus and being transmitted out to the trigeminal nerves 1/4
which transmit pain receptors in the face and head. Therefore light makes the pain worse.
Type 2 is increased sensitivity to light. Light seems brighter but it doesn’t make the headache worse. This is due to dysfunction in the brain pathways that mediate response to light. 2/4
Type 2 is increased sensitivity to light. Light seems brighter but it doesn’t make the headache worse. This is due to dysfunction in the brain pathways that mediate response to light. 2/4
Type 3 is light causing eye pain which has to do with neural pathways within the eye itself.
This is important for clinicians to ask about these because someone may have photophobia but not realize it. And this may contribute to them not getting a migraine diagnosis. 3/4
This is important for clinicians to ask about these because someone may have photophobia but not realize it. And this may contribute to them not getting a migraine diagnosis. 3/4
whenever I ask mom to make the lights dimmer she complains being in low light will give her a headache-I ask for low light as light causes headaches/migraines/sensory overload/general asd burnout/eye pain long covid&all this triggers the pain/nausea/fatigue from other conditions
I don't want to cause anybody with any condition pain so I try to compromise. its very difficult I can't have no light [ideal & sometimes necessary for me] but I have empathy so I don't complain about her needs.
it really bothers me how every single time I ask if I can dim the lights mom has to tell me how awful it is & it always makes me feel like a bad person. the hypocrisy also hurts. having some perspective would also be nice. none of my headaches or migraines are treated w/ OTC meds
