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What migraines have in common: hypersensitivity to stimuli
The evidence keeps piling up that one thing shared by migraine sufferers is a hypersensitivity to stimuli. This explains why so many migraineurs suffered from car sickness and sea sickness when they were children. (See "Motion Sickness in Migraine Sufferers" in the Abstract section.) Others have noted that antiepileptic drugs are helpful for some migraine patients, and infer ca connection between migraines and the hyperexcitabilty of epilepsy. (See "More Evidence for 'Hyperexcitability' Theory" in the Abstracts section.)
Any doubts about the connection between migraine sufferers and hyperexcitability to stimuli should be put to rest by a new book called The Migraine Brain by Carolyn Bernstein, M.D. (Simon and Schuster, 2008, $25).
"The biggest myth is migraine is a type of headache," writes Dr. Bernstein. "This is wrong. Migraine is a complex neurological disease that affects your central nervous system. Headache is one of its symptoms, but migraine almost never consists of head pain alone. There are many other possible symptonms, including nausea or vomiting, sensitivity to light or sound, tingling or strange sensations in your skin, visual changes, hunger pangs, and slurred speech. Almost everyone experiences several symptoms during a migraine attack.
"Ordinary headaches that occur randomly do not comprise a disease. But migraine is a chronic, neurological illness that you were born with. It's something you live with, a presence in your life like arthritis, although you usually can't predict when it will leap up to consume and ruin your day (or days)."
Dr. Bernstein says the new science of migraine recognizes that migraine disease involves many aspects of your physiology, including your central nervous system, neurotransmitters and other chemicals in your brain, electrical impulses, your inflammatory response, a nerve in your face and head called the trigemical nerve, and other systems. "The latest research points to a 'cortical spreading depression' as the physical reaction that begins a migraine attack." Cortical spreading depression is a dramatic wave of electrical 'excitation' that spreads across the surface of the brain ... when something antagonizes or upsets it.
Other researchers have long noted that during epileptic attacks, this "cortical spreading depression" happens very quickly. In migraines it spreads more slowly.
Dr. Bernstein is one of the first researchers to connect migraines and "sleep apnea," a dangerous health problem that causes you to stop breathing for short periods of time while you are sleeping. Sleep apnea is one of the most undertreated major health problems in the country. Effective devices are available to control it.
In The Migraine Brain Dr. Bernstein describes the reasons migraine is a neurological illness, discusses migraine triggers and offers ways to self-treat migraine.
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