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For viewers who want to further educate themselves about migraine disease, we recommend the following additional resources.

Table of Contents

Web Links
Clinical Trials
Of Special Interest for Women
Of Special Interest for Children and Adolescents
Migraines and Society
Overview: Brain and Nerves
Books, CDs

Web links

National Institutes of Health
MedlinePlus
American Academy of Pain Management
American Pain Foundation
American Pain Society
American Academy of Pain Medicine

Clinical Trials

If you are interested in participating in clinical trials of proposed new migraine drugs and devices, seet www.clinicaltrials.gov - Headaches.

Of Special Interest for Women Women and Migraine

Three times as many women as men get migraines, and experts believe that hormones play a big role. "In children, the prevalence of boys and girls with migraine is equal," says Lisa Mannix, M.D., neurologist and medical director of Headache Associates in Cincinnati. "The discrepancy doesn't begin until puberty when girls start menstruating and having hormonal fluctuations." The NHF estimates that more than half the migraines in women are menstrually related, occurring right before, during, or after a woman has her period. Some women report that these menstrual migraines are more severe and last longer than migraines they may have at other times of the month. "There is strong evidence linking migraine with estrogen," says Mannix. Estrogen levels drop right before a woman has her period, and this fall in estrogen may trigger a migraine attack in some women. During pregnancy, when estrogen levels are high, some women have fewer and less severe migraines. After menopause, when estrogen levels are low, some have fewer attacks and milder symptoms, but others have worse migraines. "About two-thirds of female migraineurs improve with menopause, but one-third do not," says Bastings. "Changes in estrogen level can trigger different reactions among patients, and it is not clear why this happens." "Women should not have to tolerate menstrual migraine pain," says Mannix. "It is treatable. The most important thing is that women get diagnosed and work with their health care provider to get the best treatment." Some studies have associated migraine with an increased risk of stroke, particularly in women younger than 45 who get migraine with aura. "The evidence is very solid that these women are at increased risk for stroke," says Lipton. They have three times the risk than that of women younger than 45 who do not have migraines, he adds. "That may seem like a scary statistic, but even though the relative risk triples, the absolute risk is very, very low." This means that the risk for women younger than 45 without migraine is 10 per 100,000 versus 30 per 100,000 for women younger than 45 with migraine with aura. A woman who has migraine with aura, takes oral contraceptives, and smokes goes from a three-fold risk for stroke to a 12-fold risk, says Lipton. "I'm not saying that women with migraine should not take oral contraceptives," he adds, "but I am advising them not to smoke."
[SOURCE: Food and Drug Administration.]

For additional information on women and migraines, visit www.4woman.gov, the web site of the National Women's Health Information Center, a division of the US Department of Health & Human Services.

Of Special Interest for Children and Adolescents

Information for parents about migraine headaches in children and adolescents can be found at the web site of the American Academy of Family Physicians:

familydoctor.org/online/famdocen/home/children/parents/common/common/757.html

Migraines and Society

The Migraine Awareness Group addresses societal issues raised by migraines at www.migraines.org. Also, see the web site of the American Council for Headache Education,

Overview: Brain and Nerves

See http:/www.nlm.nih.gov/ medlineplus/brainandnerves.html.

Books, CDs

The most important new book on migraines is The Migraine Brain by Carolyn Bernstein, M.D. (Simon and Schuster, 2008, $25). Dr. Bernstein has spent 17 years on the faculty of the Harvard Medical School, and founded the Women's Headache Center near Boston. The message of this book is that "the migraine brain" is one which has a hypersensitivity to stimuli, and is more likely to experience a cascade of neurological reactions that give rise to the symptoms of migraine.

Among new publications on migraines are: Headache Through the Ages by Seymour Diamond, MD., and Mary A. Franklin. (Professional Communications, Inc. $19.95). Dr. Diamond, director of the Diamond Headache Clinic in Chicago describes famous migraineurs (Thomas Jefferson, Mark Twain, Mary Queen of Scots, et. al.) and recounts how migraine headaches were understood and treated as far back as ancient Assyria.

Migraines for Dummies by Diane Stafford and Jennifer Shoquist, MD. (Wiley Publishing, $2.95).