American Headache Society Scientific Meeting Part II

This is a continuation of my review of the highlights of the annual headache research meeting, which was held in Los Angles in late June.

1) A Dutch study looked how children with headaches were treated by their family physicians. It found that for those prescribed a medication, 41% it was a medication not recommended by headache specialists. This would probably be true for the states. This tells us that we still have not done an adequate job in educating primary care providers in how to treat headache disorders.

2) More information on stroke. A paper was presented where hemorrhagic stroke (where a vessel bleeds in the brain) risk were compared between migraine and non-migraine patients.  This review suggested that migraine patients have higher risk, though subtle, of both ischemic (lack of blood flow) and hemorrhagic strokes. The reasons are not clear nor is it clear what we can do about it except to prevent the migraines the best we can.

3) A new (not on the market yet or even within the foreseeable future) medications for stopping migraines, called BMS-927711, was shown to be quite effective and with very low side effects in one study.

4) One interesting study showed that fake hands-on treatments (what we call “sham”) have higher results than fake pills (placebos).  So touching and patient or doing a procedure, even if that procedure is fake, seems to cause patients to think they are better.

5) When headache treatment in the US was compared to that in countries with a national health care system, there were remarkable but not unexpected differences.  The US patients tend to go to their providers less often, are hospitalized less for headaches, but visit the ER much more often.  The American headache sufferers also take less prescription medication for headaches because they are less-likely to visit their provider due to upfront costs. The non-Americans, since they don’t have a cost, are more likely to visit their provider for headaches and get an appropriate prescription medication.

6) Preliminary research on the new approach to migraine by using the migraine vaccine (not a real vaccine but an antibody) is still showing very low side effects and no liver irritation.

7) Hispanic populations, in general, do not use alternative medicine like non-Hispanics do.

8) About a third of patients with New Daily Persistent Headache improve with Botox injections.

9) A study confirmed what we had observed, that women with migraine tend to worsen around peri-menopause. Most were 50-65% worse during those years compared to the years just before and after.

10) More evidence that many people with New Daily Persistent Headache had a viral or other infection just prior to the onset. This raises further questions about the cause of that troublesome headache disorder.