A List of Little-known Headache Facts-Part I

I am getting ready to take another board exam in Headache Medicine this Friday. I thought I could pass it in my sleep, but I decided to do some reviewing to be safe.  I have reviewed a lot of facts about headaches (data from research) in the past two weeks and some of it I had forgotten. I want to share here, in bullet statements, some of the things that research has told us so far.  You may have heard something very different from Dr. Oz, but remember he is an entertainer.  Sometimes medical practitioners pass along information that they have heard, that has no bases in research.  I will be back with more later. But here are the facts:

  • If you are a man with migraine, your risk of a heart attacks is 42% increased.
  • If you are a woman with migraine, you have no increased risk of heart attacks or strokes unless you have migraine with aura, then your risk is 18 more events per 10,000 people.
  • Using triptans has, so far, shown no risk in stroke or heart attacks.
  • The risk factors for developing chronic daily headaches include;
    • Being female
    • Low socioeconomic status
    • Having a head injury
    • High frequency of attacks to start with
    • Being obese
    • Having life stressors
    • Snoring
  • Having a PFO (hole in the heart) is equal between migraine without aura sufferers and the general population. There is an increased likelihood of have a PFO if you have migraine with aura and that increase is about double (40-60% rather than 10-30% in the normal population. No one knows what this means.
  • In a given year, 5.6-6.5% of men will have a migraine and 17.1-18.2% of women will have one.
  • About 50% of people with migraine have motion sickness, only 20% of the normal population do.
  • Other illnesses associated with migraine include;
    • Depression
    • Panic attacks
    • Generalized anxiety disorder
    • Other chronic pain disorders
    • Fibromyalgia
    • Irritable bowel syndrome
    • Arthritis
  • The frequency of migraine attacks are also directly related to anxiety and depression.
  • 4% of the adult population have daily or near daily headaches.
  • The most common age to start having migraines is 10-11 for boys and 14-17 for girls.
  • In studies looking at patients who state that they have “sinus headaches,” only 1% actually have headaches related to their sinuses. The other breakdown of their diagnoses are:
    • Migraine without aura: 52%
    • Medication Overuse Headache: 11%
    • Probable migraine: another 23%, so a total of 75% with migraine or probable migraine.
    • Cluster headache 1%
    • Hemicrania continua 1%
    • Nonclassifiable headaches 9%
  • 4-11% of children between 5-15 years old have migraine.
  • Feverfew is the most widely used natural supplement. While some natural supplements do have evidence of helping (Magnesium, Co Enzyme Q 10, Vit B2) the studies with Feverfew show no benefit as compared to a placebo.
  • So far all studies with acupuncture have shown no benefit for headache reduction as compared to a placebo.
  • So far, there is no scientific evidence that allergies are related to headaches.
  • People report the follow triggers for their migraines at the percentage level indicated: Stress (80%), hormonal changes (65%), hunger (57%), weather change (53%), change in sleep (50%), smells (44%), neck pain (38%), alcohol (38), and smoke (36%). Even though some people report foods as triggers, there is, at this point at least, no scientific evidence that food is a trigger for migraines.  Mythology states that red wine, cheese, chocolate and others trigger migraine but that has yet to be proven.   That mythology may stem from a Puritan thinking that anything that is enjoyable must be bad for you.