Monday 4 October 2010

Breaking the migraine barrier

New research looking into the causes of migraines has produced what may be one of the most important and useful medical findings of the century. Scientists have found a gene that regulates how pain is felt in the brain, a gene that can be turned up or down. Called TRESK, the gene controls the sensitivity of pain nerves in the brain and it is thought that migraine sufferers may have a fault in their gene, causing the extreme sensitivity to light, noise and touch experienced during a migraine.
It’s an exciting discovery as it may lead to the creation of a new generation of drugs that can simply turn up the threshold at which the body feels pain making migraines a thing of the past. It not just migraines that will benefit however, as it could potentially lead to a new form of painkiller being developed as well. As the gene is susceptible to being switched on and off with drugs it means that it could be altered to increase the threshold to such an extent it eliminates the feeling of pain altogether.
Migraines cause a considerable burden to sufferers and their work. In the UK around 18 per cent of women and 8 per cent of men get migraines resulting in the loss of more than 25 million working days a year. The World Health Organisation has named migraine as a leading cause of disability worldwide and it has been estimated to be the most costly neurological disorder in Europe.

Sadly migraines are often very badly managed by the medical profession, many of whom still continue to promote ideas like its cheese, or chocolate that cause migraines. Actually the situation is more complex, and it is necessary for more than one trigger to be present, possible more than 48 hours before the onset of headache, in order to cross the threshold that leads to an attack. Contrary to popular belief migraines are not caused by food allergy either, and no specific antigen-antibody reaction has ever been identified although certain foods may be one of a complex of triggers. Actually, missing meals (resulting in a drop in blood sugar) and dehydration are far more important triggers. Changes in sleep pattern, hormonal changes, head and neck pains and stress are all other culprits. Very little time is spent explaining and helping to identify these interacting triggers and existing treatments are often not taken early enough. There is currently no cure for migraines but many different treatments are available which can be effective if used correctly. The problem is that it can require quite a bit of personal experimenting with different types and combinations of medicines before the most effective one is found. Even simple painkillers can work well, but many people only take painkillers when their headache becomes very bad. This is usually too late for any benefit to be felt.


My top 5 tips if your migraines are poorly controlled are:

1) Identify prodromal symptoms like changes in mood or behaviour to help identify as early as possible when a migraine may be imminent.
2) Keep a diary of all the details of what you were doing for the few days before an attack to help you better understand them.
3) Identify your specific triggers and gradually cut them from your life, if possible.
4) Take treatment early –by identifying the warning signs this should usually be possible.
5) Always carry treatment with you and ideally a little food and drink too.

If you feel your migraines are not under control then ask your GP for a referral to a specialist migraine clinic for further advice.

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