Saturday, 2 June 2018

The Migraine World Summit Summary: Day 2

Day 2

Trupti Gokani: Understanding the Gut- Brain connection in migraine

Author of “The Mysterious Mind” – takes a Mind, Eyes, Spirit approach to treatment.

Gut is our second brain (100millon neurons). The gut and brain can operate independently of each other. They are connected by the vagus nerve. When we experience that butterfly in stomach sensation it is our gut talking to our brain.

Migraine attack link with gastroparesis

Migraine attack in the gut
1.     Pain signal
2.     State of threat
3.     Nervous system is overwhelmed

Healthy gut
1.     Bowel movement in the am
2.     No gas, bloating or diarrhoea
3.     Appetite signal

95% serotonin produced in the gut.

Microbiome- genetic imprint of bacteria unique to us (100 trillion bacteria in the gut).

If we address the gut we can improve pain.

Practical steps?
1.     Routine (sleep pattern and lunch should be biggest meal of the day)
2.     Mindfulness (morning)
3.     Food as medicine (sipping warm soup during a migraine to calm down excitable migraine brain).
4.    Add in different cooling spices (cilantro, fennel & cumin tea) and supplements (magnesium, riboflavin &  CoQ10)

Cold vs warm beverage?
Warm drink in the morning is best
Cold hands & feet – bring in warm liquids

No salads in the airport – warm warm warm foods and drinks!

Medication?
1.     Impair our microbiome
2.     Ibuprofen can damage the lining of our gut
3.     More harm than good?

Day 2

Kathleen Digre: Migraine, vision and occipital neuralgia

Migraine & vision during aura - small disturbance that can build up and grow (triggered by cortisol, depolarisation).

Aura occurs before the headache and is a discreet neurological event (numbness, visual disturbance & dizziness).

As people age they sometimes lose headache and keep the aura stage of a migraine.

Visually sensitive all the time?
1.     Stripes
2.     Flickering lights
3.     Bright lights

Visual Snow?
Very different from aura. Persistent visual phenomenon (old tv, see through it)
Auras always start and end and are followed by headache

Possible triggers?
1.     Lack of sleep
2.     Altitude
Depolarisation – electrical slowing in the brain (vascular changes occur)

Visual aura without headache?
1.     Not as well studied
2.     Tends to be brief and not as disabling

Ocular migraines
1.     Eye migraine (slang)
2.     Ocular migraine not a good technical term as migraine is in the brain NOT in the eye
3.     Better to use term, migraine with aura

Retinol migraine?
1.     Truly in one eye
2.     Very rare and hard to diagnose

Migraine attack & Visual aura
1.     Blurred vision
2.     Light sensitivity
3.     Visual sensitivity from movement

Many people are often visually sensitivity in between attacks too (normal threshold).

Strategies to help
1.     Tinted lenses in between attacks (FL-41) to be worn inside only
2.     Polarised sunglasses for outside

Preventing aura with migraine
1.     Preventative medications
2.     Baby aspirin can help if you experience a lot of aura (daily low dose aspirin)
3.     Calcium channel blockers

Occipital neuralgia
1.     No known visual symptoms
2.     Pain in eye (sharp pain)
3.     Pain often travels up and over head into the eye
4.     Pinch of the occipital nerve (tend to be brief pains and can trigger migraines)
5.     Can be caused by injury and neck spasm
6.     Rarely will be treated with surgery

The Neck- trigger or symptom?
1.     Neck pain can be first symptom of a migraine (trigeminal nerve travels from the spine into the neck)
2.     Tight painful spasms in the neck (cervicogenic type migraine)
3.     Can be tricky to work out what’s causing what?
4.     Occipital neuralgia is not common

Cervicogenic headaches
1.     Does not usually trigger aura unless migraine too
2.     Good physical therapy can be very useful along with muscle relaxants

Occipital neuralgia vs Trigeminal
Occipital neuralgia – rams horn pattern of pain (ear and side of head), nerve blocks can be used to treat
Trigeminal – one spot on the face (cheek or forehead for example), anti-convulsant can be used for treatment

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