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Summit but I am a participant in the Migraine World Summit affiliate program.
This means I earn a commission from any qualifying purchases of the summit made
through my link. http://www.migraineworldsummit.com/?afmc=1k
The
migraine brain does not tolerate any change in routine well.
Why
is intermittent fasting dangerous for chronic migraine?
-
Normal things
already trigger a migraine so easily such as exercise and menstruation
-
If you are
fasting on religious grounds and you have CM then please speak with your church
leader as you shouldn’t be fasting and normally allowances are made for medical
reasons.
Is
weight associated with migraine?
-
Overweight
association with more migraines
Why?
(possible hypotheses)
-
fatty tissue –
inflammation – promotes migraine
-
Obese – leaky gut
syndrome
-
Postural factors
– more pressure on lumbar and cervical spine
-
Fatty tissue
modifying hormones
Migraines
association with weight gain also contributed by medications that can cause
weight gain as a side effect.
Topiramate
– only 10- 15% will experience weight loss.
How
to lose weight if you do have migraine?
-
PATIENCE
-
Drop calories
-
Glucose
regulation
-
Drink more water
-
Increase your
protein and veggie intake
-
No refined sugars
-
Reduce portion
size
Sleep
is key for weight loss.
Focus
on why we eat! Is there an emotional component to our eating behaviours?
Exercise
helpful for both mood and weight loss!
How
about the Ketogenic diet?
-
Some evidence –
regulate sugars – help migraine
-
Not safe diet for
everyone and very difficult to stick to
Hydration?
-
Hydration is
so important
Vomiting
& dehydration?
-
Acute therapy to
control
-
Sip on
electrolytes
-
Sometimes iv
fluids are necessary
Food
and drink to boost hydration?
-
Vegetables.
Careful with fruit as lots of sugar
-
Water and herbal
teas
-
Add some lemon,
mint or cucumber to your water to add some extra flavour
-
Coconut water? Why
not.
-
Gatorade? For
mild to moderate exercise its not necessary
Should
I focus more on healthy lifestyle or food triggers?
-
HEALTHY
LIFESTYLE FIRST
-
Trigger lists are
rarely effective unless patient knows specific foods
-
Worrying over
food triggers tends to increase anxiety and the lists of potential ones are
endless.
Calcitonin
gene related peptide
-
Small protein
made up of 37 amino acids
-
Increased during
migraine attack
-
Induce a migraine
in health participants
Central
nervous system (CNS) – Brain & spinal cord
Peripheral
nervous system – outside of the CNS. Connecting the CNS with organs and blood
vessels
Is
CGRP all bad?
Maybe
helpful in protecting against high blood pressure
Triptans?
-
Restricting vasal
constriction
-
Inhibits the
release of CGRP
Gepants?
-
New drug
-
Antagonist
receptor of CGRP
-
Binds to CGRP
receptor (stops CGRP doing its thing and inhibits binding)
Antibodies?
-
Binds to the
molecule itself (Ajovy & Emgality)
-
Binds to the
receptor (Aimovig)
Will
there be issues of MOH with the gepants?
-
Hopefully not the
case as with other pain meds as works differently
CGRP
side effects?
-
In clinical
trials – no real side effects
-
Don’t have enough
data yet to know potential longer-term side effects
-
Cardiovascular
safety?
-
In clinical
practice – mild side effects (constipation and injection site reaction)
Pros
& cons?
-
PRO: first drug
specifically for migraine. Tolerability is very good.
- CON: Need to know
more about long term safety. Access to treatment is tricky for some. Doesn’t
help everyone (not a cure).
Photophobia
-
Extreme
sensitivity to light
-
Light makes pain
wore (aggravates the pain)
Light
is painful to blind people. This is why they wear sunglasses.
Vision
and pain are two different pathways so doesn’t make sense?
Optic
nerve – required for photophobia or trigeminal nerve?
1) Blind patients with no optic nerve – no photophobia
2) Light without sight patients – photophobia
In
order for photophobia to occur, optic nerve must communicate with migraine
pathway.
Neurons
in a distinct area of the thalamus (which process pain), receive a direct input
from the retina through the optic nerve into these neurons. We can see that
these neurons fire up with light.
Why migraine patients have visual disturbances?
Visual cortex
75000
websites about filtering out blue light. Only true for blind patients. If you
only block out blue light it won’t make a difference.
Blue
and red light make head more painful.
Yellow
and white also painful but less so than blue and red.
In
contrast green light has the opposite effect. Green light decreases headache
and autonomic symptoms.
Light
increases the intensity of pain by about 20-25%.
-
Sunlight
uncomfortable for migraine patients
-
Flickering lights
– exacerbate headache
Can
we get green light to help us?
-
YES. Green
lightbulb currently $250. It will get cheaper over time. Already come down in
price a lot.
-
Company aims to
bring green light to migraine patients who need it
Testing
green light in real life?
-
When patients
exposed to green light for 2-2.5 hrs their pain goes away or is improved by
80%.
-
Patients also
report that they feel less anxious, brain fog lifts and their cognitive
function improves.
Should
we be using glasses/screen filters?
-
Cutting down on
blue light is a good thing for everyone
-
To filter it out
properly would cost thousands of dollars
-
They filter out
some of it but not all of it
Sleep
in the dark is important.
Emotional
component – aversion to light better definition than phobia.
