New Media Producer: Brad Maglinger
Thirty-one-year-old Catherine Skinner got the first of many migraine headaches when she was 18.
"I didn't know what was happening," says Skinner. "It was like an incredibly bad headache. But, in addition to that, there was nausea, vomiting, and I was having flashes of light. I was seeing colors and shapes."
Catherine was experiencing symptoms of a classic migraine, a throbbing headache so debilitating that most patients have to lie in a quiet, dark room for hours and wait until the pain passes.
"According to the World Health Organization, migraine is one of the most disabling disorders known to mankind," states Dr. Stephen Silberstein. "And during an attack, a patient with migraine is as disabled as a person with psychosis or a quadriplegic.
Dr. Silberstein is the director of the Headache Center at Thomas Jefferson University Hospital in Philadelphia. He is the featured speaker at an American Medical Association media briefing in New York on advances in neurology, featuring migraine headaches. He says migraine traditionally has been treated as an episodic disorder, with medications known as triptans. But physicians are beginning to treat it as a chronic disorder to reduce the amount of acute attacks.
"Acute treatment is great for patients with infrequent attacks, but patients who have frequent attacks, who overuse the medication for acute treatment, wind up with daily headaches. And the strategy is to then go to not treating the attack when you get it, but to prevent the attack from occurring," says Dr. Silberstein.
As a preventative measure for migraines, doctors are now using anti-epileptic drugs, a class of medications that quiet down the nervous system. Another new type of treatment involves injection with botulinum toxin, which has recently been shown to be an effective migraine preventative therapy. A recent study found one of these new medications significantly decreased the amount of migraines in more than half the patients.
Dr. Silberstein says the most common migraine trigger in women is menstruation, due to falling estrogen levels. Other triggers include too much or too little sleep, stress, a blow to the head and food triggers like caffeine withdrawal, starvation, wine and MSG.