May 29, 2008
More than headaches: Speaker to explain migraines, research
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Any severe headache is frequently accompanied by the statement, “I have a migraine.”
But those who actually live with migraines from day-to-day face an onslaught of potentially debilitating symptoms, which may or may not include a headache, and say the disease is widely ignored by the medical community.
The New Canaan YMCA will join the Stamford Jewish Community Center and two-year-old Migraine Research Foundation to sponsor a talk by neurologist Dr. Joel Saper and Samuel Yates, chief operating officer of the MRF, from 7 to 9 p.m. Monday, June 2, at the Jewish Community Center, 1035 Newfield Avenue, Stamford. Those who wish to attend should RSVP to Amy Padva at (212) 249-5402 or apavda@migraineresearchfoundation.org.
“Migraine has become synonymous with any bad headache,” Dr. Saper, who runs the Michigan Head Pain & Neurological Institute (mhni.com) in Ann Arbor, said in a phone interview. “The irony is you can have a migraine and have no headache. Headache is one of the symptoms. It’s usually present and it’s usually moderate to severe, but you can have no headache and still have a migraine. Brain biology determines it.”
Dr. Saper, who said he works with many patients from this area referred by Dr. Fred Shaftel, rhetorically asked, “How many people have a migraine and do not realize it, because they have been told they have tension headaches or sinus headaches? Some of the epidemiology has to focus on how many people in the U.S. are impaired by migraines and don’t have the right diagnosis.”
Advances are being made in understanding what’s happening with a migraine.
“In the last 10 or 15 years we’ve come to better identify the brain mechanisms that are at the heart of the cascade of events that causes migraines,” Dr. Saper said. “Many of the events are related to inflammatory neurochemicals.”
As the mystery behind the cause of migraines unravels, some doctors are working on ways to ease the pain and prevent the activation of the inner mechanisms that cause migraines.
But Dr. Saper said patients are not being helped by a current overuse of medication — including prescribed narcotics — to mask the pain without addressing the symptoms.
He described “rebounding:” “The more drugs you take, the more of a headache you get. The more of a headache you get, the more drugs you take.”
Regarding over-the-counter painkillers, he said, “If used in a migraine person more than two or three days a week, week after week, month after month, if you persistently overuse, it will actively change brain receptors and the headaches will progress.”
During an episode of ABC’s “20/20,” Dr. Saper shared the case of a man who was up to 55 Excedrin a day to ease headache pain, causing terminal damage to his liver, spleen and kidneys.
“We’re now in the narcotic revolution, where people we would never before be giving narcotics to are getting narcotics,” he said. “I’m not talking about breaking a bone or having surgery — that’s appropriate, that’s acute pain. I’m talking about people with day-in/day-out headaches being given narcotics. I have argued against that, but we have lost the battle. I see a lot of patients from your community.”
Genetics is crucial to the proper diagnosis of a migraine.
“One is born with the predisposition,” Dr. Saper said. “By the nature of genetics, things that are not bothersome to another person could be headache-provoking to a migraine person. Plus, a very important factor left out of any discussion is the role of estrogen.”
Women, he said, are more likely to suffer migraines than men, particularly after the age of 13, due to the influence of estrogen.
All of the factors that converge to create a migraine are being studied by the Migraine Research Foundation, for which Dr. Saper is chairman of the Medical Advisory Board.
“We support science that gets at the problem, either at treatment or at the cause, and sort of focus on practical and relevant research,” he said.
“The Migraine Foundation is attempting to focus it on something that can help in the next several years, rather than years and years from now, which is why I think it’s such a wonderful opportunity to get at the heart of the problem,” he added.
“There’s very little research,” said Cathy Glaser, president of the New York-based Migraine Research Foundation. “The NIH (National Institutes of Health) funds only $13 million in a disease whose prevalence is 10 percent of the population. It’s extremely underfunded and not recognized as a serious illness.”
She said when organizers found that migraines were listed as the 11th most disabling illness, “We decided we had to do something about it because no one else would.”
“Thirty million people in the U.S. get migraine headaches — that’s just an astronomical number,” Ms. Glaser said. “Twelve million people have chronic daily headaches. Once a migraine transforms into a chronic, daily headaches, there’s a lot of trouble being treated.”
The foundation awarded $200,000 in grants in 2007 and plans to distribute another $500,00 this year. More information can be found at migraineresearchfoundation.org.
Monday night, Dr. Saper will describe the symptoms, causes and treatment of migraines and of other headaches, and detail the diagnosis of a migraine.
Mr. Yates said he’ll talk about the Migraine Research Foundation and its mission to research a means to relieve the pain sufferers feel has long been ignored.
“It’s very frightening and disturbing to people who suffer from this,” Ms. Glaser said. “I can’t tell you how many phone calls we get from people who go through this and are desperate for help. It’s like shooting in the dark ... .”
Many try medications, only to find temporary relief, if any relief at all.
“They’re in the dark basically trying to figure out what to do next,” she said. “A lot of people are seriously disabled by this.”
© Copyright 2008 by Hersam Acorn Newspapers
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