Migraine Headache Syndrome
Definition: 'A migraine is a throbbing, unilateral headache that is
often associated with nausea, vomiting, photophobia, or an aura
~i.e., a transient disturbance of vision or of various aspects
of neurological function. More than 10% of Americans
suffer from migraines, with the prevalence in women
being about 3 times that in men. The cause of migraine is
not well understood, although it is thought to be due in
part to vasoconstriction followed by reactive vasodilatation.'
Disclosure -- I'm not afflicted by headaches often (unless my child flunks a math quiz) and, never, migraines, yet I've met a ton of people with migraines. Many of my friends experience migraines or used to (half of my favorite gal pals and guy friends). Certain phenotypic characteristics and 'gifts' are inescapable IMHO that I have observed in these individuals: extreme intuition, sometimes clairvoyance, approachability, and super-powered senses (smell, sound, sight, sensory stimuli, barometric pressure, mind-reading). Additionally, migraineur patients, acquaintances and friends have told me that random people just enjoy blindly going up to them and spilling their entire life stories. (No one does that to me) I think that is notable. What do you think of your migraineur family or friends? I'd like to hear other perspectives on this...
These pals who suffer headaches are special to me. They read my mind and I don't need to talk or articulate...wish I could marry them (...just kidding). Some I speak to rarely like Patrik V. who runs Paleohacks.com, yet before he has said things and I'll think 'wtf exit my head.' When some paleo friends first convened, he reported that he had once suffered incapacitating migraine headaches since age six (hiding under tables whilst his mother couldn't find him for hours) until he serendipitously discovered the headache-banishing benefits of the grain-free and dairy-free paleo diet. That's a common story in paleo-land.
Migraine headaches are a P-A-I-N and that is a distinct understatement if you talk to any patient who suffers from migraines which are described as debilitating to the point of impairing function leading to lost quality of life and days of work, family, and leisure time.
Takano and Nedergaard (see above photo) describe a migraine headache as a sweeping change in electrical depolarization across the brain which is followed by an extended period of neural torpor or suppression. They call it cortical spreading depression (CSD), stating 'Written accounts of migraine are nearly as old as writing itself. Descriptions of headaches, dating to roughly 3000 BCE, have been found in the ruins of the ancient Sumerian civilization.' Perhaps like narrow jaws, occclusions, and tight dental arches (per Weston A. Price), mass migraines and brain pain initiated with the advent of agriculture and the ubiquitous introduction of refined grain carbohydrates into the prehistoric human hunter-gatherer diet? Perhaps migraineurs have indeed a set of gifts that were naturally selected for despite the outstanding pain and discomfort?
Evolutionary Advantage of Migraine Headaches?
Harvard neurology professor Loder wrote a Cephalalgia review and presentation 'Migraineur in the Interictus' suggesting evolutionary benefits of the development of the characteristics seen in migraineurs. Highly responsive nervous systems that detect sensory stimuli at low inputs definitely would be traits worthy of evolutionary selection and retention in the progress of human civilization. 'Hearing the approach of enemies, being eaten by a saber-tooth tiger or detecting or avoiding spoiled or adulterated food' might have been compelling pressures that were affected by the communication of low or nearly negligible levels of sensory information in the environment, plants, people, animals and other living creatures.
Ancient Treatment for Migraine Headaches: Hole(s) in the Head, Trepanation
In ancient times, it is hypothesized that headaches and migraines were treated with trepanation (boring a hole or holes into skull to release the pressure and pulsation). If I had severe head pain I'd seriously consider but, yeah, I need a hole in my head like a new Jimmy Choo fake purse! Several lines of evidence relating to archaeological remains report that clinical outcomes and survival were astonishingly decent: HERE.
Photo credit: Asylum Science
Our Brains are Still Evolving
I'd wildly speculate that the ancestors of individuals with migraines had unique abilities which allowed them to thrive in certain conditions requiring sensitivity to environmental changes and influence in group cooperation, gaining trust, tight social networks and perhaps weather/storm predictions. In is not a coincidence that the individuals with migraines (if not completely unfunctional) are frequently leaders in their little (or big) so-called tribal units, in my shallow awareness. NY Times science writer Nicholas Wade wrote in The Twists and the Turns of History, Our DNA, 'The political scientist Francis Fukuyama has distinguished between high-trust and low-trust societies, arguing that trust is a basis for prosperity. Since his 1995 book on the subject, researchers have found that oxytocin, a chemical active in the brain, increases the level of trust, at least in psychological experiments. Oxytocin levels are known to be under genetic control in other mammals like voles.' He has written quite a bit more extensively that our sapien brains grew in size for the machinery necessary to handle intricate, complicated and peaceful social complexity.
Super Perception, e.g. Mind Reading
Many new studies highlight the salient features of oxytocin for perception, feedback, empathetic accuracy and affiliation reward reinforcement. Two recent human controlled trials showed a demonstrated increased gaze focus and the ability to visually read and interpret facial emotional cues after oxytocin administration (some authors called it mind reading). From sciencedaily.com one of the researchers Lerknes explained "We found that oxytocin intensified test subjects' awareness of the emotions present in the photos. Faces expressing anger stood out as angrier and less happy, and correspondingly, faces expressing happiness were happier." Graded results occurred -- "It turns out that those with the lowest aptitude for judging emotional expression properly -- that is, those with the poorest scores during the saltwater round -- were the ones who showed the greatest improvement using oxytocin."
Author Nancy Casey hypothesizes in a post 'Oxytocin Gaze' that human hunters emulated carnivorous predators in their meticulous gaze and visual assimilation of the terrain. She posits that the same gaze that is possibly related to oxytocin which maybe employed by mothers in surveying and tracking their newborn babies, meeting their needs, and ensuring their survival in the face of vast helplessness and under-maturity.
Modern Conventionally-Schooled Medical Treatment of Migraines: Overwhelmingly Uneffective
One out of every six women experiences migraine headaches of some form in America. The population prevalence is 11.7% and comparatively higher than the insane diabetes epidemic in adult Americans (11.3%, 2011 data). Migraine headaches are no small statistic. With a wide gender divide, women have triple (17.1%) the incidence as men (5.6%). It's also no coincidence women have more oxytocin than men as well; for us it can regulate love, lust, labor, lactation, and maternal caregiving.
Funny thing is that if migraineurs have mega mindfulness and their oxytocin is messed up by being either super fluctuating high/low or inappropriately inconsistent or unstable levels (like blood glucoses in the reactive hypoglycemia model), then it may explain why oxytocin given as a I.V. drug it was 100% successful in halting immediately two cases of refractory migraines seen in an ER unit and in a prospective human study where oxytocin was provided (intranasally, ya know, like cocaine) by Yeomans and Jacobs, Stanford pain researchers, to refractory patients was associated with halting 50% of migraines and reducing 27% (total, 77% better) compared with 11% of placebo.
My observations are that migraine prevalence and occurrence are unchanged despite great 'advances' in pharmacology (abortive triptans and preventive pharmaceuticals), diagnostic science and understanding of the physiology of this condition. Like essential hypertension and the great majority of textbook medical conditions, the underlying pathophysiology are still elusive and undetermined, despite wonderful and fantastic fMRI and genetic sequencing techniques. A recent review confirms these considerations, the prevalence of migraines is still the same as 15 years; absolutely no improvements despite the triptan class of medications (which can abort a migraine in 20-60 min 50-70s%, versus placebo 17-40%), preventive therapy (modification of neurotransmitters and vasculature; BP drugs, antidepressants, anti-epileptic drugs), and the standard 'migraine trigger avoidance diet' of avoiding the 5 C's (cheese chocolate coffee coke citrus). Pharmaceuticals and ridiculous wheat-based diets fail long-term.
What Does Work Long-Term for Migraines: Paleo/Oligo-Antigenic Diet (OAD)
Some of oxytocin's target organ sites include the brain, the gut and thymus. All are organs responsible for the enormous function of homeostasis, immunity and controlling inflammation. It is no wonder that the brain cannot function optimally in isolation from the gut, and no wonder at all that all things that promote healing of the gut can improve migraine headache prevention and amelioration.
The medical literature from the last 30-80 years in fact identifies wheat (78% Grant, Lancet 1979), cow milk (37%), other cereals, cane sugar, yeast, corn, citrus, and eggs as top migraine-inducing factors. Identification and elimination of food antigens is key to healing the gut. Sealing of the damage and microperforations by altering intestinal permeability is secondary and vital. The paleo/ancestral diet and oligo-antigenic diets maybe best with focus on individual susceptibilities and immuno-endocrine optimization. Similar to the results obtained by Frasetto et al in their 10-day paleo experiment for reversal of pre-clinical hypertension in overweight patients, the researcher Grant (Lancet, 1979) in a seminal study looked 60 migraineurs with food antigen immunoreactivity. After only 5-days of an elimination diet (pseudo paleo) she reported 'When an average of ten common foods were avoided there was a dramatic fall in the number of headaches per month, 85% of patients becoming headache-free. The 25% of patients with hypertension became normotensive.'
Dealing with circulating antigen-antibody and immune complexes that are formed in the body when food antigens and microbial peptides (cell walls, DNA, cellular contents, junk) interact with immune system may help permanently to achieve and to maintain disease resolution, I believe. Two recently published human RCTs (Aplay et al and Mitchell et al) showed that by eliminating foods linked to high food-antigen related immune globulin IgG titers, an association for statistically significant reductions in migraine headaches occurred at 6 weeks and 4 weeks, respectively. Heal...Seal...Deal...
http://www.hcop.com/PDF/Migraineur%20in%20the%20Interictus%20-%20Loder.pdf [Elizabeth Loder MD]
http://www.nytimes.com/2006/03/12/weekinreview/12wade.html?_r=1&pagewanted=print [Nicholas Wade]