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New Hope for Migraine Sufferers

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WebMD Health News

April 24, 2000 -- Her mother had migraines. Her sister has migraines. Hers are as predictable as her monthly cycle. Arlene O'Connor, RN, age 55, has been pushing through life -- getting through exhausting workdays -- despite having pounding, nearly incapacitating migraines since she turned 30.

But new guidelines for diagnosis and treatment of migraines may help primary care physicians find a solution faster for people like O'Connor.

O'Connor had taken "the gamut" of pain medications, prescribed by her primary care doctor, with no relief. Twice she had gone to the ER for the debilitating pain. She even had brain scans to make sure there was no tumor. Finally, three years ago, she got her "miracle" -- a new drug that stops her migraines before they become full-blown.

"My life has changed drastically," she says. "I've gone six months without a headache. It's unbelievable."

Migraines occur because of increased excitability in the nervous system, Stephen Silberstein, MD, tells WebMD. The trigeminal nerve -- in the center of the brain stem -- is believed to be key in causing painful inflammation of blood vessels, he says. Very often, migraines are triggered by certain foods, intense exercise, or flashing lights. Even environmental factors like changes in the weather or excessive noise can mean migraine. Silberstein is a neurologist at the Jefferson Headache Center of Thomas Jefferson University in Philadelphia.

Nearly 28 million Americans suffer from migraine headaches. An estimated 10 million migraine sufferers seek doctors' help every year, yet more than half are dissatisfied, says Silberstein.

"Migraine is not so much complicated as it is ignored," he tells WebMD. "Most patients who have migraine don't know they have it. And in fact, when they go to a doctor, they don't get diagnosed; they don't get adequately treated. A lot of times, doctors don't have the time; they don't want to be bothered. They aren't educated about it, and they think headache is a trivial disorder."

But the guidelines created by Silberstein and the U.S. Headache Consortium offer new hope for migraine sufferers. The U.S. Headache Consortium is composed of neurologists, family care physicians, emergency room doctors, and osteopaths.

The guidelines allow virtually any doctor to effectively take care of migraines. "It's the primary care physicians who take care of most headache patients," he says.

Silberstein himself has suffered migraine pain since childhood. Migraine headaches are basically the same -- yet each is unique, he tells WebMD. His migraines bring on "auras ... I start to see these flashing lights ... sometimes I actually can't see. You push through the day. That's what migraine patients do, they push."

The first crucial issue, says Silberstein, is for patients to get involved in their own care. "Patients should keep a headache calendar, start getting regular exercise, regular sleep," he advises. Aerobic exercise increases the brain's production of endorphins, chemicals that reduce pain and enhance mood. Exercise also helps people sleep better, which is important because insomnia can cause migraines.

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