HeadWise HeadWise: Volume 2, Issue - Page 8

reader mail You ask. We answer. seizure-like activity. If the work-up is normal, he likely has what we call “acute confusional migraine,” a rare migraine event that can manifest with speech difficulties, amnesia and agitation. To help prevent further attacks, he should drink plenty of fluids, exercise regularly, get regular sleep and take care of his stress. A headache specialist can discuss the appropriate medications to treat the headache. —Jack Gladstein, MD, Pediatric Headache Clinic, University of Maryland, Baltimore, MD migraine, but this would be hard to prove. In any event, packing your mouth with ice cream or ice as a treatment for migraine is potentially dangerous because prolonged cooling of the oropharynx (the back of the throat) with ice or ice cream could interfere with your normal coughing reflex—and there is always a danger of choking on the ice. My advice would be to discuss your headaches with a headache specialist and come up with a more conventional strategy to manage migraines. —Edmund Messina, MD, Michigan Headache Clinic, East Lansing, Mich. FROZEN FIX The information on brain freeze in the NHF e-newsletter was interesting, since my situation is just the opposite. When I have a migraine, I can help myself somewhat by packing ice cream in the roof of my mouth. I’ve always loved ice, but I don’t know if that works quite as well. Unfortunately, I can’t afford the calories of ice cream every time I have a headache; but if I could, I would be using it all the time. I have also experienced brain freeze when I don’t have a migraine, but it doesn’t leave me with a lasting headache. Why do you think ice cream would help a headache already under way? Why don’t I react as others do to brain freeze? —Ruth F. THE OXYGEN DEBATE I suffered for years and years from migraine and chronic daily headache and had two concussions previously in my life. I tried every medication and treatment regimen under the sun without relief, until I underwent hyperbaric oxygen therapy for my brain injury. I’ve gone more than three months now without a full-blown migraine. What is your opinion of hyperbaric oxygen treatment for headache? —Mary M. have a higher likelihood of experiencing migraine. We don’t exactly know why. It could relate to what is causing the asthma, whether it is allergies or the neurologic component of asthma. Further, rhinitis (inflammation of the mucous membrane in the nose) and migraine are highly related to one another. It’s possible that even if asthma was associated with migraine, we wouldn’t know if it was the asthma or the rhinitis. Just like rhinitis, there is an allergic and a non-allergic asthma, and it seems to be the non-allergic rhinitis that is associated with migraine. That suggests there is some sort of neurologic component to asthma that is likely to be the same component contributing to migraine in the brain; they are just different parts of the nervous system contributing to both disorders. It’s also possible for the treatment of asthma to cause headaches as well. —Vincent Martin, MD, University of Cincinnati College of Medicine, Cincinnati PRESSURE COOKER I occasionally get pressure around my eyes and forehead that causes sleepiness with only mild migraine. I have non-allergic rhinitis. Are these symptoms common, and do I tr eat with nasal steroids or just the usual ibuprofen? At other times I have regular migraines. I also have a deviated septum. Would repairing that help with my migraines? —Colleen B. Tired of searching the Internet for answers? It’s time to learn from those in the know. In every issue of Head Wise, our experts respond to reader-submitted questions about migraine and headache disorders. ADOLESCENT AMNESIA I have a 12-year-old son, and one month ago he started to see colored lights; then he couldn’t look at me easily. Then, when I would ask questions, he couldn’t answer me; he couldn’t remember my name or his school name. This lasted for about 10 minutes, and then he had a big headache. The doctors told me it was just a migraine, but I want to know if losing memory is normal. Six months ago he saw lights and lost consciousness for about two minutes, but then he didn’t have a headache. I’m a little confused. Can migraine cause all of this? —Alina Z. This is a very interesting observation on your part. So-called “ice cream headaches” have been long described in the headache literature (see page 11), and they do not seem to directly relate to migraine. Brain freezes can occur for migraineurs and nonmigraineurs. One study showed that they were slightly less common in migraineurs. The mechanism of pain is not entirely clear in this type of headache so it is very difficult to understand why you seem to have relief of what you are calling migraine headaches. One can only speculate that you are applying a stimulus that is countering the underlying process of the Hyperbaric oxygen is a treatment in which an individual is placed in a chamber where they are exposed to pure oxygen at three times the normal pressure of oxygen experienced at sea level. It has been used for the treatment of both migraine and cluster headache, but there has not been any convincing evidence that it is useful. Furthermore, the high cost and lack of availability of such chambers would severely limit its usefulness for most migraineurs, even if it were an effective treatment for attacks. —Mark Green, MD, Mount Sinai School of Medicine, New York City STRUGGLING TO BREATHE I am 71 years old and have suffered with migraines since I was 19. I was recently diagnosed with asthma. Is there a connection between migraine and asthma? —Carol D. Yes, migraine can cause this. Your son needs a medical work-up to be sure he isn’t experiencing 6 The National Headache Foundation has a list of headache specialists who may be of help. See www.headaches.org or call 888-NHF-5552. Yes, studies have shown that patients with asthma The way I look at migraine is that there are three main components: There is the migraine pain, which is really severe; then there’s the tension pain where the headaches don’t reach migraine proportion and there isn’t any sensitivity to light or noise; and at the lowest level, there is the pressure sensation you get. What we have found in some studies is that if you have migraine or tension-type headache and you have pressure, your headaches tend to be more frequent and more disabling. It looks like the pressure sensation is a predictor for more severe migraine. About 80 percent of migraineurs report pressure over their sinuses. What may be causing this? A migraineur has a www.headaches.org | National Headache Foundation 7