Headache: A Significant Health Problem

  Head pain accounts for 3.0% of all emergency department visits and was the 5th leading cause for such.
  Headache is the 12th most common diagnosis among emergency docs (1.8% of all visits).
  In 2014, there were 4 million ER visits for headache.
  Women of childbearing age made up more than half of the ER visits for headache.
  Interestingly, native Hawaiians and other Pacific Islanders have the highest prevalence of migraine.
Headache. 2018 March 12

Acupuncture Found to Reduce Episodic Migraine

  A Cochrane database review of 22 trials with 4,985 participants revealed an apparent reduction in headache frequency in patients with episodic migraine. By this review acupuncture reduced headache frequency more than prophylactic drugs (but not at the six month follow up).
Ann Int Med 2016;165(8):JC44
Additional reference : JAMA 2017 Feb20

Attacks of Migraine : More Than Just A Headache

  The postdrome phase of migraine  ie. the time between headache resolution and feeling completely back to normal, consisting mostly of fatigue and cognitive disability is an underappreciated contributor to migraine symptomatology.
  Disability from migraine is substantial. It is estimated to be the sixth most disabling condition worldwide (Lancet 2015;386:743).
  According to a recent study, even after the headache passes, sufferers are not able to perform optimally at work or in school for at least several hours.
Neurology 2016 Jul 19;87:309

IBS, Migraine and Tension Headaches Linked ?

   Irritable bowel syndrome, (the most common GI disorder internationally with 45 million sufferers in the US alone) , tension headaches and migraine may share common genetic mutations.
  Researchers from Istanbul University in Turkey when looking at the serotonin transporter gene and serotonin receptor gene 2A found that IBS, migraine and tension headache groups had at least one gene that differed from healthy participants.
AAN ANNUAL MEETING 2016 Vancouver

Transcranial Electrical Stimulation For Migraine Re-visited

  Patients treated with four weeks of transcranial electrical stimulation (tDCS) found relief from their chronic migraine headaches unresponsive to typical therapies. In this study the motor cortex was stimulated. High current was able to be safely and effectively to deep brain structures.
  Researchers from the university of Michigan, Harvard and the city college of the city of New York employed tDCS on 13 patients as preventative therapy resulting in a 37% reduction in head pain in the treated individuals.
 A  positive response was seen at four weeks but repeated treatments were needed for a lasting effect.
http://www.ns.umich.edu/new/mutimedial/videos/20347-migraine-patients-find-pain-relief-in-electrical-brain-stimulation

Front. Neuro., 21 March 2013 | doi 10.3389/fneur.2013.00025

Elsevier Electroencephalography and Clinical Neurophysiology/Evoked Potentials Section Volume 108, Issue 1, January 1998, pp. 1-16

Elsevier Brain Stimulation Volume 1, Issue 3, July 2008, pp 206-223

Integrative Physiological and Behavioral Science Vol 31,Issue 2,pp88-95 April-June  1996 

Colicky Infants at Risk for Childhood Migraine

  Children that presented to the ER with migraine were 6x more likely to have a history of colic during infancy.
  It is theorized that colic may represent sensitization of the perivascular nerve terminals in the gut.
   Sadly, the brain-gut relation remains one of the least understood and least researched areas of medicine.
JAMA 2013;309(15):1607-1612

Lightning Triggers Migraine

  In this study, ninety patients with headache underwent a review of their headache diaries over a 3 to 6 month period. The results indicated that there was an increased likelihood of having a headache on days with  lightning after other variables associated with thunderstorms were added as covariates. 
  The mechanism resulting in this phenomena is unknown.
Cephalgia Jan 24,2013

NEW MIGRAINE DRUG CLASS

Telcagepant (MK-0974), the first orally bioavailable neuropeptide calcitonin gene-related peptide (CGRP) receptor antagonist, relieved pain and other migraine symptoms.

Merck is in phase III of the clinical development of this drug and is addressing dose dependent liver toxicity. Neurology2009;73:970-977