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HeadWay, Issue #088 -- Causes vs Triggers
May 27, 2011

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In this month's issue:

Causes vs Triggers

Recent News Highlights...

Say what?!  Cluster

Causes vs Triggers

It's one of the most important distinctions to keep in mind when it comes to migraine and headaches.  The difference between a cause and a trigger.

In their book Migraine and other Headaches, Dr. Young and Silberstein share this story as an illustration:
Marie Alvarez suffered from two severe migraines a month for much of her life.  They were severe and responded moderately well to treatment.  In her 40s, she developed pain in the right front of her head that moved to the left and back of the head.  She had a mild, chronic, nagging, left-sided headache, and then developed neck pain.  These migraines were more frequent and difficult to treat.  Eventually she was found to have a herniated disc in the upper part of her neck that was pushing on the nerve on the left side.  She eventually had surgery, her headaches returned to their original location, and once again they became simple to treat.
So what was the cause of Marie's migraine attacks?

Well, we don't know.  No one knows for sure what causes migraine.  Why does Marie get migraine, and not someone else?  It's probably partly genetic, but we don't understand all the details.

You could say that something caused her headaches to get worse, or change.  That was the herniated disk.  And you might even say that it partially caused the headaches.  But really, when it comes to migraine, this was actually a trigger.

Triggers of migraine attacks or tension-type headache attacks are many.  Something like a herniated disc could be a trigger.  Certain foods.  Weather changes.

But none of these things cause a migraine or tension-type headache attack.  One reason we know this?  Because two people can be exposed to the exact same trigger... one will have a migraine attack, one won't.  That could be because one person has the underlying disease of migraine, while the other doesn't.

Why is this important?
  1. Because just taking away a trigger will not cure you of migraine, because the trigger is not the underlying cause.  "Oh, you just need to relax."  Or, "Just stop drinking coffee, then you won't get so many headaches."  Of course getting rid of triggers may alleviate your symptoms, but many people find that migraine disease isn't so easy to treat, and symptoms can crop up again when you least suspect.
  2. Mixing up the two gives some people the false impression that migraine has been cured.  Just because some people found out that avoiding bananas got rid of their migraine attacks, doesn't mean that we understand the disease or that the same thing works for everybody.
As Marie discovered, many things can trigger migraine attacks (take the time to learn about different types of migraine triggers here).  Those triggers can change throughout life, so it's very important to see a doctor right away when symptoms change or become worse.

For cluster headache patients, triggers may be a factor also.  But triggers do tend to have less impact on the severity of the attack.  As with migraine and tension-type headache, we're still not 100% sure of the cause of cluster.

So remember - the cause is unknown, though we have theories.  The triggers, though different in everyone, are often known.  Triggers may induce a specific attack.  It's the cause that makes you susceptible.

Recent News Highlights...

Here are some recent news stories you might want to check out at Headache and Migraine News...

Say what?!  Cluster

So you've heard of cluster headache, but have you heard of cluster?  Actually, in my context I often use them interchangeably.  But I prefer to talk about cluster when I talk about the disease itself.  Why?

Though it seems that cluster symptoms almost always involve headache, some have suggested that it may be possible to get cluster without headache.  For migraine, this is fairly common (a migraine attack without headache).  But because it seems to be rare when it comes to cluster, we still commonly talk about cluster headache as the disease or disorder someone has, not just the symptom.

Still, it's probably more proper to talk about cluster in general and the common (and overpowering!) (though not alone) symptom of the cluster headache.

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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