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HeadWay, Issue #062 -- Migraine, stroke and heart disease
October 21, 2008

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In this month's issue:

Migraine, stroke and heart disease

Migraine Art: An interview with Jim Chambliss

Say what?!  Scotoma

Migraine, stroke and heart disease

We've talked a lot about the connection between migraine, stroke and heart disease in the past few years.  Today it's time for a quick summary of the information you need to know.

If you have migraine, are you at an increased risk of stroke or heart disease?  A growing number of studies say yes.  For example, this research of 14 studies estimated that people with migraine had 2.16 times the risk than the general population (a little higher for those with migraine with aura, a little lower for those without aura).  There is special concern that people with certain types of migraine may have even more risk, such as basilar migraine and migraine with aura.  A study of men released in 2006 suggested that men with migraine have a significantly higher risk of cardiovascular disease - especially heart attack.  Also, if you have a migraine that lasts for more than 3 days (status migrainosis), you need to see your doctor immediately - you could be at increased risk.

How concerned should I be?  You should be aware, but there's no reason to panic.  If you have 2.16 times the risk of stroke, your risk is still fairly low, especially if you avoid other major risk factors (ie high blood pressure, smoking, inactivity, poor diet).  But you do need to be aware, for reasons we talk about below.

Can a migraine attack look like stroke?  Absolutely.  You may remember in 2006 when American Senator David Long had stroke-like symptoms that turned out to be migraine.  Some types of migraine in particular look like stroke - hemiplegic migraine is a prime example.  Some researchers believe there is a type of migraine (cardiac migraine) that mimics heart attack.  Because of the similarities, it's very important to get a proper diagnosis from someone who knows your medical history (remember this case from France).  If you're having stroke-like symptoms, see a doctor right away!

Just what is the connection?  We're still learning about why exactly there is a connection, but recent studies continue to give us clues.  A study of 4577 Caucasian women with a history of migraine showed a connection between a specific gene and stroke risk (read Migraine with Aura: the Gene that increases Stroke Risk?).  A study released just this year added more questions than answers, but let doctors to wonder if a migraineur's blood clots more easily (read Migraine and blood clots? New study…).

Why do I need to know this?  There are a number of reasons.  First, this is another indication that migraine is a serious disease that needs to be treated.  Proper treatment is very important.  If your doctor keeps giving you painkillers and isn't interested in getting closer to the root of the problem, find a new doctor.  Second, if you have a number of stroke or heart disease risk factors, you may need to change the type of migraine medication you take.  Triptan drugs need to be used with caution.  Drugs such as naproxen sodium (an ingredient in Treximet) also may increase your risk at higher dosages.  Make sure your doctor knows your medical history!

Third, we need to make sure we control the risk factors we can control.  A great reason to quit smoking, improve your diet, and get active.  Finally, migrainous infarction or migrainous stroke is when a stroke occurs during the course of a migraine attack.  Though little understood, it is another reminder to see your doctor if you're experiencing any unusual or stroke-like symptoms.

Migraine Art: An interview with Jim Chambliss

There is research going on to learn about migraine art and epilepsy art.  The study is being led by Jim Chambliss.  Recently I did an interview with Mr. Chambliss, and because of the length I decided to publish it in two parts at the Headache and Migraine News Blog.

Below is the first part of the interview.  Follow the link to continue reading.  Part 2 will be posted tomorrow (22 October 2008).

Tell us briefly what happened in 1998.
I suffered a brain injury in a car accident in 1998.  It was initially diagnosed with a minor concussion, to go along with the knee, neck and back injuries.  Strange things were happening to me.  I generally felt 'out of it' and had trouble with my mental focus.  I began having what I later learned were partial and complex-partial seizures.

About three months later I had a tonic seizure, stiffened and fell flat on my face on a hard-wood floor.  I woke in the hospital with no memory of what had happened.  Continue reading here...

Say what?!  Scotoma

Scotoma is a term referring to an area of impaired or lost vision.  It's normal to have a "blind spot", but certain diseases can cause temporary or permanent scotoma, such as multiple sclerosis, and of course migraine.  Migraine aura can be what is called scintillating scotoma (the moving, shimmery flickering visual hallucination), or simply a blind spot (scotoma).  The migraine scintillating scotoma is often depicted in migraine aura art.

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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