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HeadWay, Issue #082 -- Answering Your Questions - Part 2
August 25, 2010

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In this month's issue:

Answering Your Questions (part 2)


Say what?!  Visual Cortex

Answering Your Questions (part 2)

I'm going to answer your questions one more time (as I did in the last edition of HeadWay) before moving on to other topics.  (All right, I'm still trying to decide - I may do one more Q&A next month!)  Here are some of the most recent questions from our subscribers:

Migraine: Visual Aura

Sharon asked about visual aura - what is it exactly, and how can we avoid it?

Sharon, we've learned a lot about aura in recent years, though it still remains much of a mystery.  Probably the biggest breakthrough came when we connected it with something called a cortical spreading depression (CSD).

A CSD is a wave of electrical activity, or hyper-excitability, that spreads across the surface of the brain.  Changes in blood flow happen, and neurotransmitters are released.

As the "brain storm" proceeds, it naturally hits various parts of the brain that are responsible for various organic functions.

Sometimes, as the storm passes over certain areas, there are symptoms.  As the CSD hits areas responsible for visual activity, there may be visual symptoms.

This most likely accounts for the visual aura symptoms in a lot of people - flashing lights, zig zags, and other patterns are common to see in this stage of the migraine attack.

But we are still left with a mystery.  Some people experience this phase of the attack with no symptoms at all.  Others seem to have visual symptoms almost all the time.  So although this is part of the answer, we still have a lot to learn.

To see how the CSD fits in to the migraine attack as a whole, read What is Migraine? (the scientific story).

What can we do about these symptoms?  Treating visual aura is much like treating migraine - in fact, that's what it is.  Now, your doctor will treat you differently depending on your symptoms, how severe and frequent they are, etc.  You'll need to rule out other possible diseases.  And you'll need to talk to your doctor about what other symptoms you have.

Often your doctor will prescribe a migraine medication or other migraine treatment to help alleviate the symptoms, which can be mild or quite serious at times.

More on Why Migraine Auras are the way the are.

Vitamin B2

Erin from the USA:  You talked a lot about magnesium, but have you heard much about using high dose (200mg twice daily) Vitamin B2?

Yes, Erin, absolutely.  Vitamin B2, or riboflavin, is a supplement that has helped a lot of migraineurs.  There is some discussion about the dosage - for migraineurs, 200mg to 400mg daily is quite common, but some have suggested a lower dose (25mg/day) may be better.

Read more about vitamin B2 here.  Also, some research from last year regarding B2 and genetics.

Riboflavin may be even more powerful in combination with other supplements, which is why the well-researched MigreLief is so popular.

Occipital Nerve blocks

Stacie from USA:  I could be wrong but I don't recall seeing Occipital Nerve blocks being discussed?  I have been getting them now for going on 5 years and they are a God Send!

Thanks for mentioning this one, Stacie.  Nerve blocks have been used for treating various types of headache for half a century.  One of the most common versions is the occipital nerve block, which involved an injection in the back of the neck.  The injection contains steroids, local anaesthetics, or a mixture of both.

The procedure does seem to provide temporary relief for some people (a few days).  This can be a great help particularly for people with chronic migraine.

People do have varying experiences with the occipital nerve block.  In spite of its long history, there are very few good studies, and the methods vary greatly from doctor to doctor.

Dr. David Dodick and his team at the Mayo Clinic are currently conducting a study to help answer more questions about this procedure.  The results are due next year.

Rebound Headache

Ann from the USA asked about transformed migraine and rebound headache.  She's had a lot of challenges dealing with chronic symptoms.

First we need to define our terms, since transformed migraine is an old term.  Transformed migraine is now usually called chronic migraine, but it can also be diagnosed as chronic tension-type headache and medication-overuse headache, as well as some other diagnosis I won't get into here.

Without going into a lot of detail, there's no doubt that diagnosis and treatment of all of these can be challenging.  It is so important to have a doctor's care, preferably the care of a specialist with experience in this type of diagnosis.

Ann mentioned that she's not close to a specialist, which is a challenge many people in the world face.  I can't say what you need to do, Ann, because I don't know all your circumstances.  But I will say that it's worth it to make the sacrifices now to find someone that can really help, rather than let things drag out.

I'll just point you to some other articles that go into more detail - first, on transformed migraine, and also on medication-overuse headache.

Oxygen for Migraine

Marc from the USA:  I know that oxygen therapy helps those that suffer from cluster headaches.  I would like to try oxygen therapy for migraines/headaches.  What is your opinion regarding this?

Thanks for the question, Marc.  Yes, oxygen therapy does seem to help some migraineurs.  Again, this is a temporary measure - something to stop an attack that has already started.

Migraineurs usually use oxygen therapy known as hyperbaric oxygen therapy (HBOT).  This is breathing 100% oxygen while under increased atmospheric pressure, and it's used for a number of conditions.

HBOT may be used to stop a migraine in its tracks when more standard treatments don't work.  It's usually not recommended for patients with asthma or seizures.


Gary from the USA asks about sunglasses and migraine.  I'm going to cheat on this one since I just published an article on the topic - check it out at How Sunglasses are helping fight Migraine.

Quick note on Magnesium

I keep getting follow-up questions on magnesium for migraine, so I'm going to address one more thing because I do think it's important.

Many people have asked about diarrhoea and magnesium.  Some types of magnesium are better absorbed than others.  I recommended the specific brands that I did because they tend to be well absorbed by most people.  For example, I've taken a very high dose of Ultra-Mag Magnesium complex and I've never had the slightest problem.

Now, everyone is different, but I think most people will find fewer problems if they try the brands I recommended here.  If you're still having trouble, try a lower dosage.

Of course, I'm assuming you are also under a doctor's care when you try any supplement.

I'm going to have to stop there for this week!  Some people have suggested that HeadWay is too loooooong, so I'm going to restrain myself. :)

However, I do want to thank many of you who have sent in notes of encouragement and thanks lately.  It's very much appreciated!  It helps me to keep going when I know that I'm being a help!


Our page on Facebook has now gone over 1000 "likes"!  Thanks, everyone, for keeping the conversation going!

If you're not yet part of the discussion, you can become a Facebook fan here and be a part of it.

Say what?!  Visual Cortex

The visual cortex or primary visual cortex is the part of the brain (two parts, actually - one in each hemisphere) that processes visual information.  The visual cortex is in the lower rear part of the brain.  When the cortical spreading depression starts influencing the visual cortex, you may see visual aura, like flickering lights, zig zags, and lattice patterns.  These patterns may actually be a reflection of how the visual cortex is set up.

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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