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HeadWay, Issue #030 -- Fighting nausea
January 21, 2006

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In this month's issue:

Fighting nausea

Recent headache news

Say what?! Ophthalmoplegic migraine

First, some thanks!

This is the 30th issue of HeadWay!  As we begin 2006, I want to take the time to thank loyal subscribers and visitors to  Thanks especially for those who have taken the time to leave your input and ideas in the comments of the Headache and Migraine News Blog, by mail, and in the HeadWay MailRoom (rememeber, your password is nomoache).  The article below is at the request of a subscriber (thanks, Charlene from Canada!), and you're going to see more improvements thanks to your suggestions.

Thanks to you, is solidly in the top 1% of most visited sites on the web (actually, in the top 0.7% at the moment).  Someone even recently offered to buy the site, but don't worry, I'm not selling in the foreseeable future!  Let's keep fighting migraine and headache together.  Thanks!

Fighting nausea

One of the most familiar and least welcome symptoms of migraine is nausea.  You may feel sick to your stomach, or you may throw up once or many times.  Believe me, I've been there and it's not pretty.  In rare occasions, it may get so bad you become dehydrated.  Aside from the headache, this symptom is usually the most debilitating (although there are rarer symptoms that can be pretty debilitating too!).

About 80% of migraineurs get nauseous, but only 30% actually throw up.  Nausea is not just a migraine symptom - it can occur in cluster headaches, and even on rare occasions with a really bad tension headache.  Children with migraine usually deal with nausea, often nausea with no headache at all.  The symptoms can arrive quite suddenly in children.

What can I do about it?

1. General migraine treatment
Dealing with your migraine as a whole may be the best bet.  The popular triptan drugs (such as Maxalt, Frova, Imitrex, etc) are known to help with nausea.  A study in 1997 (by Palevitch, D. G. Earon, and R. Carasso) showed that the herb feverfew may also help with nausea.  Note that sometimes over the counter painkillers may actually cause nausea (actually, some migraine drugs can as well).  Check the label and try a new approach.

For children, there are drugs that can help with pain and nausea together, such as metoclopramide (Reglan).

2. Anti-nausea drugs
Antinausea or antiemetic drugs are another line of attack.  Common drugs used for migraine patients include Tigan (trimethobenzamide), Compazine (prochlorperazine), and Phenergan (promethazine).  Phenergan is often prescribed for children with migraine as well.  Gravol (dimenhydrinate)is also common.  These types of drugs often cause drowsiness, which can be a blessing during an attack.  However, if you need to stay more alert ask your doctor for Reglan (metoclopramide) or another less-drowsy option.  Reglan may also help your migraine drug absorb more quickly (see this Mayo Clinic article on migraine)

Of course, if you can't keep anything down, you won't be able to swallow these pills.  A suppository is another option.  Suppositories are usually easy to take and they take effect very quickly.

Caution: Be very careful when taking more than one medication that can make you drowsy. For example, a narcotic painkiller and Gravol for nausea - full doses of both could actually cause you to stop breathing. Talk to your doctor about what doses are safe.

3. Self-help measures
The Mayo Clinic offers these common sense suggestions - take it easy, stay hydrated (try sips of water, weak tea, clear soft drinks or broth.  Don't drink too much at once), avoid food odors, and eat bland foods.

When you know a migraine attack is coming on, try to eat a healthy snack right away, while you can still stomach the food.  This alone may keep the nausea away.  You may also want to vary your migraine treatment.  I found that when I stopped using an ice pack, much of my nausea went away.

What has worked for you?  If you have suggestions, stop by the HeadWay MailRoom (password nomoache).  Your advice may show up in an upcoming article.

If you have access to Headache and your Child by Seymour Diamond, MD, it has many more great tips for dealing with children's migraine and nausea issues.

Recent headache news

Everyone's been talking about the Transcranial Magnetic Stimulator, that thing that looks like a hair dryer that's supposed to zap your headaches.  Follow the links from this post on the TMS to get the lowdown on the research that's being done.

Also big news has been some recent internet migraine fraud - watch out!

Many visitors have come looking for information on so called eye migraines, so there's now a longer article on ocular migraine here.

Say what?! Ophthalmoplegic migraine

Ophthalmoplegic?!  Now there's a mouthful!  This is not generally considered to be true migraine anymore, so you won't see this term very often.  The headache is usually severe, and there is weakness in one or more of the eye muscles.  Most often diagnosed in children, the symptoms may include temporary double vision, drooping eyelid, or dilated pupil.

Because of the changes in terminology and understanding, there seems to be some confusion over the classification and what actually ophthalmoplegic migraine is.  Some equate it with ocular migraine, others use the term to describe different symptoms.  Hopefully in the months ahead further research will clarify things.
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