For many migraineurs the weather is thought to be a trigger, but recent research seems to cast a cloud of doubt over this as the following paper from cephalalgia reports.

Migraine and weather: A prospective diary-based analysis

Karin Zebenholzer1,
Ernest Rudel2,
Sophie Frantal1,
Werner Brannath1,
Karin Schmidt3,
Çiçek Wöber-Bingöl1 and
Christian Wöber1

+ Author Affiliations

1Medical University of Vienna, Austria.
2Central Institute of Meteorology and Geodynamics, Austria.
3Donauspital Vienna, Austria.

Christian Wöber, Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria Email: christian.woeber@meduniwien.ac.at

Abstract

Aims: Weather is mentioned as a trigger factor by migraine patients most frequently. We examined the impact of meteorological factors and the impact of their day-to-day change on the risk of occurrence and persistence of headache and migraine and the correlation of subjective weather perception with objective weather data.

Methods: We performed a prospective, diary-based cohort study in 238 patients suffering from migraine with or without aura. Patients had to live within 25 km of the Vienna meteorological station and were required to keep a diary for 90 days. We analysed 11 meteorological parameters and 17 synoptic weather situations. For evaluating the hazard of occurrence and persistence of migraine and headache, we performed a univariate and a stepwise multivariate Cox regression analysis. We calculated correlations between subjective weather perception and meteorological data.

Results: In the uni- and multivariate analysis, a ridge of high pressure increased the risk of headache occurrence, lower mean daily wind speed increased the risk of migraine occurrence and a day-to-day change of daily sunshine duration increased the risk of migraine occurrence. A day-to-day change of the daily minimum temperature decreased the risk of migraine persistence. After correction for multiple testing, none of these findings remained statistically significant. Subjective weather perceptions did not correlate with the occurrence or persistence of migraine or headache. Subjective perception of cold and too-cold weather and of too-warm weather correlated with daily minimum, mean and maximum temperature.

Conclusion: The influence of weather factors on migraine and headache is small and questionable.

For a full text copy click here

A recent study highlights the existance of neck pain with migraine and makes interesting reading for those who have not considered seeing a Headache Clinics UK chiropractor for their migraines.

The prevalence of neck pain in migraine.

Calhoun AH, Ford S, Millen C, Finkel AG, Truong Y, Nie Y.
SourceCarolina Headache Institute, Chapel Hill, NC 27516, USA.

Abstract
OBJECTIVE: To determine the prevalence of neck pain at the time of migraine treatment relative to the prevalence of nausea, a defining associated symptom of migraine.

METHODS: This is a prospective, observational cross-sectional study of 113 migraineurs, ranging in attack frequency from episodic to chronic migraine. Subjects were examined by headache medicine specialists to confirm the diagnosis of migraine and exclude both cervicogenic headache and fibromyalgia. Details of all migraines were recorded over the course of at least 1 month and until 6 qualifying migraines had been treated. For each attack, subjects recorded the presence or absence of nausea as well as the intensity of headache and neck pain (graded as none, mild, moderate, or severe).

RESULTS: Subjects recorded 2411 headache days, 786 of which were migraines. The majority of migraines were treated in the moderate pain stage. Regardless of the intensity of headache pain at time of treatment, neck pain was a more frequent accompaniment of migraine than was nausea (P< .0001). Prevalence of neck pain correlated with chronicity of headache as attacks moved from episodic to chronic daily headache.

CONCLUSIONS: In this representative cross-section of migraineurs, neck pain was more commonly associated with migraine than was nausea, a defining characteristic of the disorder. Awareness of neck pain as a common associated feature of migraine may improve diagnostic accuracy and have a beneficial impact on time to treatment.

PMID:20100298[PubMed - in process]

Headache Clinics UK training day

The latest HCUK training day for our existing and potential chiropractors took place at the Belfry on July 10th and was a complete success, selling out and gaining high marks for the day and the presenter, Dr Andrew Dowson.

Dr Dowson is a well known Headache Specialist and author of many papers and books on headaches. Dr Dowson regularly lectures around the world on the subject of headaches and is the Clinical Director of Headache Clinics UK.

News from the USA.
In March 2011, the FDA issued a warning around the use of topiramate, often used in the treatment of migraine.

“..New data suggest that the drug Topamax (topiramate) and its generic versions increase the risk for the birth defects cleft lip and cleft palate in babies born to women who use the medication during pregnancy, the U.S. Food and Drug Administration said today.

Before prescribing topiramate, approved to treat certain types of seizures in people who have epilepsy, health care professionals should warn patients of childbearing age about the potential hazard to the fetus if a woman becomes pregnant while using the drug.
Topiramate also is approved to prevent migraine headaches, but not to relieve the pain of migraines.”

The issue was also raised in the UK in 2008 in a Daily Telegraph article.

For full details of FDA comment go to: http://www.fda.gov/Drugs/DrugSafety/ucm245470.htm

The 15th International Headache Congress will unite medical professionals committed to reducing the pain and suffering caused by headaches.

IHC provides the international headache community with an advanced scientific platform for the exchange of the latest information, treatments, care, and research of this debilitating disorder.

For details go www2.kenes.com/ihc2011/pages/home.aspx

Manual therapies for migraine: a systematic review.
For Full-Text
Headache Pain. 2011 Feb 5. [Epub ahead of print]

A recent article in the British Medical Journal has cleared Migraine of causing cognitive damage although as in past studies Migraine with Aura has been linked with brain infarcts.

For more information go to:
http://www.bmj.com/content/342/bmj.c7357

The National Institute for Health and Clinical Excellence (NICE) held the first stakeholder scoping workshop for guidelines on Headaches on 7th July 2010. 

Following on from this NICE have now reviewed comments from all headache guidelines stakeholders including us here at HCUK and have issued the final scope document.

For more information on NICE visit www.nice.org.uk or follow this link:

http://guidance.nice.org.uk/CG/Wave23/2/ScopeConsultation

Botox has been approved as a preventive treatment for chronic migraine by UK drug regulators.
HCUK will be reviewing this new treatment over the coming weeks.

Botox gets green light for chronic migraine
Courtesy of Pharmatimes 15 July 2010

UK regulators are the first in the world to issue the stamp of approval for the use of Allergan’s neurotoxin Botox as a preventive treatment for chronic migraine.

Specifically, the Medicines and Healthcare products Regulatory Agency has licensed the drug, which is most famous for its anti-wrinkle properties, for adults who have headaches for at least 15 days per month with migraine on at least eight of these days.

The approval is based on a clinical trial programme known as PREEMPT which showed that nearly 70% of patients treated with Botox (botulinum toxin type A) experienced a 50% reduction in migraine days, as well as a significant improvement in quality of life and headache-related disability scores compared with those given a placebo.

Moreover, the treatment was found to be generally well-tolerated in the study, with the majority of side effects mild to moderate and discontinuation rates low in both treatment arms – 3.8% in the patients receiving Botox and 1.2% in those given a placebo.

Welcoming the approval, Dr Andy Dowson, chairman of Migraine Action’s Medical Advisory Board
(note:added by HCUK, Dr Andy Dowson is Clinical Director of HCUK), said while he had been using Botox ‘off-label’ for migraine prevention for 10 years, “it is important that we now have the PREEMPT study results to confirm the impression from this clinical practice experience”.

“Botox will give many chronic migraineurs a new lease of life where individuals will be able to make more plans and not be so debilitated by their condition,” added Lee Tomkins, Director at Migraine Action.

One in seven people in the UK suffer from migraine, which costs the economy around £1 billion a year, highlighting the need for new and effective treatments – particularly prophylatic ones – to help combat the condition.

Botox is already a blockbuster pulling in annual revenues well over £1 billion, largely from its cosmetic use but also other medical conditions such as excessive sweating, and its official approval in chronic migraine should give sales a further boost given that it could benefit around 700,000 people in the UK alone.

For more information on this announcement visit:

http://news.bbc.co.uk/1/hi/health/10577609.stm