The ‘ow’ factor: Some painful truths about migraines
There are different types of headaches, so get diagnosed before you try to treat them
Genes strongly influence people’s risk of having certain types of migraines, the biggest ever family study of the headaches has found.
Approximately one in five adults in developed countries get migraines, defined as one of the “most common brain disorders worldwide”.The scientists analysed the genetic data and medical histories of more than 8,300 individuals from 1,589 families in Finland and calculated the individuals’ “personal genetic risk score”.
People who started to develop migraines before they were 20 had a significantly higher genetic risk score, reported the researchers from the University of Helsinki.
They also discovered that common genetic variants combined to increase the risk of hemiplegic migraines, an uncommon type of migraine in which the symptoms (including muscle weakness) mimic those of a stroke.
About a quarter of the 2,420 patients diagnosed with “migraine aura” had hemiplegic aura symptoms.
“In many families there are much more migraine patients than would be expected by chance alone,” said first author Dr Padhraig Gormley from the Broad Institute of MIT and Harvard.The study found “rare, high-impact and common” genetic variants which could explain the family clustering of migraines. However, much of the genetic predisposition to migraine still remains unexplained.
Dr Elliot Shevel, the medical director of the Headache Clinic in Johannesburg and chairperson of the SA Headache Society, said they have found it possible to treat hemiplegic migraines, which are rare, with surgery.“This is a rare form of migraine when a slightly lower blood supply to the motor area of the brain causes weakness. It can be successfully treated by closing the arteries causing the problem,” said Shevel.
In his clinical experience migraines should be diagnosed according to where the pain is coming from, not by the symptoms alone.
Among the migraine symptoms listed by the International Headache Society are one-sided throbbing and pain, nausea and vomiting.
“Often it originates in the muscles of the jaw and the neck, or the arteries in the scalp on the other side,” said Shevel. “Both of those things can cause exactly the same symptoms, but the treatment is different.”Shevel said: “We investigate the patient to find out if they are having muscular or vascular pain and then we know what to treat.”
The headache clinic has about 100 new patients a month and has been successful in treating debilitating headaches, he said.
“We’ve found that a headache called a cluster headache, known as a ‘suicide headache’, can be treated by closing the artery at the back of the mouth. People come from all over the world for this.”