Migraine 3: Mechanism
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- čas přidán 2. 07. 2024
- Migraine Mechanism. What is going on in the Brain. Visual Aura and Headache. Cortical Spreading Depression. Trigeminal Nerve carrying Pain Impulses. Role of Serotonin. Treatment with Triptans and CGRP Blocker. Select References.
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I used to get migraines so bad, but they have calmed down as i got older. thank you for sharing
Thank you for the video. Very well explained. Much love!
Thank you for these videos!!! Really apprediated!
Finally now I know what is that vission blur I had few times in my life. (always followed by a migraine headache)
Great supplemental video for my pharmacodynamics course. Thanks!
Great video. My visual aura starts at the bottom, gets bigger and moves up and out the top right of my vision.
Thank you so much for this very educational and informative video!
This was an amazing video!! I'm a medical student and you covered almost everything my professor did in her migraine presentation but even clearer!!! I really enjoyed it so thank you so much :)
Please see my post so you can learn the truth.
Awesome video!
I've been experiencing an aura without a headache for a while now and had no idea what it was until I got my first classic migraine. The brain is so cool.
fascinating and very useful. im grateful i dont get painful ones, but ive been experiencing the auras. these theories are pretty interesting! thank you for producing such a good video.
I've found I get do-it-yourself relief if I put a cold compress (see video named below) on the trigeminal nerve (at side of head) and the 3 major nerves that descend from it. See CZcams video "What is Migraine - instant fix - WHERE to place cold flannel". After 50 years of crippling pain often, I now evade migraines every time - no-cost, easy, drug-free. A viewer has just thanked me that it worked for him too. Bruce Thomson in New Zealand.
Thanks for such a well-presented video!!
I understand, a lot of alarming things happening. At some point it's good to check in with a neurologist to be sure there isn't anything else of concern and to consider treatment options. Good luck.
Thank youu, this really help me to summarize before reading the hard core in medical books :)
Great video, and I'm interested in the CGRP theory. I've had primarily visual aura-only migraine since I was a teenager, and am 23 now. Also got TMJD around the same time as the migraines started, and wouldn't be surprised if there is a bit of IBS going on sometimes as well lol. I think that "stress" is my trigger, but often times, it's not that I "feel" stressed, but rather that I'm going through an overall stressful time in life. Migraines unfortunately only add to the stress.
Like the thunderstorm analogy too, Cortical Spreading Depression is much like a thunderstorm's outflow boundary.
I’ve made the connection that salt intake triggers my migraines. It turns out that salt stimulates the release of serotonin. If my baseline serotonin levels are low and then I eat something really salty, then my pain perception would be altered and vascular system in my brain would constrict, causing a migraine. This video is really helping to connect the dots. Thank you!
This is helpful. Thank you
thanks for your great lecture.its useful to anyone who is experi encing migraine.they also might know what happens in their body.
Very helpful to me in understanding mechanism of my scintillating aura that is huge sometimes and causes a need to lay down close eyes and rest till it reseeds.
Great video- clear and concise explanation compared to my med school lecture!
This video explains a lot. I've had migraines with auras since I was a small child. I get auras when I don't get a migraine and it's gotten so bad my vision goes black for a couple minutes, thank goodness it doesn't happen all the time
Researchers are nearly as frustrated as you are, but look at the progress over the old vascular theory. I tried to present the current state of research. The visual aura is well understood. Trigger mechanism is still subject to two competing theories. For background look at the references. There are good detailed summaries; most are available on the web.
If you want the aura headache chemical cocktail, try
1 - 2 weeks of:
+ depression
+ bad sleep
+ drinking coffee (lots of coffee)
Triggers being:
+ a sudden bout of anxiety
+ bright lights.
+ maybe jogging
interesting points ,if anyone else wants to uncover natural ways to get rid of migraines try Elumpa Migraine Remedy Alchemist (just google it ) ? Ive heard some amazing things about it and my m8 got amazing results with it.
@@whitefusion9688 I cured my migraines completely.
I find your video's on migraines very helpful. I have been suffering from migraines since I was a teen and inherited them from my mother. What's interesting is that I can tell what kind of migraine I am going to have (or cause) based on whether I get the aura. If I have a migraine without an aura, it is typically resulting due the hormonal changes in my body. If I do have an aura, there was another trigger, such as stress or computer screens, or a TV.
Mine are 1-4 times per week, have aura, last for 2 days....so it's mostly present, but trails off the 2nd day. Mine are not as severe as Emily's, but more frequent, very likely. Aura is the same in both eyes, and nothing has helped with relief. The main specific triggers, which sounds strange, is when I actually get some sleep...then I tend to get a migraine that afternoon (though they occur at different times of the day). body seems to shut down somewhat and motor skills diminish enough to lose balance.
New findings sound great!!
Fast forward 10 years and he is right! New medications like Aimovig (CGRP blocker) have proven to be extremely effective, reducing the number of monthly migraine episodes and pain intensity. I have been taking Aimovig for a year now. I’ve gone from weekly episodes-lasting sometimes up to 5 days! to having them once in a while. The intensity has also decreased dramatically from 8/10 to 2/10 on the pain scale. It has been a miracle drug for me!
I wanted you to know that I thought you did a very good and thorough job on these videos. I work in a headache specialty clinic. In the last couple months the first CGRP receptor blocker has come out. We have been using it with pretty effect so far!
Thank you for the kind comment. Glad to hear migraine sufferers are finding some more help. (Good time for an update, but EHR, you understand.)
Thanks for the video. I had migraines since I was a pre-teen and really only came to understand them over the last 10 years (around 35).
Anyway, I have experimented over time with non drug treatments because of the ill at ease feeling that seems to be associated with such drugs. My experience seems to indicate that there is at least some form of vascular mechanism, which undoubtedly has neurological components as well.
I have outlined what I have discovered by trial and error below. I use a combination of these to alleviate migraine symptoms, but not always all of them at the same time).
1) Application of an extremely cold compress to the along the superficial temporal artery. Adding pressure to this area, particularly where it branches around the ear sometimes offers immediate relief.
2) Cold applied to the side of the neck around the carotid artery. Depending on the nature of the pain, this sometimes works better. Heat also seems to work under certain conditions when the trigger seems to have been a tension headache, but cold usually works better.
3) Sudafed, Advil and caffeine. Although cold can often deal with the pain, the remedy works much faster and more completely when taken in conjunction with this cocktail. Optionally, Afrin greatly improves the effectiveness of this treatment. I do not like the side effects of rebound inflammation that are possible, so I normally only go that route in extreme cases.
4) Relaxation in a very cold and dark room with low humidity.
5) Relaxing and focusing on the pain in a meditative way. Strangely, this often seems to convert the pain into sleepiness. I am not sure of the mechanism, but by trial and error it does seem to have some effect.
6) Just plain pressure on the superficial temporal artery. If applied in the right spot with enough pressure to nearly be painful, the symptoms sometimes go away immediately and return upon release. This makes it impractical for all but short term relief while other options work longer term.
With your purely neurological mechanism, I cannot see how these could be as effective as they are.
I know ur trying to explain good for you
Glad it was helpful. If you are interested in Serotonin and Triptans, there are a couple of article about the history of their discovery I didn't include on the reference list. First by Humphrey, Headache 2007:47[Suppl 1]:S10-S19. Second by Moskowitz, Headache 2008:48:688-690. Should be available on line. Good luck with your project.
Nice. Thanks.
Thanks a lot....
great videos. I have found that ice on my temple works the best at stopping the migraine. That seems to lend support to the vascular theory rather then chemical though
The general answer is yes. Avoiding stress may be easier said than done. There are general measures like getting enough sleep. A few people have specific food triggers.
The American Headache Society has lots on migraines including fact sheets and other information sources you might find useful.
very informative video on migraine. very disturbing condition. my girlfreind was also suffering from this condition. the pain is so intense. she visited many hospitals but no one cure this disease. one day she visited planet Ayurveda and they gave her a migraine care pack. now she is fit and fine. thanks to planet Ayurveda
Nice!
I have suffered with migraines for years they started before I was ten and I always got both kinds of auras both lasting the entire duration of the migraine (usually between 8 and 30 hours. I would also lose the ability to talk, forgetting how to form words properly. and be unable to walk because my legs would be completely numb or too tingly. At one point this was happening at lease two times a week, then I got what was diagnosed as a sinus infection which was basically the same as a migraine but it lasted about two weeks, and since then they have been getting less and less frequent although I now suffer from less serious migraines almost literally 24/7. I have had countless doctors appointments and am now seeing a neurologist and trialling different medications some of which as seemed to ease the nausea and head ache but none have helped with the visual symptoms.
I am also now experiencing depersonalisation/derealisation disorder (which is possibly a side effect of the constant migraines)
Emily Paul emily i want to talk with you.. i have akso depersonalization. Had panick attacks ans now i have depressuon.. add mw on fb leluka khvedelidze
thanks for uploading
actually mine is classical aura last for 1 to 2 hrs and head ache for 3-5 hrs and then vomitings i found some of the causes of mine are
1. when i shake my head or any activities which involves quick movements of my head definitely i will get migrine with in one or two days thats why i stopped playing all games
2. if my head gets cooled extremely (during winter when i stay more time out side).
but now with out head ache i am facing visual disturbance for 10-15 days
Very good video!
Im 32 and I suffer from migraines for a long time. My neurologist gave me betablockers to prevent atacks and triptains for "SOS".
This works!
But I have 2 questions:
Why betablockers work to prevent migraines
And, what are the dangers/side effects of triptains?
thanks a lot! Really! This kind of free information Is key for us (migraine patients) better understand your condition and take steps to have a better quality of life :)
Disturbed Neuronal activity in the Hypothalamus may be the cause. The cortical depression is called the spreading depression of Leao. Mutations of the calcium channel genes have been proposed.
CGRP identified in various functions, vasodilation, pain transmission and probably more. From a medical perspective, Peter Goadsby is a leading migraine researcher. Try "Recent Advances" in Trends in Molecular Medicine (2006) 13:1, pp 39-44. More basic biology in Stewart Tepper, Headache (2008) Sept. pp1259 -1268. Both should be available on line.
Yet, there are still a lot of unexplained parts of Migraine.
I have all these symptoms every time I get a migraine. Motor, speech, vision all affected. Hours of vomiting. I get pins and needles sometimes starting from my toe moving through one side of my body to my face or from my hand to my face, it seems random.
Sometimes I have a huge fit of rage or short spell of extreme depression before it hits. I often crave chocolate to the point i would step over my mother to get it before a migraine.
I see flashing zig zags and sometimes I get tunnel vision where everything in my peripheral is flashing white. I lose my apetite sometimes a couple of days in advance and my senses are hyper sensitive, especially smell and taste.
Sometimes I get bad lower back pains before it hits. The aura lasts up to an hour with extreme nausea before the headache phase begins. This phase lasts up to 12 hours. I ether get really cold or unbearably hot or flushes of extreme temperatures.
Noises are noisier and all smells are unbearable. Sometimes a few lyrics or notes from a song will repeat obnoxiously in my head out of nowhere and taunt me until the motor stage has passed. Also sometimes I get fixed thoughts on things that are difficult to escape such as food, that make me feel more ill.
I the worst migraine I had I had a massive rage attack then my face got really hot and I felt a jolt in my chest. I ended up in hospital that night on morphine. I still have no memory of how I got there.
Sometimes I get these fits of paranoia during an attack where I am very diorientated and don't recognize people or where I am.
My thought patterns become very scrambled for example I will not be able to count to 5. I usually count my fingers to test if I have aura onset.
My doctor is now looking into pheochromocytomas because I have a new symptom which is a huge jolt in my chest before the onset.
this week I have had 3 complex/aura migraines. I have had them since I was 4 years old.
Recently I also noted a new symptom this time. My left eyelid was twitching for about 4 days before the 72 hour attack. It continued to twitch until last night when I had another attack.
Wonderful video - THANK YOU for all that information! I have been dealing with migraines all my life and in addition to migraine with visual aura, I sometimes experience what my Neurologist called "basilar" or "seizure type" migraines in that I have episodes where I can't talk clearly, I have double vision, severe vertigo and weakness in my legs. It always scares me - and my doctors - a bit because of the concern about stroke, but so far all extensive testing is normal except for some "lesions" in my white matter. I am curious if the mechanisms you show in this video are believed to be the same for "basilar" migraines as well? Also, I am interested in the role of GABA receptors in headaches. The two medications that I have found help my "aura" and my vertigo during an attack are benzodiazepines and butalbitol, both of which I understand affect GABA receptors. Additionally, benzodiazepines were once used with seizures so could something in the GABA system be contributing to the neuronal migraine symptoms? I am still trying to find a way to prevent, not just treat, the "basilar" migraines and nothing so far has worked.
U will fine trust me just read my above comment or reply me
First, look in Selected References: Bolay, Goadsby, and Hamel are helpful.
I usually start my searches in PubMed and review articles in major journals, like NEJM.
Science Watch has a list of the top 25 migraine authors (through 2007).
Hope that helps.
Interesting question. By the vascular theory heat should increase vasodilation and pain. It turns out people report help with either heat or cold. The latter is proposed to work by decrease in inflammation and/or pain conduction. Heat is usually for muscular pain. Not sure why it is helpful here, but you are not alone in that.
Just a thought: has any correlation been established between migraines and tinnitus?
The descriptions and explanations are very thorough and easy to follow. I am very exhausted and very beat from this problem. I need help. this problem interrupts my productivity and ruins my mood. I hope to learn as much as i can on this subject. thank you.
I hope you find something to alleviate your pain. I know how disruptive and maddening this problem is, and I hate knowing that so many people go through it other than myself.
I don't have visual aura, though my migraine does cause tingling sensations along my limbs and nausea/vomiting. The pain part of this video is what I'm interested in understanding. The only thing that helps my pain is to keep lots of heat on my skull. I noticed this when I tried taking a really hot shower while in the middle of a migraine. As long as the heat was there, the pain lessened a lot. So I bought a low-power electric blanket (which is actually made for the lower back), and if I put it on a pillow and tilt my head so the heat is on the lower back of my head, on the side where the migraine seems to be coming from, this helps tremendously. I spoke to my doctor, who goes by the old blood vessel theory, and she said the heat helps because it increases blood flow in these swollen vessels.
But if that theory is no longer valid, why does the heat help me so much?
at times pressure points also help. I have observed its something to do with my cervical and neck muscles.
Dam pussy and head r u jokeing
I also get popping and a pressure sensation in my left ear.
Excellent! Updated info! Common M for 33 yrs. had enuf sumatriptans to stroke out, I assume. Topamax for yrs, all keeps me still 12-15 a month. Awful. Need more research
Craig Blackwell. . any cgrp blockers fda approved and on the market right now. Tried everything else. Can't take vasoconstictors of any kind. Can't handle low dose antidepressant. What about some kind of eye drops I think for cataracts or a different eye condition that give migraine relief. I read an article about that.
Yet, I haven't had any signs of my usual headache since... I had an MRI done 5 years ago to rule out something serious because I've been getting scotomas in my vision since I was 18. These are tiny and last up to a few weeks but are never associated with headaches.
i get migraines with aura and without,the ones with aura are normally quiet mild and my vision comes normal after about 5 or 10 mins then i get a headache, but the other day i got one with no aura ,just pain and it was really bad!i was 12 hours in the a & e,they gave me oxygen which helped a bit,but the pain killers were no use!i think my migraines are to do with my menstral cycle
This is very helpful. I was scheduled to have a Third Occipital Nerve Block for my migraines but I chickened out. Now that I've seen this video and the part that the occipital lobe plays in migraines, I'm wondering if maybe the surgery just might be a good idea. Please give me your honest opinion of that procedure. Does it actually work very often or is it a way for pain doctors to make money?
I get the fuzzy vision which over 5 mins time goes into the bright zig zag colors lasting about 20 mins. I have noticed before I get one I may have days of odd sleep patterns and depression . I used to get them every few years but this year I have had 6 of them . Strangely most occur during winter months . I have no pain with them but feel very out of it after one . I also have kerataconus which greatly adds to the light show . Any suggestions, Im getting so Im fearful to drive far due to the worry of having one while driving
Sometimes before migraine headache occurs to me , i get very strange vision: everything seems to be farther that before, hand visialy becomes longer etc., its like tunnel vision but i dont know if it can be a symptom of aura
Variations on this theme are studied and commented upon by leading headache specialists. CZcams doesn't allow links to be posted here, but if you go to Google Scholar, you can search for ONB. There is an expert review by WB Young, in the journal Headache in 2008. Volume 48, page 1122. It is fairly readable and not long.
A person can have more than one type of Migraine. Menstrual association occurs in more than half of women with migraine, and is an interesting subject to itself. There seem to be two types with possibly different causes and treatments. If they are a frequent problem a neurologist may help sort that out for you.
Cluster headaches? Those don't normally cause a pulsating pain, do they? Most of the time, my headaches consist of pangs at every heart-beat. They are never a constant ache, unless they are on the other side of my head or bilateral.
The interesting thing is, I get aura but they almost never come with, or precede a headache. Yesterday at about noon I saw a small scotoma (a tiny pill-shaped dot) and next to it, a moving snake-like string, which seemed to pulsate with each heart-beat.
I understand about serotonin being low in migraine sufferers, but isn't Serotonin what helps cause the visual aura?
I know that serotonin is a sympathetic neurotransmitter and that is how it causes the initial neuroexcitation at start of CSD whilst causing vasoconstriction after the excitation resulting in blind spot. Also that Ca2+ channels open allowing Ca2+ to flood into the neuron leading to excitotoxicity.
I know that aspirin can help prevent aura from happening by reducing blood clotting and thus serotonin release, also aspirin helps improved blood flow which can stop the ischemia.
So would it not be best to simply block activity of serotonin in the first place?
One sided bad headache with eye watering (variable severity) could also be cluster headache. Cause uncertain. Similar to migraine, and no fun either. There are available treatments some same as migraine.
This problem have any treatment yet,?
Discovery of the roles of Serotonin and CGRP in migraine were big steps forward, but the whole puzzle isn't solved yet. Lots of people have migraine so there is lots of ongoing research.
Craig Blackwell hi everyone ,if anyone else wants to uncover at home remedies for headaches try Elumpa Migraine Remedy Alchemist (Have a quick look on google cant remember the place now ) ? Ive heard some extraordinary things about it and my cousin got great results with it.
I get numbness on my left cheekbone and around my left eye (I have left-sided headaches) and sometimes my left eye waters or fills with a thick liquid that causes my vision to get smudged. My headaches are unilateral (left side only). Sometimes they last only a few minutes and other times they are present in some for every single day for an entire month. Most of the time the pain is mild to moderate but on certain occasions the throbbing is so bad it hurts to think.
i can get a migraine once a month ,but them i could go months without having one,im not very experimental with food and usually eat the same things must days so im not sure its to do with food,its hard to know the triggers,but if they get worse i think i will take your advice
My graduate project is about migraine triggers and their role in its mechanism. This video is very helpfull, but can you suggest me other resurces? Thank you.
Exc tk you. Mig w aura, not only not fun n painful but scary and so destructive...its like having a bomb exploiding inside my brain and damaging me n messing up my life more and more every time they happen...they come twice a week and stay for 3 painful days,it brings temp paralysis, restriction of speech, loss of vision, long days confussion, loss of memory and cognitive skills.Started in May/12 meds dont work enough! no explanation,i m so frustrated waiting4 the new med cgpr blocker !
Great info - thanks.
I also get repeated aura attacks - although v.rarely - i.e. Visual attacks of about 20 mins (as usual) - then it fades - then almost immediately another starts off ! Which is really depressing when it happens. Am I just unlucky ?
d3nv1 I have the same every now and again. Only the aura starts off the opposite side, alongside paralysis and the beaches the opposite. Then the symptoms go (headache stays) and it starts again the opposite side, now with both sides sore.
what are you thoughts on botox
Easily understood video with not too much medical jargon.
Don't have personal experience with Botox. But, Amer Acad of Neurology has comments on their site. They published a tech review in: Neurology May 6, 2008 vol. 70 no. 19 p.1707-1714 (M. Naumann, MD). (Paste into search.) Skip down to headache section for discussion of different types of headaches. Don't worry about the tech terms, the conclusions are clearly stated.
@devilndisguise666 - I understand, that's no fun. If the migraines are frequent or particularly painful there are treatments that may help. One kind of med you take with the migraine to help reduce the pain phase. Other kinds can be taken to reduce frequency. Best to get a doc experienced with migraine treatment.
Deep
which is disturbing my academic career i am not able to work hard even tough i stopped completely playing stopped jogging.
Make sure you are all getting enough Magnesium and Potassium in your diets. Eat a minimum of 4 cups a day of leafy green salads and many of you will never have another migraine again for the rest of your life.
usually my migraine does not last more than a couple of hours max and induced vomiting helps somehow but today it lasted for so long that now i feel like i have a permanent throbbing pain on my right frontal lobe:( i will try ice packs next time
Sumatriptan is 5HT1agonist and 5HT1is a autoreceptor which decrease serotonin levels well serotonin is the vasoconstrictor then how sumatriptan which acts on 5HT1cause vasoconstriction plzzzz tell me
One of the properties of serotonin is to.cause vasodilation via releasing edrf..by decreasing serotonin level..this vasodilation is blocked. Hope this clears your doubt
I used to get cephalagia, but no aura. For years. Then years of aura - but no pain. Go figure. Doctors know little or nothing about what is really going on.
my migranes are everyday with numbness etc.. I'm tired of living with this
I understand plz keep fighting
@@mdv5845 how did you curr
@@mdv5845 I appreciate your reply but for me it's first time does it go permanent or I should take the supplement when migraine comes back and I need permanent solution to my migraine and I love working at gym now it's not possible to go gym because it makes me worse.so I need permanent solution if there please help me 🙏
@@mdv5845 how many years did you suffer from migraine and what are the symptoms you experienced in beginning and how many days it took you to get of rid of migraine
@@mdv5845 where do we get this ariginine products and share me the link does migraine go permanently taking this and how long we should take
i have a migrianie
If low serotonin people are sensitive to excess serotonin then I guess SSRI drugs would increase migraine.
A bug flies by a citronella candle it knows to avoid it, why, if you understand this the Riddle you will understand the source of most migraines.
What do wines,citronella have in common?
the migraine money machine keeps on rolling.Millions if not billions, everyday, get stressed, eat sugar, drink wine, watch electrical screens. yet non of them lose their vision from these "triggers", WHY ? Tell me why
Excuse my skepticism. Show me how you came to these stated conclusions, and maybe I'll be less skeptical. There is no shortage of people who have cephalagia that doesn't conform to any specific type. Probably everyone, as the types are arbitrary classifications - no objective tests for a type - based on what the sufferer SAYS.
Bad sound quality!
This is further proof that no one has a clue about migraines. :(
useless trivia, but i suppose when you have no knowledge of the true cause and it's correction, it's all you can offer.
useless babble. the only knowledge of use to the patient is how to correct the cause, knowledge medicine does not have.