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Oliver Sacks Answers New York Times Migraine Blog Readers’ Questions

Renowned writer and neurologist Oliver Sacks describes non-visual auras, correlations between migraine and memory loss, migraine’s connection to strange dreams and more in Answers to Reader Questions on the New York Times migraine blog. Inquiries and responses aren’t about medical advice, but less frequently discussed components of migraine.

Topics covered:

  • Non-visual auras (like hallucinating or distorting sounds or smells, tingling in limbs, etc.)
  • Hormone levels
  • Genetics
  • Emotional changes
  • Creativity and intelligence
  • Bizarre dreams
  • Memory loss

As always, his post contains thoughtful answers and colorful stories.

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Children & Headaches

Nearly every child has a headache at some point. Like in adults, an occasional headache is normal. Although headaches are typically benign, they could signal something serious. If kids have headaches frequently or the headache seems different than usual, it’s time to see a doctor.

Contact a doctor if your child’s headaches:

  • Occur at least once a month
  • Keep him or her out of school
  • Follow an injury, such as a blow to the head
  • Awaken him or her from sleep
  • Feature persistent vomiting or visual changes
  • Are accompanied by fever, along with neck pain or stiffness

Causes of headaches in children include a genetic predisposition (especially to migraine), head trauma, illness and infection, environmental factors, emotional factors, and certain foods and beverages. See the Mayo Clinic article in the above link for details about these causes.

Information comes from the Mayo Clinic. See Headaches in Children: Common, But Sometimes Serious to learn about causes, types of headaches, diagnosis and treatment. The National Headache Foundation also has a guide to children’s headaches, which even has a section for kids to explore.

Your child having headaches isn’t a reason to panic, but it isn’t something to ignore.

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Migraine News: Migraines May Ease With Age, Parents’ Influence on Kids’ Migraines, More Poor Teens Have Migraine

I’ve neglected news lately and haven’t shared a lot of good stuff with you. I’m catching up over the holiday weekend.

Migraines May Ease With Age: In Swedish Study, Most Patients’ Attacks Decreased or Disappeared Over 12-Year Follow-Up

Good news for most migraine sufferers: With age, you can expect to get fewer, less- painful migraine attacks that don’t last as long, a new study from Sweden suggests.

“It does seem that in most people migraine is not a progressive disease,” says Carl Dahlof, M.D., Ph.D. . . .

Poorer Teens May Get More Migraines: Stress, Poor Diet, and Less Medical Care May Be Linked to Migraines in Teens

Poorer teenagers may be more likely to suffer from migraine headaches than richer teens.

Genetics play a big part in determining the risk of developing painful migraine headaches, but a new study suggests that family income may also play a role in migraine risk.

Researchers say psychiatric factors — such as depression, anxiety, and substance abuse — were not examined in this study and may help explain the results. . . .

“Our study also suggests that we should explore environmental risk factors, such as stressful events and nutrition, as they relate to low income and migraine to understand how we might reduce the occurrence of migraine among these individuals,” says Bigal.

Also: If No Genetic Link, Family Income Affects Migraine Risk (MedPage Today)

Do Parents Play A Role In Their Kids’ Migraine Pain? Study: How Much Headache Pain Is Genetic, How Much Is Mimicked?

[A]re children feeling the same levels of pain as adults, or are they simply reacting to it in the same way?

Dr. Pakalnis has launched a study to find out just how much is learned. She’s noticed that when talking to adults and kids separately, there is a difference. Kids tend to report less pain and disability, but the adults…

“They tend to over-report their child’s perception of pain from their migraine headaches compared to parents or guardians that don’t have a chronic pain problem,” says Dr. Pakalnis.

In other words, parents who have migraines might be projecting their pain onto their kids. That could lead to unnecessary treatment or excessive medication. It’s important to understand that no one doubts these kids suffer from migraines. But doctors say if they can better understand their individual level of pain, they can develop individual treatments that are best for them.

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Clarifying Reports on Migraine Genetics

Over the last few years, news articles have declared that researchers have found the migraine gene. That’s not exactly true. Multiple genes are thought to be involved with migraine and all its variations. Several chromosomal regions for migraine have been identified, but only one true gene has been found – and that’s for the familial form of hemiplegic migraine. The “familial” part means that a close relative of someone with hemiplegic migraine also has hemiplegic migraine.

Although it’s not detailed, the abstract of Migraine Genetics: An Update is an overview. The full article appears in the June issue of Current Pain and Headache Reports.

Genetics of Migraine, a previous post on The Daily Headache, provides a less scientific overview.

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Genetics of Migraine

Genetic research of migraine began more than 35 years ago, but the last 10 years have yielded numerous studies identifying various genes and chromosomes involved in different types of headache. The Queensland Institute of Medical Research study, which was reported earlier this month, zeroed in on chromosomes responsible for different migraine symptoms. This is important for distinguishing migraine from other neurological disorders with similar symptoms. The particular symptoms described in the study are sensitivity to sound (phonophobia), sensitivity to light (photophobia), pulsing headache, exertion-induced pain and severity of headache.

The lead researcher, Dr. Dale Nyholt, that a chromosomes have been identified, but that a specific gene implicated in headaches has not yet been isolated. He says, “We haven’t quite found the gene yet. We’ve found a region where there could be any number of a few dozen genes, which could actually be causing the migraine. So what we need to do now is go and test all these genes to find out which specific gene is causing the migraine.”

Previous research has determined a chromosomal region for migraine without aura and migraine with aura, among others. The only type of migraine for which a specific gene has been identified is familial hemiplegic migraine. Visit PubMed for more journal article abstracts on the genetics of migraine. For much less technical information, search the ACHE website matching all the terms “migraine gene headache news.” (This isn’t an elegant way to read the information, but it’s all there if you’re willing to look through the pages.)

Teri Robert of About.com’s headache page has written a good summary of the latest research in More of the Genes Responsible for Migraine Discovered.

Note: I edited the first two sentences of the third paragraph to make them more clear. 9/15/05