Yesterday, Minnesota Vikings wide receiver Percy Harvin collapsed at practice and was hospitalized for a migraine. Harvin, a long-time sufferer, recovered remarkably quickly. He returned to the Vikings’ practice facility today and was reported to be observing from the sidelines.

Harvin serves as a pretty strong counter-point to the stereotype that migraines are a woman’s disease. More importantly, he demonstrates that a person cannot brace himself through a migraine, no matter his pain threshold. It would be hard for a news outlet to publish a piece questioning Harvin’s ability to brace himself against discomfort.

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I was disappointed back in 2008 when The New York Times stopped updating their Migraine Blog, an powerful collection of posts by migraine sufferers (my favorite was a slide show of migraine art).

Last Wednesday, however, The New York Times invited questions about migraine on their Consults blog, Ask an Expert. Dr. David W. Dodick of the Mayo Clinic has been answering plenty of questions, with daily blog posts named after the biggest question of the day, but plenty of other questions listed underneath. It’s unclear whether new questions are still being addressed, but worth a shot.

Glad to see the return to the topic! Twelve pages of 25 comments on the christening post speaks to the popularity of the topic.

Also check out their comprehensive section on migraine in the Times Health Guide.

Dr. Rami Burstein, a researcher at Beth Israel Deaconess Medical Center and Professor at Harvard Medical School, has led a lab researching migraine for the past sixteen years. I had the opportunity to talk to him about migraine, stigmatization, and the research in the field today:

I may have written a lot about hyperflexibility, but isn’t a picture worth a thousand words?

Michael can bend his thumbs

Angel’s hyperflexibility in her hands is even more extensive:

She can go beyond her thumbs, however. She can bend back her fingers:

and even touch her ear to her shoulder:

Just to put all those quotes in context.

Last week, Great Britain’s National Health Service approved Botox for the treatment of chronic migraine, and the FDA has been expected to follow soon. Before you launch into a rant about how: (a) Botox is disgusting; (b) sick people shouldn’t poison their muscles; or (c) these migraine sufferers are vain people trying to get free Botox, consider the hurdles the NHS establishes before any treatment can gain official approval.

Allergan, the manufacturer of Botox, did not petition cosmetic dermatologists or plastic surgeons to support the use of Botox for migraine treatment. Allergan did not poll middle-aged migraine sufferers to find out if they wanted to remove their wrinkles, and then use it for support for the drug. Rather, years of study have determined that freezing the muscles that can trigger a migraine have reduced the incidence of attack. In 2002, it was hypothesized that Botox would be approved for treating migraine; in 2008, Dr. David Simpson, a neurology professor at Mount Sinai School of Medicine in New York, acknowledged to Reuters, “There’s certainly quite a bit of off-label use [of Botox] in headache [treatment] now.” The cumulative results of years of clinical trials were not published until the June 2010 issue of Headache.

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As promised, the following is a video of common photophobia-producing phenomena. Please don’t watch it if you’re suffering from a migraine!! None of the images are jarring, but some might be unpleasant if you’re feeling over-sensitive. Enjoy!

Photophobia, or light sensitivity, is one of a migraine headache’s landmark symptoms. In migraineurs, photophobia can affect the perception of light both during a migraine (usually by intensifying the pain) and between migraine attacks (typically by feeling uncomfortable). Photophobia can also accompany non-migraine headaches—I occasionally experience it during a tension-type headache.

As I mentioned in my first post, the majority (66-88%) of migraineurs experience photophobia. You might experience a bit of photophobia when you walk outside after sitting in a dark movie theater and find yourself blinking profusely, but this isn’t really photophobia. For many migraine sufferers, just looking at a light during a migraine attack can be excruciating. For others, certain kinds of light are always uncomfortable. By “certain kinds” I mean wavelengths, that is, colors, of light.

Angel, 16, described how she feels during episodes of photophobia between migraine attacks. “Light, in general, can feel uncomfortable. It makes your head feel tense like a headache, but more focused… your eyes really hurt.” Angel would normally take refuge in a dark room or put on sunglasses. “Most of the sunglasses I wore were black, not brown, but I couldn’t really tell a difference.”

A study conducted in 2000 at the European Institute of Health and Medicine Sciences found that low-level (blue) and high-level (red) wavelengths of light affected migraineurs differently between attacks than did white light, supporting the idea that tinted lenses, rather than just brown or black sunglasses, might be more protective against photophobia during a migraine. Are your eyes feeling uncomfortable at the desk? Read the rest of this entry »

Beyond the case studies that Burstein mentioned, longitudinal research has shown that being hyperflexible (commonly known as being double-jointed or, in some physicians’ terms, exhibiting hyperlaxity) is correlated with the development of osteoarthritis. As Arthritis Research UK describes:

You may have been aware from an early age that your joints were more supple than usual, and this might not have caused any problems or symptoms. And for some people, especially dancers and athletes, this high level of flexibility can be an advantage.

I do not suffer from migraine headaches but am hyperflexible. It’s definitely seemed like an advantage: not everyone in Phys Ed could do yoga without the warm-ups. Beyond the jump, however, were some more sobering points:

Sometimes hypermobility is caused by weakened collagen fibres (which normally give strength to our ligaments), and weakened collagen can cause other symptoms including hernias or varicose veins.

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Touch your thumb to your forearm. Bend your pinky all the way backwards. Lean your ear to your shoulder.

Over the past year, I have conducted an informal survey consisting of the above directions with those who professed to suffering from migraine. A vast majority (at least 60%) of people who suffer from migraine showed me that they are able to do one of the above and therefore exhibit hyperflexibility (or hypermobility), although the behaviors were exhibited during headache-free periods.

There are a few plausible explanations for the potential link. Perhaps migraine sufferers (migraineurs) have altered muscle strength. A 2008 study found increased neck muscle cross-sectional area in adolescent boys with migraine, possibly compensating for an underlying problem. A majority of migraineurs have reported neck symptoms at some point during their headaches. A change in flexibility, then, may be consistent with a change in muscles.

Interestingly, no research has confirmed or denied these speculations. My searches on PubMed and WebMD for “migraine” and “hyperflexibility” or related terms retrieved no relevant results.

Dr. Rami Burstein, a migraine researcher at Beth Israel Deaconess Medical Center and professor at Harvard Medical School, offered an explanation to me for the dearth of research. “Anecdotally, migraine patients would say that their neck is stiff,” said Burstein. “You really don’t see [hyperflexibility], so no one that I know of took the time to look at it quantitatively.”

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Migraine headache is a gender-discriminating disease that disproportionately affects women at a rate 2-3 times higher than the rate at which it affects men. Recent estimates pin the number of migraine sufferers at 15-18% of women and 6-8% of men worldwide, data that, applied to the 2009 US Census population estimates, translates into upwards of 32 million Americans.

One of the most important issues I hope to address in this blog is the stigmatization of migraine. Headaches as a whole are often portrayed as an excuse of lazy women. Migraines are particularly disabling and therefore face even more bias. Both migraines and headaches are:

  • misdiagnosed (88% of sinus headache diagnoses are actually migraines)
  • and misunderstood (some might have judged Cindy McCain for wearing over-sized sunglasses during her husband’s 2008 Presidential campaign, but she was really struggling with photophobia, or light sensitivity)

A second goal for this blog is to publicize recently published research about migraine. Although migraine research does not receive a surplus of funding from the NIH and other similar institutions, many scientists around the world are working to demystify migraine.

Thirdly, this blog will include personal struggles, anecdotes, and multimedia to personalize the issue of migraine. At the moment, there are several blogs exploring migraine with similar goals. However, many of these websites are written from the perspective of either migraine sufferers or professionals in the field. By writing as a migraine-free individual who has seen friends and family battle with migraine, I hope to illuminate the reality of an issue that costs the United States $17 billion to treat and $13 billion in lost productivity. Along the way, we’ll explore the science behind the issue for those with and without migraine.