Day 2
Trupti Gokani: Understanding the Gut- Brain connection in
migraine
Author of “The Mysterious Mind” – takes a Mind, Eyes, Spirit approach to
treatment.
Gut is our second brain (100millon neurons). The gut and brain can
operate independently of each other. They are connected by the vagus nerve.
When we experience that butterfly in stomach sensation it is our gut talking to
our brain.
Migraine attack link with gastroparesis
Migraine attack in the gut
1. Pain
signal
2. State
of threat
3. Nervous
system is overwhelmed
Healthy gut
1. Bowel
movement in the am
2. No
gas, bloating or diarrhoea
3. Appetite
signal
95% serotonin produced in the gut.
Microbiome- genetic imprint of bacteria unique to us (100 trillion
bacteria in the gut).
If we address the gut we can improve pain.
Practical steps?
1. Routine
(sleep pattern and lunch should be biggest meal of the day)
2. Mindfulness
(morning)
3. Food
as medicine (sipping warm soup during a migraine to calm down excitable
migraine brain).
4. Add
in different cooling spices (cilantro, fennel & cumin tea) and supplements
(magnesium, riboflavin & CoQ10)
Cold vs warm beverage?
Warm drink in the morning is best
Cold hands & feet – bring in warm liquids
No salads in the airport – warm warm warm foods and
drinks!
Medication?
1. Impair
our microbiome
2. Ibuprofen
can damage the lining of our gut
3. More
harm than good?
Day 2
Kathleen Digre: Migraine, vision and occipital neuralgia
Migraine & vision during aura - small disturbance that can build up
and grow (triggered by cortisol, depolarisation).
Aura occurs before the headache and is a discreet neurological event
(numbness, visual disturbance & dizziness).
As people age they sometimes lose headache and keep the aura stage of a
migraine.
Visually sensitive all the time?
1. Stripes
2. Flickering
lights
3. Bright
lights
Visual Snow?
Very different from aura. Persistent visual phenomenon (old tv, see
through it)
Auras always start and end and are followed by headache
Possible triggers?
1. Lack
of sleep
2. Altitude
Depolarisation – electrical slowing in the brain (vascular changes
occur)
Visual aura without headache?
1. Not
as well studied
2. Tends
to be brief and not as disabling
Ocular migraines
1. Eye
migraine (slang)
2. Ocular
migraine not a good technical term as migraine is in the brain NOT in the eye
3. Better
to use term, migraine with aura
Retinol migraine?
1. Truly
in one eye
2. Very
rare and hard to diagnose
Migraine attack & Visual aura
1. Blurred
vision
2. Light
sensitivity
3. Visual
sensitivity from movement
Many people are often visually sensitivity in between attacks too
(normal threshold).
Strategies to help
1. Tinted
lenses in between attacks (FL-41) to be worn inside only
2. Polarised
sunglasses for outside
Preventing aura with migraine
1. Preventative
medications
2. Baby
aspirin can help if you experience a lot of aura (daily low dose aspirin)
3. Calcium
channel blockers
Occipital neuralgia
1. No
known visual symptoms
2. Pain
in eye (sharp pain)
3. Pain
often travels up and over head into the eye
4. Pinch
of the occipital nerve (tend to be brief pains and can trigger migraines)
5. Can
be caused by injury and neck spasm
6. Rarely
will be treated with surgery
The Neck- trigger or symptom?
1. Neck
pain can be first symptom of a migraine (trigeminal nerve travels from the
spine into the neck)
2. Tight
painful spasms in the neck (cervicogenic type migraine)
3. Can
be tricky to work out what’s causing what?
4. Occipital
neuralgia is not common
Cervicogenic headaches
1. Does
not usually trigger aura unless migraine too
2. Good
physical therapy can be very useful along with muscle relaxants
Occipital neuralgia vs Trigeminal
Occipital neuralgia – rams horn pattern of pain (ear and side of head),
nerve blocks can be used to treat
Trigeminal – one spot on the face (cheek or forehead for example),
anti-convulsant can be used for treatment
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