Migraines Survival with Christina Peterson, M.D. (cont.)

amleko_WebMD: Do migraines cause strokes?

Dr. Peterson: Usually not. There is a very slight increase in the risk of stroke in migraineurs in general versus the general population. There are some specific, unusual subtypes of migraine that do carry an increased risk of stroke. The concept of "migraine stroke" is controversial. Many researchers feel that migraine stroke has been grossly overestimated. People with migraine get older, have risk factors for stroke or a family history of stroke. Some of them will have strokes when older, but not necessarily because of the migraines. So new diagnostic criteria are being developed so that we can be more specific about this and determine which strokes really are due to migraine so that we can quote accurate statistics as to the risk of migrainous stroke.

wabe_grb_WebMD: Are there any herbal remedies for migraines?

Dr. Peterson: There are a few. Feverfew has been shown to be useful for migraine prevention in about 40% of cases, but may take two months to become effective. High dose riboflavin (vitamin B-2) has also shown some effectiveness, but this needs to be taken for about three months before you can tell if it will work. Magnesium can also be helpful for some migraine patients. Problem is -- we can't predict which ones, but magnesium is fairly safe to try--so are the others. I often use riboflavin in pregnant women who cannot take medications. Peppermint and lavender oils used to massage the skin can also help. Other aromatherapy oils are being studied.

amleko_WebMD: How common is migraine aura without the headache?

Dr. Peterson: This does happen occasionally. We do not know why. I have a friend who gets aura without headache only while pregnant. I have several patients who get both aura with headache and without, and often women who have had migraine with aura will notice fewer headaches as they age, but will see an increase in visual aura in older age. This is not an indicator of stroke risk, although it can mimic a TIA (transient ischemic attack), which IS a sign of cerebrovascular disease, and can lead to stroke, so it is important to let your doctor know you have a history of migraine if this occurs.

estelle31_WebMD: Is there a way to know the difference between a migraine and a bad muscle tension or stress headaches or are they all the same?

Dr. Peterson: Well -- that depends. If you are a migraine sufferer and also get tension headaches, there is a point at which it can be difficult to tell. Tension headaches can go on into a migraine if you are prone to migraine, and sometimes it is tough to tell if that is about to happen. And sometimes the migraine pain causes a secondary tension headache. You can tell this by feeling the neck muscles to see if there is a pattern of muscle spasm. When this occurs, I treat both types of headache.

Moderator: Well, our time is about up...

Moderator: Do you have any parting comments?

Dr. Peterson: Thank you for your questions. I hope you all find good doctors and gain good control of your migraines.

estelle31_WebMD: Thank you for being here and answering our questions.

Dr. Peterson: You are very welcome--would be happy to do so again some time

Moderator: Thank you. Our guest this afternoon was Dr. Christina Peterson, a neurologist in private practice and the medical director of the Oregon Headache Clinic in Oregon City, Oregon. Thank you also to our members who asked some great questions! Peterson is also author of The Women's Migraine Survival Guide. Is that title available everywhere?

Dr. Peterson: Yes, it is published by HarperCollins. It is available at bookstores and online through the usual channels.

Moderator: Great! Thank you for your time this afternoon!

Dr. Peterson: You are welcome.

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