Anonymous, that's interesting, about the blood pressure spike. (I always like finding out that there's a physiological reason for what used to be dismissed as "all in their heads").
And as for chronic fatigue - having known one or two sufferers - it always seemed to me that it had to be something "real" in the sense of having a physiological cause and not being "all made up," as some doctors dismissed it to be.
I should read more of the migraine literature. I read Oliver Sachs' book about it and found it not to be quite as user-friendly as some of his other works. (And also, he discussed - and seemed to ascribe to, a bit - a theory that migraines were something people "did on purpose" to get attention. Which annoys me. Because, you know, I live alone? So what "benefit" do I get from crushing agony a couple times a year? Supposedly the idea is that migraineurs "willed" their condition because in the past they got attention or pity for it. That seems like bunk to me - or at least, bunk in some of the cases - because I didn't start with migraines until I was out living on my own - so I have no one to "pity" me for having them or give me attention. And secondly, I'm one of those "I'm sick! Leave me alone!" types. I mean, it's nice to have someone there in case you spike a bad enough fever you need to go to the ER, but other than that, I prefer to be left alone to recover in peace, rather than having someone poking their head in the door every 30 minutes to see how I'm doing.)
I don't know. It seems to me that migraines have a pretty obvious physiological cause.
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I agree that Oliver Sacks' book is not an easy read. But by the time I had plowed my way through all that he says on the subject, I found myself a bit more willing to consider that migraine might have a psychological *component* (clearly that's not the whole story).
As I understand it, the most recent thinking on migraine is that the vascular effects are (1) a secondary side effect, and (2) not what actually causes the pain. The root cause actually seems to be neurological, an electrical disturbance something like (but different from) epilepsy. There has been some promising research on treatments that attack migraine from that angle.
I suffered a number of disabling migraines until my doctor gave me Imitrex (sumatriptan). For me, it's magic -- when I take a dose, nothing happens for about 45 minutes (which can be hard to live through when you're in pain) and then over the course of the next 15 minutes, all the pain just melts away. It's expensive, so doctors tend to try other things first, and it doesn't work for everyone, but it's meant I get *maybe* one migraine a year that's bad enough to interfere with daily life, and it never lasts more than a day.
I think there might also be a hereditary component to migraines. My dad used to get terrible ones. When I was younger, especially in my teens and 20s, I'd get them too complete with vomiting just like Dad. About the only thing that helped me was to lie quietly in a dark room and if I could, fall asleep. I could sometimes sleep off the headache.
I think there is also a hormonal component. My sister got a monthly migraine around the time of her period when she was in her late 40s, early 50s.
Lots of areas for research of an utterly miserable condition as anyone who ever had one would know.
Both the hereditary tendency to develop migraines and the connection to female hormone cycles are pretty well known. (Both true for me, too. I actually get the tendency to migraine from both sides of my family.)
Also, a lot of people (about a third, according to my migraine specialist) who get migraines seem to be sensitive to hot weather and high positive-ion content in the air as well as to glare.
Just to complicate things further, migraines are also part of the "cluster" of symptoms that go along with fibromyalgia.
That's very interesting about hot flashes and blood pressure spikes. My blood pressure has always been lower than normal but the last two times I got it checked the first number was high. And having that BP cuff tightening around my arm is apparently one of the things that triggers a hot flash for me.
Here's something you might find interesting. Hildegard of Bingen probably had migraines.
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