Migraine and Neuralgia Flashcards
1
Q
Migraine
A
Recurrent neurological headache involving multiple networks and regions in the head.
2
Q
Migraine: Signs and symptoms
A
- Moderate to severe headache (pulsating or throbbing; often unilateral; lasting < 72 hours) ― often preceded by tiredness, increased food cravings or bowel changes.
- Nausea and / or vomiting, photophobia and phonophobia.
- ⅓ of individuals also suffer from an aura. This presents as transient neurological symptoms e.g., visual zig zag lines, pins and needles.
It can precede or accompany the headache.
3
Q
Migraine: Causes and risk factors
A
- Diet - Food allergy / intolerance, histamine /
- Inflammation
- Stress
- Toxic overload / poor detoxification
- Oestrogen imbalance
- Excess histamine (inflammation or diet)
- Gut brain axis
- Nutrient deficiencies
- Low magnesium
- Low serotonin
4
Q
Migraine: Natural Approach
A
- CNM Naturopathic Diet
- Identify and remove trigger foods (gluten, dairy, peanuts).
- Avoid / reduce tyramine / histamine,
‒ Probiotics
‒ Quercetin (500‒3000 mg / day) - Support serotonin status
- Support the GBA
- Increase omega 3
- High quality multivitamin + mineral supplement with CoQ10
5
Q
Migraine: Supplementation
A
Magnesium
Vitamin B6
5-HTP
Ginger
Feverfew
6
Q
Migraines: Magnesium
A
- Plays a key role in migraines headaches by altering neurotransmitter secretion, synaptic transmission by cortical spreading depression, and platelet aggregation.
200-400mg/day
7
Q
Migraines: Vit B6
A
- Exerts modulatory effects on GABA and serotonin .
- It is also a DAO co factor (lowering
- Studies have also shown that raised homocysteine is linked to migraines. B6 reduces homocysteine.
50-100mg/day
8
Q
Migraine: 5-HTP
A
- Supports serotonin levels, and has been shown to reduce migraine frequency. Check for interactions!
100-200mg/day
9
Q
Migraine: Ginger
A
- Has been shown to reduce migraines: it is anti inflammatory (COX 2 inhibiting) inhibiting), analgesic and anti oxidant. It is also thought to increase serotonin levels.
400 mg x 3 per day
or 1 inch fresh ginger
infusion
10
Q
Migraine: Feverfew
A
- Has been shown to reduce migraine headache frequency, pain, nausea / vomiting, and light sensitivity.
- Inhibits both histamine release and prostaglandin synthesis ; reduces vascular smooth muscle
300mg or feverfew tincture 2‒3 ml two to three times a day.
Avoid in pregnancy and anticoagulant use.
11
Q
Neuralgia
A
Pain in the distribution of a nerve or nerves,
that is often described as burning or stabbing in nature.
12
Q
Neuralgia: Common types
A
- Sciatic neuralgia (or ’sciatica’) compression
or irritation of the sciatic nerve causing pain into the buttocks, posterior leg and often into the foot. Typically accompanied by pins and needles, numbness and weakness. - Trigeminal neuralgia a chronic condition
affecting any or all of the three branches of the
trigeminal nerve (cranial nerve V). Produces
sudden and severe stabbing pains in the face.
13
Q
Neuralgia: Causes
A
- Structural e.g., lumbar intervertebral disc herniation (sciatica),
piriformis compression (sciatica), tumour, blood vessels. - Infections e.g., viruses such as herpes simplex and zoster .
- Inflammation e.g., due to poor posture, inflammatory diet, obesity, intestinal permeability (LPS leakage -> inflammatory mediators)
- Demyelinating diseases e.g., MS.
- Chronic stress (SNS dominance -> muscle shortening).
14
Q
Neuralgia: Natural approach
A
- Focus on anti-inflammatory foods
- Vitamin B1, B6, B12
- St John’s wort 2 tsp tea infused x 3 cups daily
- Omega 3 500-1000 mg / day EPA / DHA
*Acetyl L-carnitine (1 2 g / day)
*Magnesium 200-400 mg / day ) - Turmeric (2 tsp daily)
- Immune support/anti virals if applicable, e.g., L Lysine, olive leaf extract, elderberry, echinacea, vitamin C etc.
- Nervines e.g., passionflower, valerian (also analgesics) as a tea
1 cup 2 3 times daily and 30 min before bed; 0.25 2 g /150 ml water.
