COVID-19 triggers migraine attacks

By Henrylito D. Tacio

Stress and anxiety induced by the coronavirus disease 2019 (COVID-19) have been found to trigger migraine attacks.

A social media analysis done by Novartis found that the stress and anxiety brought about by the COVID-19 pandemic have generated migraine attacks in patients all over the world.  The analysis took a closer look at 3,645 posts (in English), mostly on Twitter, from March 15 to April 15, 2020 that mentioned migraine.

The overlapping of migraine and COVID-19 symptoms – such as headache, nausea and vomiting – was the main stressor among migraine sufferers, the study showed.

“Due to these overlapping symptoms, migraine sufferers feared they had COVID-19, which triggered migraine attacks,” Novartis said in a press release.  “Limited access to clinic visits and migraine medications due to the coronavirus lockdown and fear of infection increased the risk of patients’ migraine to worsen, which further induced stress and anxiety.”

In the Philippines, around 12 million Filipinos suffer from migraine, the Global Burden of Disease Study 2016 showed.  This is alarming as suffering from migraine is no joke.

“Unfortunately, migraine is widely misunderstood and misconceptions abound,” Dr. Regina Macalintal-Canlas, president of the Philippine Headache Society, was quoted as saying.  “People living with migraine may experience a lack of empathy from employers and colleagues when frequent migraine attacks prevent them from delivering optimal work outputs.”

The Geneva-based World Health Organization (WHO) reports that in the United Kingdom alone, some 25 million working-or school-days are lost every year because of migraine.  Ninety percent of people report they cannot work or function with a migraine, according to Migraine Research Foundation.

The Journal of Headache and Pain singled out migraine as the third most common disease in the world – after dental caries and tension-type headache.  The estimated global prevalence is 14.7% – that’s around one in 7 people.

When migraines attack, it can be chilling.  “It’s very difficult to be a migraine sufferer,” admits television host and model Bianca Gonzalez.  “My worst migraine attacks last three days.  Whenever I had to host shows and events, there were bright lights and loud sounds, which are all migraine triggers.  I have to take a strong medicine and take a nap before showtime, so I could ease my migraine and be able to perform my role as host.”

Generally, migraine strikes women.  In fact, seventy percent of migraine sufferers are female.  In 2006, Janet Jackson cancelled a number of concerts due to migraine.  In her book, Coal Miner’s Daughter, Loretta Lynn wrote about her migraine attacks while on stage.

Other famous migraine sufferers are Carly Simon, Sharon Stone, Gwyneth Paltrow, Whoopi Goldberg, Lisa Kudrow, Virginia Woolf, Serena Williams, and Elizabeth Taylor.

Males, however, are not spared from migraine.  In his autobiography, This Is Me, Olympic gold medalist Ian Thorpe, admitted he has migraine.  British reality TV judge Simon Cowell is noted for having a migraine attack which caused him to miss five hours-worth of auditions from one of his TV shows.

The following famous men also suffer from migraine: Hugh Jackman, Ben Affleck, Elvis Presley, John F. Kennedy, Ulysses S. Grant, Charles Darwin, Thomas Jefferson, Miguel de Cervantes, Julius Caesar, and Sigmund Freud.

Migraine has been around for more than 2000 years.  Hippocrates, the father of medicine, was familiar with its symptoms.  However, it was Greek physician Galen who called it “hemicrania,” which, loosely translated, means half a head.

“It alludes to the fact that a migraine typically affects only one side of the head – usually around the eye – and caused by changes in the blood vessels,” Philip Goldberg and the Editors of Prevention Magazine wrote in Pain Remedies.

The pain may be accompanied by nausea and vomiting and preceded by an hour of more other symptoms, like numbness or weakness on one side of the body that marches up the arm, leg or face over the course of minutes.  Occasionally, speech may be impaired, and the attack may be disabling.

Sometimes, a migraine is preceded by an aura – visual distortions such as blurred vision and zigzagging lights.  This “announcement” of a migraine’s pending arrival is never welcome: It foretells incapacitating pain that can last anywhere from a few hours to several days.

The sad thing is that medical science doesn’t know what causes migraine until now.  “The exact cause of migraine is unknown, but an attack may be triggered by emotional factors, including excitement, tension, shock, physical exertion, a blow to the head, some foods, and some drugs,” says the Guide to Prescription and Over-the-Counter Drugs.

Some studies show that migraine can be hereditary.  Up to 90 percent of sufferers have a family history of the condition.  The father of Gonzalez, for instance, is also a migraine sufferer.  “If your parents are migraine sufferers, there’s a 75% chance you’ll acquire the disease,” Dr. Macalintal said.

Hormones may also play a major role.  Studies have shown that women are twice as likely to suffer from chronic migraines, and most of them get hit during their menstrual periods.  Other women develop migraine for the first time when they are pregnant.  Some are first affected after menopause.

There are some foods that can trigger attacks.  Pain Remedies enumerates the following common triggers that migraine sufferers must watch out for: tyramine (found in cheese, chicken livers, sour cream, and red wine), phenylethylamine (found mainly in chocolate), nitrates (added to meat as preservatives), lactose (found in milk and milk products), caffeine (found in coffee, tea, and some soft drinks), and aspartame (an artificial sweetener).

Most people require prescription medication to relieve migraines.  A doctor may prescribe either prophylactic (preventive) or abortive medication, depending on the frequency and severity of the attacks.

“Prophylactic drugs are taken on a daily basis, while abortive drugs are taken only when a migraine occurs,” says Dr. Jerome Goldstein, director of the San Francisco Headache Clinic.

“Migraine patients and their neurologists should discuss treatment goals, which should not be limited to stopping the headache attack but to prevent recurrence,” Dr. Macalintal stated.  “Newer treatment on preventive management addresses recurrence and other limitations of oral medications.” – ###

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