Altered Brain Activity In Migraine And Relationship To Chronicity
Common structural areas and functional pathways between brain areas in migraine and mood and fatigue states, as well as aminergic neurotransmitter systems involving dopamine, serotonin, and noradrenaline, are therefore likely involved in the association between migraine and mood and fatigue states.
Emerging functional imaging work has suggested that longstanding and chronic disease in migraine can alter brain network function , and it is clear that these networks can be modulated by various means including medication overuse . Pain is a complex experience, and migraine clearly involves altered function in brain areas both within and external to regions of the pain network. Inherent to migraine as a disorder is the theory of thresholding and disordered sensory processing. Such brain alterations may be dynamic and therefore also susceptible to exogenous or endogenous triggering. Brain alterations may also become fixed with time and may be a cause or an effect of disease chronification. Chronic migraine studies have suggested fixed changes in brain structure with increased disease burden .
What Can I Do To Prevent Migraines
One of the best ways to prevent migraines is to try to avoid the things that might trigger your attacks. Most people benefit from trying to get stable sleep, eating regular meals, drinking plenty of fluids to keep hydrated, and trying to manage stress. Taking regular exercise may also help prevent migraines since it helps with breathing, improving blood sugar balance and maintaining general wellbeing. Although you should take care not to engage in very strenuous activity that your body is not used to as this can sometimes act as a migraine trigger.
Keeping a diary of your migraines can be a useful way to record when and where you experience attacks, check for any patterns, and try to identify your triggers. Take the diary when you see your GP so you can communicate your symptoms with them and they can find the best way to help you.
Is It Possible That I Have Pots And Was Incorrectly Diagnosed
This is entirely possible. Given how common POTS symptoms are and how unfamiliar many doctors are with this condition, diagnostic mishaps happen. POTS is frequently misidentified as chronic fatigue syndrome, fibromyalgia, myofascial pain syndrome, anxiety disorder, ADHD, irritable bowel syndrome, myositis, etc. It is also possible that you have both POTS and one of these conditions, which may complicate the diagnosis. Sometimes people with POTS are told that its all in your head, implying that the cause of their symptoms is psychological. If you feel like something is physically wrong, dont hesitate to seek a second, and even a third or fourth opinion.
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What Can You Do To Clear The Fog
There are a few things you can do to help clear brain fog.
First, be sure to get enough sleep. Seven to eight hours per night is ideal.
Second, make sure youre getting regular exercise. Exercise helps improve brain function and energy levels.
Third, eat a healthy diet rich in fruits, vegetables, and whole grains. These brain-healthy foods are rich in omega-three fatty acids, which help improve cognitive function.
Fourth, drink plenty of water. Dehydration can cause brain fog and fatigue.
Finally, try to reduce stress levels by practicing yoga or meditation. Stress can worsen brain fog and fatigue.
If youre still struggling with brain fog after trying these tips, be sure to speak with your doctor so that they can help you identify and treat the underlying causes of your brain fog.
What Steps Can I Take
Dr. Rosen says there are a number of steps you can take to try to keep headaches and excessive sleepiness at bay. Be sure to get enough sleep. Minimize your caffeine intake. Drink enough water and don’t skip meals. And be sure to get regular exercise. NINDS recommends not using over-the-counter headache medicine more than twice a week. Taking it more often can lead to a rebound headache.
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Other Reasons For Headaches And Tiredness
Headaches aren’t always to blame for tiredness. “Sometimes headache and fatigue may be symptoms of another condition,” says Noah Rosen, MD, director of the Northwell Health Headache Center in Great Neck, New York, and a specialist in neurology, psychiatry and pain management. “Often this may be a disorder of homeostasis â that is, of the natural balance.”
According to Dr. Rosen, other conditions that could cause both headaches and tiredness include:
- Snoring and obstructive sleep apnea
- Viral infections like mononucleosis
- Tick-borne illness, such as Lyme disease
People sometimes jump to the worst conclusion and suspect that a headache every day along with being tired might be a brain tumor, but Dr. Rosen says that’s usually not the case. “Fatigue itself would be a rare symptom of a brain tumor,” he explains, adding that it would be more concerning if someone were so sedated in sleep that it was very hard to rouse them.
A Vitamin Or Nutrient Deficiency
A vitamin deficiency, such as not getting enough vitamin D or vitamin B12, could cause you to feel severely tired, per the Cleveland Clinic. Dehydration can have the same effect.
You could also feel suddenly exhausted if you’ve recently started a high-protein diet. It’s not the protein itself making you tired, but the lack of carbohydrates. Severely restricting carbs causes your body to enter ketosis, where it breaks down fat for energy, per the Mayo Clinic. The side effects of ketosis include fatigue as well as headache, weakness and bad breath.
These side effects are usually temporary, but if ketosis is causing your sudden energy crash, you may want to add more fiber-rich, complex carbohydrates to your diet, such as fruits, vegetables and whole grains like oatmeal and brown rice. The Dietary Guidelines for Americans recommend carbs make up 45 to 65 percent of your total daily calories.
Similarly, skipping meals or following a very low-calorie diet could sap your energy. Keep in mind that people assigned female at birth should avoid eating fewer than 1,200 calories per day, and people assigned male at birth should eat at least 1,500 calories per day, according to Harvard Health Publishing.
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Fatigue And Arousal In Migraine
Fatigue is a vague and multifactorial symptom, which is clearly influenced by sleep and arousal, systemic health, mood, and other exogenous factors including medications. While sleepiness and fatigue are different, there is clearly an interaction between them and a general difficulty among patients distinguishing the two. To our knowledge, the two separate issues or the distinction between them has not been studied in migraine studies. While it has been historically recognized that fatigue is a dominant feature of migraine , more recently, associations with sleep disorders and shared physiological mechanisms with sleep pathways have been recognized . In addition, sleep disruption is a commonly reported migraine trigger among sufferers .
In general, it is estimated that approximately 60% of migraineurs report pathologic fatigue, based on several questionnaires including the Karolinska Sleepiness Scale, the Insomnia Severity Index, and the Fatigue Severity Scale . Interestingly, emerging work using the novel CGRP pathway antibodies has suggested a beneficial impact on symptoms including fatigue and concentration on non-headache days and therefore improved function .
Excessive Daytime Sleepiness Sleep Duration And Poor Sleep Quality Assessment
We used the Epworth Sleepiness Scale for assessing participants daytime sleepiness. The total ESS score ranged from 0 to 24. If a participant scored more than or equal to 11 on the ESS, they were classified as having EDS. The ESS has been previously validated in the Korean language . The Korean version of the ESS has been reported to have good internal consistency and test-retest reliability
We assessed the weekday and weekend sleep durations of participants. Average sleep duration was defined as /7. Short sleep duration was defined as average sleep duration of less than 6 h and poor sleep quality was defined as a Pittsburgh Sleep Quality Index score of more than 5.
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The Relationship Between Fatigue And Headaches
It’s also common for people who get frequent headaches. As researchers have looked into the connection between fatigue and headaches, they’ve uncovered a definite relationship.
One study found fatigue in 70% of people with headaches, and another study found fatigue in 84% of those with chronic migraine.
People with chronic fatigue syndrome, a medical condition characterized by fatigue lasting at least six months plus flu-like symptoms and cognitive dysfunction, also have a higher prevalence of migraine, with and without aura.
The Postdrome: Migraine’s Silent Sister
Last week I had a migraine. To some that won’t mean much, but fellow sufferers will know that it means hours, or even days, of nausea, light sensitivity, sound sensitivity, and crushing, pulsing pain. The kind of pain that makes you think that self- trepanation with the rusty drill from the understairs cupboard might be a viable option. Eventually – minutes, hours, or days, later – the pain subsides. For me the days following a migraine are filled with a mixture of relief and mental exhaustion. My head is sore and my brain is tired.
It feels kind of like a mental hangover – like being drugged. Sometimes the migraine lasts for days and when it finishes I want to make up for lost time. I want to function. And somehow somehow I just can’t. For a day or more after a severe migraine, I feel like I’m working through a mental fog, one so heavy that even routine tasks take on an otherworldly quality.
What is this feeling AFTER the pain? I knew I would face skepticism at best and outright disbelief at worst when I talked to people about it. And I even began to doubt myself. Maybe I was just tired? Finally I decided to look for a study. Is this real, or am I just imagining things?
Scicurious has a PhD in Physiology and is a postdoctoral researcher. Her work has appeared in three years of The Open Laboratory: the Best of Science Blogging , and on the Scientific American Guest Blog. She blogs at Neurotic Physiology
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Tips For Relieving Fatigue
There are also a lot of strategies to relieve fatigue, and remember that one method may work for you but may not be as effective as another, but here are some of the most common ones that are deemed to be efficient:
- Drink plenty of fluids, especially water
- Get enough sleep every night and take short naps throughout the day if needed
- Restrict your physical activity and allow your body to recover
- Eat a balanced diet with plenty of fruits and vegetables
- Avoid caffeine and alcohol
- Take supplements such as iron or magnesium if you are
Both brain fog and fatigue can be debilitating conditions that affect your daily life. However, by knowing what they are and the most common causes, you can take steps to alleviate these symptoms and improve your quality of life.
Vertigo Or Double Vision
One type of migraine, also called a basilar migraine, causes brainstem aura symptoms, per StatPearls. The brainstem is the lower part of your brain that connects the brain to the spinal cord. These migraines come with symptoms that are typically more severe and last longer.
The brainstem-related symptoms include vertigo and double vision, slurred speech, tinnitus, lack of coordination, and confusion. Some may experience a loss of consciousness.
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How Is A Pots Diagnosis Made
Problems with the autonomic nervous system can be difficult to diagnose. The standard test for POTS is the tilt table test. During the test, you are secured to a table that tilts from being horizontal to almost a 90-degree angle. The test measures your hearts response to switching from laying down to standing up. Some people with POTS faint during this test, even if they rarely faint standing up.
Although the test seems straightforward, many things can interfere with it. Its important that a POTS specialist oversees it. Its best to work with a doctor who has diagnosed and treated patients with POTS. This could be a cardiologist, a neuromuscular specialist or another doctor.
Six Warning Signs Of A Migraine Headache
Migraine headaches have multiple phases and understanding each phase in more detail can help migraine sufferers manage this condition. It is common for people who suffer from frequent migraines to experience warning signs before the migraines begin. These warning signs are also known as the premonitory phase or prodrome phase, which marks the beginning of a migraine attack. A research study completed by the American Headache Society determined that about 32% of people with migraines experience a prodrome. This phase begins 60 minutes to six hours before a migraine attack, and can last several hours or may even occur over several days and can present numerous symptoms. These symptoms can include irritability, concentration problems, food cravings, sensitivity to bright lights and nausea, among many other warning signs listed by the American Migraine Foundation. Research shows early identification of migraine prodrome symptoms can help signs in a timely manner, the more effective. Here are six common migraine warning signs or prodromes:
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Heart Disease And Fatigue
Symptoms: Fatigue from an activity that should be easy
If youre exhausted after an activity that used to be easy — for example, walking up the steps — it may be time to talk to your doctor about the possibility of heart disease. Heart disease is the leading cause of death in women. If your fatigue is related to your heart, medication or treatments can usually help correct the problem, cut the fatigue, and restore your energy.
Coping Strategies To Ward Off Migraine Fatigue
Researchers believe the fatigue that often accompanies migraine is not because of the toll pain takes on us. Rather, the evidence points to fatigue being part of migraine pathophysiology, which is defined as the functional bodily changes produced by the disease. Include fatigue symptoms in your migraine diary, and mention them to your health care providers. There may be help available that youre not aware of.
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Which Migraine Treatment Works Best
There is no surefire solution to treat migraine pain. Instead, a patient may require a combination of treatments to address his or her migraine symptoms.
Generally, an individual who is dealing with migraine pain can consult with a doctor. At this time, a doctor may provide a migraine diagnosis, as well as offer medications and other treatments.
If a patients migraine symptoms linger, a neurological consultation may be required. By meeting with a neurologist, an individual can take additional steps to treat his or her migraine symptoms. This individual may also receive a chronic migraine diagnosis.
If a patient receives a chronic migraine diagnosis but finds that his or her migraine medications are ineffective or cause intolerable side effects, Dr. Cabin can help. Dr. Cabin works closely with chronic migraine patients to identify the underlying cause of migraine pain. Then, Dr. Cabin crafts a personalized chronic migraine treatment plan designed to deliver long-lasting pain relief.
Migraine Fatigue: Its Beyond Feeling Tired
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Migraine attacks come with a plethora of symptoms and side effects. These can be from both the migraine itself or even our self-care measures like the abortive medications we use to help ease an attack. The one thing that holds true about migraine fatigue for me is that it is way beyond just being tired. Many people experience fatigue as part of other conditions and situations in their life. Lack of sleep, heavy exertion, and jet lag are three common factors that can cause fatigue. For a migraine sufferer, though, fatigue takes on a whole new aspect during an attack.
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Rheumatoid Arthritis And Fatigue
Symptoms: Fatigue, morning stiffness, joint pain, inflamed joints
Rheumatoid arthritis , a type of inflammatory arthritis, is another cause of excessive fatigue. Because joint damage can result in disability, early and aggressive treatment is the best approach for rheumatoid arthritis.
Medications that may be used early in mild RA include:
- Nonsteroidal anti-inflammatory drugs
- Disease-modifying antirheumatic drugs
Other drugs used in more serious forms of RA include the anti-cytokine therapies , as well as shots and other forms of treatment.
Other autoimmune disorders, such as lupus and Sjogren’s disease, may also cause fatigue.
Fatigue During Prodrome And Postdrome
As part of a migraine cycle, I almost always experience extreme fatigue symptoms. It presents itself like an energy-sucking beast that just wont let go. It seems as if my knuckles are dragging on the floor and the total body exhaustion keeps me from anything close to normal functioning. I often feel the effects of fatigue in the prodrome and postdrome phases of an attack. I guess I dont notice it as much during the aura or pain phase of an attack because I am preoccupied with other aspects of the event. During an attack, it is hard for me to stay focused on more than one main thing at a time, and most of my concentration gets thrown into my self-care routine and getting the medication I need to help ease the attack.
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