Image painted by Angela A Stanton, Ph.D. (me) and is the 2nd edition book cover. Copyright Angela A. Stanton 2017.

I recently received an email from a chiropractor requesting information about migraine. Here I post my latest response to him. I am sharing so you can see some misconceptions about migraine.

I hope to clarify what migraine is and what it isn’t. Unfortunately misdiagnoses are rampant in headache disorders. It seems that any pain in the head is considered a migraine. Not only is this incorrect, but it can be dangerous! There are many headache type disorders that can lead to serious consequences and these are often labeled as migraine, causing delay in important treatments.

The chiropractor asked why I am not discussing conditions, such as cervicogenic headache and neuroinflammatory headaches under migraine:

You are also asking about neuro inflammation and trigeminal pain, but neither of those is associated with migraine. As you also see, there is a large misdiagnosis “epidemic” of migraine. Doctors (and scientists) tend to associate everything that hurts in the head with migraine. 

But we must remember that migraine is not a headache and a large percent of migraines don’t have a headache component. So a headache is by no means a requirement and so we can’t define migraine as a “headache” or a “headache disorder” if it may not come with a headache. 

Furthermore, in terms of the headache part of migraine, if such exists, it is defined by me very narrowly to be the kind of headache that is very specifically associated with the region of the brain that is experiencing electrical problems. Any other form of pain, such as trigeminal, cervicogenic, occipital, or inflammatory are not considered migraine headaches by me at all. They each have their specific name and fall into general headache disorders. 

The one slight exception is that cervicogenic headache is often specific to migraineurs and it can lead to a migraine headache but the cervicogenic headache itself is not a migraine headache. Migraineurs have EDS (Ehlers-Danlos syndrome), most do and I find an over 70% overlap between the genes of EDS and migraine and EDS frequently leads to cervicogenic headaches. However, I have people who have cervicogenic pain and aren’t migraineurs, and migraineurs without cervicogenic issues. The two conditions aren’t “causal”, just associated. 

In summary: there is only one migraine. And that is defined as a genetic condition based on channelopathy. There may be various locations in the brain affected by channelopathy and the symptoms tell us where in the brain the migraine is. For example, for those slurring or unable to speak, the location is the Broca area; those with aura have a visualization of the CSD (Cortical Spreading Depression) by the occipital area, and those without aura don’t have the visualization of the CSD, but all migraines have CSD.  

My definition of what a migraine is doesn’t include a headache but if there is a headache, the following holds for migraine headache:

• unilateral 
• doesn’t move 
• doesn’t throb or pulse
• independent of positional changes, so pain intensity is unaffected by lying down or standing up or bending forward
• there is at least one prodrome
• there is at least one postdrome
• there is at least one symptom that is not a headache
• it lasts minimum 4 hours 
• it is not caused by something—like TBI, a cold, an accident, etc., can’t cause a migraine headache. Migraine headache is a primary headache that isn’t caused by anything other than an electrical signal issue. It is strictly caused by one thing: an electrolyte imbalance. 

Based on what I wrote, migraine can’t be treated successfully by chiropractic care because it has nothing to do with bones or connections of the bones, such as joints. The pain may be reduced temporarily by such manipulation but the migraine itself is unaffected because it is an electrical problem. 

If you want more information, read my recently published academic article on migraine: Specifically Formulated Ketogenic, Low Carbohydrate, and Carnivore Diets Can Prevent Migraine: A Perspective.

Comments are welcome, as always, and are approved based on approproateness.

Angela