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Triggers May Not Actually Provoke Migraine Study Suggest


Published online January 23 in Neurology, a study lead by Anders Hougaard, MD, from the Danish Headache Center, Copenhagen suggested that their results could have implications regarding advice given to patients about triggers. The  research suggests that this may be limiting people’s lives and causing them unnecessary stress in trying to avoid what they believe are triggers that may not be.

He states that patients still need to try to identify triggers but be sure of them before cutting them out of their lives.  He  advised allowing several exposures before you are sure it is a  trigger. Many people avoid  red wine, chocolate, cheese, coffee, exercise, and sunlight and it could not be necessary the study suggests.  Trigger are not a simple yes or no he said in and article by Med Scape News.  Factors may include stress, tiredness, hormone levels, etc.

Triggers may be confused with cravings or certain behaviors.  Dr. Hougaard states in an article by Med Scape News, “While we can’t extrapolate our results for sure to other triggers and to migraine without aura, I would think there is a strong possibly that the results would also apply to these too.”


Objective: It is well-known that migraine attacks can be precipitated by various stimuli. More than 50% of patients with migraine with aura (MA) know of at least one stimulus that always or often triggers their MA attacks. The objective of this study was to expose patients with MA to their self-reported trigger factors in order to assess the causal relation between trigger factors and attacks.

Methods: We recruited 27 patients with MA who reported that bright or flickering light or strenuous exercise would trigger their migraine attacks. The patients were experimentally provoked by different types of photo stimulation, strenuous exercise, or a combination of these 2 factors. During and following provocation, the patients would report any aura symptoms or other migraine-related symptoms.

Results: Of 27 provoked patients with MA, 3 (11%) reported attacks of MA following provocation. An additional 3 patients reported migraine without aura attacks. Following exercise, 4 out of 12 patients reported migraine, while no patients developed attacks following photo stimulation.

Conclusion: Experimental provocation using self-reported natural trigger factors causes MA only in a small subgroup of patients with MA. Prospective confirmation is important for future studies of migraine trigger factors and in the clinical management of patients with migraine.

Source: Various


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