Allodynia is common in migraine, but patients often don’t know how to talk to their doctors about treatment. Dr. Richard Lipton explains the condition and offers tips on finding effective treatments
Dr. Richard Lipton, Director of the Montefiore Headache Center, a Professor of Neurology at the Albert Einstein College of Medicine, and past-president of the American Headache Society recently received the 2017 Harold G. Wolff Lecture Award for his paper on the appearance of allodynia in relation to acute migraine treatment. He spoke with us about allodynia and migraine research, and how to talk to your doctor about treatment.
What is allodynia and how does it impact people in different ways?
Allodynia is the experience of ordinarily nonpainful stimuli as painful. So, during migraine attacks, people may report that taking a hot shower hurts on the side of their head, or putting their head on a pillow may be painful. Even the weight of an earring pulling down the ear can be painful, as can brushing your hair or wearing your hair back in a ponytail. So ordinary stimuli, ordinary life experiences that wouldn’t be painful outside the migraine attack, can be painful for up to two-thirds of people with migraine during attacks.
Do certain types of headaches make someone more likely to experience allodynia?
Allodynia is more common in migraine than in tension type headache. It is more common in people with relatively frequent headache, say 10 or 15 headache days a month, than people with less frequent headache.
What new information have you found in light of recent research that you can share with us about the condition?
One of the things we’ve learned is that allodynia predicts headache progression. So people who have allodynia are much more likely to make the transition from episodic migraine, with headaches less than 15 days a month, to chronic migraine with headaches 15 or more days a month. So it’s a predictor of pain progression.
The reason recognizing allodynia is helpful is if you’re a person who gets allodynia, it’s very important to treat early before allodynia develops. So, for an average person with episodic migraine who gets allodynia, it might develop an hour or two into the attack.