Some interesting newer studies:
1.A study of older(60+, average age 71) headache patients indicated that peripheral nerve blocks(mostly occipital nerve blocks, and some others) given weekly for 4 weeks works pretty well for the chronic migraine. We need studies on older age ranges; also, more discussion on treatment at age 65..versus 75…versus 85; our treatment differs for varying ages. At age 80+, there are increased risks with many medications; so, doing nerve blocks(with a “caine”: lidocaine etc…) is safer than many of the meds.
2. An interesting study concluded that emotional abuse, even MORE than physical/sexual abuse, is a major predictor of having migraines later on; many with various forms of abuse go on to suffer from chronic headaches, as well as: fibromylagia, anxiety and depression, chronic pelvic pain, TMD(jaw) disorders, and others. The abuse changes our developing serotonergic pathways in the central nervous system(brain and spinal cord)….this leads to an increased risk for “central sensitization syndromes”, like the ones I listed above.
3.A peds study indicated that commonly used pecs preventive meds for headache may not work all that well; however, another conflicting study indicated that some of these may work. It is VERY difficult to prove that meds in kids work well; this is due to the high placebo rates, among other issues. When a study has a high placebo rate(say, 50% responders), it is tough to prove that the “active” drug works so much better(by measuring “therapeutic gain”, or the difference between the active drug, and the placebo)…..Many kids do have migraine and also daily headaches, it is an enormous problem; lots of lost school time.
Another interesting kids study indicated that kids with migraine DO NOT have an increase in psychological issues, particularly anxiety/depression; this also conflicts with earlier studies that indicated an association between anxiety and/or depression, and frequent headaches in kids.