Migraine.

[lobelsteve]

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https://forums.studentdoctor.net/threads/energy-vampires-and-garbage-bin-diagnoses.1499600/post-24430920

Odd that the Neuro forum has not had recent threads on the topic given the huge numbers of new meds.
Over in the pain forum, someone believes that migraines are not real. Hoping your HA guru folks might stop on by and throw down a little pathophysiology, Dx criteria, latest research/reviews.

 

[VA Hopeful Dr]

That's in the private pain forum, most people here won't be able to see it

 

[lobelsteve]

So are we saying migraines are a questionable entity? If so, I agree.

…you don’t think migraines are real?

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…you don’t think migraines are real?

I think it’s a an exaggerated, almost somatiform reaction to a cervicogenic HA.


Reactions:jsaul and SpineandWine

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lobelsteve​

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• I think it’s a an exaggerated, almost somatiform reaction to a cervicogenic HA.

  Time to go do cme.

 

[Thama]

It's almost a stereotype that you aren't allowed to be a neurologist if you don't get migraines, so it would need to be mass psychosis on the part of our entire specialty. (I don't get them, but I'm probably not a real neurologist anyway)

Given that we can observe cortical spreading depression on MRI, have described multiple concrete genotypes causing familial migraine syndromes, and a robust pipeline of very effective medications based on a biochemical understanding of migraine cascade, it seems more clear that migraine is a real organic disease than almost anything else your average pain doc sees regularly.

 

[dozitgetchahi]

It's almost a stereotype that you aren't allowed to be a neurologist if you don't get migraines, so it would need to be mass psychosis on the part of our entire specialty. (I don't get them, but I'm probably not a real neurologist anyway)

Given that we can observe cortical spreading depression on MRI, have described multiple concrete genotypes causing familial migraine syndromes, and a robust pipeline of very effective medications based on a biochemical understanding of migraine cascade, it seems more clear that migraine is a real organic disease than almost anything else your average pain doc sees regularly.

Rheumatology here. I don’t treat migraine, but I see a lot of people with nebulous pain symptoms/fibromyalgia etc and thus I hear about a LOT of migraine symptoms.

I think it’s a real thing, but overdiagnosed. It also seems to have a very big overlap with the CFS/fibro/IBS axis of symptoms, so I can totally see why people may look at it and think it’s not a separate issue with a biologic basis etc.

Much like RA or SLE, I think the people who have it *really* have it and benefit from the robust medications we now have to treat it. However, also like RA or SLE, I think a lot of people have been told they have it when they really don’t, and that also contributes to the perception that it’s bull****.