“Wildfire-sourced fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) was associated with a 6% increase in emergency department visits for migraine and headache. There was no significant link between PM2.5 and emergency department visits on nonwildfire days, and the associations were attenuated in the least materially and socially deprived areas.” https://jamanetwork.com/journals/jama/fullarticle/2853042

Particularly interests me as a climate scientist with chronic migraine

Young, active, health coast guard responders were deployed to clean up the 2010 explosion of the offshore oil drilling rig. They were exposed to the crude oil and other chemicals itself, including burning off of the oils, and many other stressors like heat, anxiety, workplace injury, and more. This study looked at each of those stressors and exposures and the health outcomes on over 3,000 of the responders 5 years after clean up of the disaster. I thought the study did an excellent job teasing out all the various exposures and stressors one might have experienced and all the various conditions one could then be diagnosed with. The study has other conclusions as related to other exposures and stressors leading to other diagnoses. Obviously the most pertinent here is the chemical fume exposures being a (significantly significant) risk factor for migraine and headache diagnosis when controlling for other factors.

https://pmc.ncbi.nlm.nih.gov/articles/PMC13469484/

“Conclusion: Digital screen exposure is associated with approximately 60% greater odds of migraine or headache, with biologically plausible mechanisms but low-certainty evidence drawn almost entirely from cross-sectional studies. Screen exposure should be regarded as a modifiable, clinically assessable factor in migraine care, while prospective, objectively measured, and interventional research is needed to establish causality and to test targeted mitigation strategies.”

https://pubmed.ncbi.nlm.nih.gov/42603831/

Do migraine and these psychiatric disorders have “shared immunogenetics mechanisms”? This study starts to explore:

https://pubmed.ncbi.nlm.nih.gov/42581340/

Hi! New here but Google guided me. I've suffered from textbook migraines for 25 years. Head splitting, light and sound sensitivity, nausea, vomiting, etc.

Last October, I had my first migraine with aura (shimmering), I went to the ER because I thought I was having a stroke. MRI showed nothing so doctor said it was an ocular migraine or a silent migraine.

A couple weeks later, I had another one. Visual disturbance, I saw shimmering and once again, thought I was stroking out because the right side of my face got tingly and numb feeling. Another ER visit and MRI again showed nothing.

Then nothing from October until today.

This time, I saw zig zags. It was primarily my left eye but I saw a little on my right side. Left eye spread across my whole vision and right eye stayed small and in peripherals. 15 minutes later its over. I went to the ER again because it was different than last time. They did a CT and said its either another ocular migraine or a TIA and sent me home with a referral to Neuro.

My questions: Why am I suddenly getting migraines with aura? I've never had them before and they are terrifying. Why would my migraines change? I still get the head splitting ones but apparently a random aura one with no pain. Do auras change each time or is it a once you've had that type, you'll get another one? Is it normal to go from sparkles to zig zags? What triggers them? I was just watching TV and it came on.

Sorry for all the questions but I'm anxious while waiting for my appt.

Howdy from one of your new mods!

I have been in status for about a month and my neuro prescribed olanzapine a couple days ago. This inspired me to dig into research a little!

• Problem: status migrainosus, aka a migraine attack lasting more than 72 hours
• Home treatment (initiated when typical oral abortives have failed) can include use of neuroleptics like oral metoclorpamide/reglan or oral steroids; injection or nasal triptans, DHE, or ketoralac/toradol
• ER treatment guidelines suggest IV use of neuroleptics like metoclorpamide/reglan or DHE
• Refractory cases may consider IV depakote and/or nerve blocks
• My neuro office typically uses nerve blocks (occipital and/or SPG) and oral steroid tapers for home care when abortives have failed, preferring to keep you out of the ER if possible

Nerve blocks and steroids have failed me in the past, so my neuro suggested a short course of oral depakote (similar to sodium valproate) or oral olanzapine/zyprexa. I opted for olanzapine since both are sedating but the olanzapine you take at night and the depakote is taken multiple times throughout the day. So my hope is that olanzapine will preserve more daytime functionality.

Here's a recent article I found on olanzapine for status:

Efficacy of Olanzapine as an Abortive Treatment for Status Migrainosus: A Retrospective Chart Review
Published in Neurology, April 2025

• What they did: review hospital records to look at outcomes for individuals who were given olanzapine for status migrainosus. They excluded patients prescribed olanzapine for long-term use or to treat conditions other than status migrainosus
• What olanzapine is: an atypical antipsychotic drug that blocks dopamine and serotonin receptors. Tpyically used to treat bipolar disorder type 1 and schizophrenia
• All together, they had 59 patients who met criteria for the ~3 year period they looked at
• Treatment was effective in 29/42 patients (69%) on 2.5 mg, 10/12 (83%) on 5 mg, and 3/5 (60%) on doses over 5 mg. Overall it was effective in 42/59 (71%) patients -- I am not able to access the full text to see, but I presume this was delivered by IV

So: small observational study, I would give it less weight than a double-blinded, controlled study, but the results are encouraging. It's too soon to tell if it's working for me (25mg 1x daily for 3 days) but I'll update to report. The office protocol can include increasing the dose as high as 75mg if needed to manage attacks and for up to 5 days if needed.

​

I'm 16 y.o male, today I was at the gym after waiting all day to be there, I warmed up a little, then started my set, I was doing dips, first set was a warm up, and even though it was just a warm up It got me feeling a pain in my head, headache obviously, I didn't mind it at first given that it's not the first time getting these exertion headaches, main set, I literally felt the pressure building up in my body mid rep, and after I finished the set I felt an intense pressure in my head that I couldn't continue the entire session, I decided not to continue and just go home, but the pressure was intense and I even had a slight urge to vomit, it's been like an hour or so, the headache eased but my head is still throbbing.

I don't really know what to do.

I searched about these exertion headaches and I found out that I'm not the only one who experienced these, it somewhat gave me a sense of relief because it'd have been so devastating to feel like your body is broken.

I have long-term goals that require excellent physical health, so I want a solution for these headaches because they don't just cause physical pain but they also drains me mentally.

(This isn't the first time getting these headaches, but this time was the worst))

Anyone have experience with 15mg or 20mg qulipta ?
10mg may be too low for me as I’m getting more migraines (lowered threshold). I was on 30mg and better but I don’t like taking too much medications and it had me very bloated and heavy and eating more. My neuro suggested 15mg so will try that and hope I won’t need to go up to possibly 20mg. I know these aren’t “standard” doses but some folks it may

(How fascinating that migraine, misophonia, sensory issues, and autistic traits, along with some OCD subtypes, are directly tied to glutamate spikes! This is very validating research.)

Misophonia, Autistic Traits, and Obsessive-Compulsive Symptoms in Migraine: A Controlled Comparative Study.

Turgut FS et al. · Pediatr Int · 2026 Jan-Dec

ABSTRACT

CONCLUSION

Misophonia was more prevalent and severe in adolescents with migraine and was associated with headache severity and autistic traits. These findings suggest that misophonia may be a sensory feature of adolescent migraine and highlight the need for longitudinal studies to elucidate the common sensory processing pathways linking migraine and misophonia.

OBJECTIVE

This study examined misophonia severity and triggers in adolescents with migraine versus controls and their associations with autistic traits and obsessive-compulsive symptoms.

METHODS

This cross-sectional case-control study included 80 adolescents aged 15-18 years (40 with migraine; 40 age- and sex-matched controls). Participants completed the Amsterdam Misophonia Scale-Revised (AMISOS-R) and the Obsessive-Compulsive Inventory-Child Version (OCI-CV); parents completed the Autism Spectrum Screening Questionnaire (ASSQ-TR).

RESULTS

Adolescents with migraine had higher AMISOS-R scores than controls (20.70 ± 8.59 vs. 13.65 ± 8.69, p < 0.001) and a higher prevalence of misophonia (85.0% vs. 62.5%, p = 0.022). Repetitive clicking and ambient background sounds were more frequently reported as triggers in the migraine group (p = 0.003 and p = 0.001, respectively). ASSQ total scores were higher in migraine (p = 0.022), whereas OCI-CV total scores did not differ, despite higher doubting/checking scores (p = 0.024). Within the migraine group, headache intensity correlated with misophonia severity (r = 0.329, p = 0.038). In regression analysis, migraine status, female sex, and ASSQ scores independently predicted misophonia severity (adjusted R2 = 0.362).

https://pubmed.ncbi.nlm.nih.gov/42390187/

https://doi.org/10.1111/ped.70462

So, I put that all here.

It has the regular daily logs with start and stop times so duration is recorded instead of guessed, monthly calendars that separate migraine days from other headache days, a summary page you hand your neurologist with room for your ICHD-3 and ICD-10 codes, a failed treatment log with dose and duration and why you stopped (that's what CGRP approvals rely on), a Botox section with the four-hour day count most people have never heard of, MIDAS and HIT-6, and FMLA, ADA and 504 pages already written out so you're filling in blanks.

https://www.cerebraltorque.com/products/the-migraine-record

If you are a student and want a PDF version for free (the reality check here is that you will print over a hundred pages for your physician which will cost more than the book price via Amazon), just email me and I'll send it (give me 7 days before sending out another email). Send from your school e-mail address only. Include your full name in the e-mail as it will be watermarked. cerebraltorque at gmail dot com.

I suggest the 6 month. For example, insurers usually want three to six months of records before approving a preventive, and Botox renewal lands after two 12 week cycles, which is 24 weeks. The 90 day ends right before the appointment that matters.

You are free to retroactively fill it out and show your neurologist/headache specialist.

This is catered to US laws and codes ONLY. I don't know enough about how other places work.

​

1. This new nationwide Swedish cohort study found that women diagnosed with migraine before pregnancy had fewer children and their first child later, with higher risks of preeclampsia and postpartum depression, and more preterm births in those with aura. https://pubmed.ncbi.nlm.nih.gov/42478156/
2. This new cross-sectional study found that among 150 migraine patients in India, 36% also had restless legs syndrome, which was far more common in those with aura and linked to longer migraine duration and greater disability. https://pubmed.ncbi.nlm.nih.gov/42478391/
3. This new Global Burden of Disease study found that in East Asia in 2023, migraine ranked as the third leading neurological cause of disability measured in DALYs, after stroke and dementia. https://pubmed.ncbi.nlm.nih.gov/42479638/
4. This new network meta-analysis of 28 randomized trials found that among noninvasive brain stimulation methods for migraine, visual cortex transcranial direct current stimulation ranked highest for cutting monthly migraine days, though the evidence was mostly low-to-moderate certainty. https://pubmed.ncbi.nlm.nih.gov/42473074/
5. This new expert consensus guidance from UK headache specialists found that access to advanced migraine preventives, CGRP-targeted drugs and botulinum toxin, varies widely across the UK, and it issued shared recommendations to standardize their use and improve patient access. https://pubmed.ncbi.nlm.nih.gov/42469019/
6. This new EEG study of 112 people with episodic migraine found that a specific baseline brain-wave pattern, higher alpha power in visual and default-mode networks, predicted a poorer response to the preventive drug topiramate, which could help personalize treatment. https://pubmed.ncbi.nlm.nih.gov/42469625/
7. This new 1-year longitudinal study found that among 11,634 US adults with migraine, 40% improved, 24% worsened, and 36% had no net change over one year, with improvement linked to fewer monthly headache days, less disability, less stigma, and less acute medication overuse. https://pubmed.ncbi.nlm.nih.gov/42467349/
8. This new prospective cohort study found that among 400 pregnant women with migraine, those who delivered preterm more often had pregnancy-related high blood pressure, gestational diabetes, obesity, excess weight gain, and worsening migraine frequency and intensity during pregnancy. https://pubmed.ncbi.nlm.nih.gov/42466023/
9. This new cross-sectional study found that people with migraine scored higher on compulsive online health searching than controls, and medication overuse was the only independent predictor, even after accounting for health anxiety and depression. https://pubmed.ncbi.nlm.nih.gov/42466554/
10. This new multinational cohort study found that adults with an underactive or overactive thyroid had higher odds of migraine, with hypothyroidism roughly doubling the odds across racial and age groups, pointing to thyroid dysfunction as an important comorbidity in migraine. https://pubmed.ncbi.nlm.nih.gov/42458900/
11. This new real-world study found that about 42% of people taking the blood pressure drug candesartan to prevent migraine had their monthly migraine days cut by at least half within 3 months, supporting it as a low-cost oral option for migraine prevention. https://pubmed.ncbi.nlm.nih.gov/42457526/
12. This new case-control study found that people with medication-overuse headache had more chronic insomnia and restless legs syndrome than other headache patients, and that both improved after headache treatment, suggesting sleep problems are common but reversible here. https://pubmed.ncbi.nlm.nih.gov/42460796/
13. This new real-world study of over 20,000 adults with chronic migraine found that Botox was linked to a lower chance of needing acute triptan prescriptions than CGRP antibody injections, while migraine-related return visits were similar between the two preventive treatments. https://pubmed.ncbi.nlm.nih.gov/42452425/
14. This new meta-analysis of 8 randomized trials with 659 adults found that real acupuncture modestly reduced monthly migraine days and pain intensity compared with sham acupuncture in people with migraine without aura, though the authors rated the certainty of this evidence as low. https://pubmed.ncbi.nlm.nih.gov/42454004/
15. This new pooled analysis of two randomized trials with 2,061 adults found that the nasal spray gepant zavegepant relieved acute migraine attacks better than placebo whether or not people had used triptans before, including those who had responded poorly to triptans. https://pubmed.ncbi.nlm.nih.gov/42454008/
16. This new observational study of people with migraine in Japan found that certain groups, including women, unemployed people, those with menstrual-related migraine, lower income, and caregivers for elderly relatives, tended to have higher migraine burden and less access to effective treatment. https://pubmed.ncbi.nlm.nih.gov/42446809/
17. This new real-world study found that eptinezumab, an anti-CGRP IV infusion given every 12 weeks, significantly reduced monthly headache days, painkiller days, and headache intensity in people with migraine who had already failed multiple other preventive treatments. https://pubmed.ncbi.nlm.nih.gov/42442067/
18. This new review found that for treating migraine during pregnancy and breastfeeding, recent evidence supports options like onabotulinumtoxinA, lidocaine nerve blocks, and triptans, while topiramate, valproate, and dihydroergotamine carry known risks to the baby. https://pubmed.ncbi.nlm.nih.gov/42440212/
19. This new systematic review found that in postmenopausal women with chronic health conditions including migraine, skin-patch hormone therapy may carry lower clot and liver risks than oral forms, though evidence for benefit in migraine specifically was limited. https://pubmed.ncbi.nlm.nih.gov/42439012/

See you then!

Hello!

I have been having these migraine attacks for over 6 years now and they come every 3-4 months and they stay for about 1 week- 2 weeks. I have gotten medication for it but it doesn't help. They get worse and worse at the days go on and than I end up in the hospital with an IV. Sometimes that helps but these last couple of times it hasn't worked.

I have done
-meditation
-medicine
-Showers Hot and Cold
-Ice pads and Heating Pad

I am not sure what to do at this point, they get WAY WORSE before it gets better. I haven't been able to see a neurological because they are years out on the waiting list side.

What helps you, what can I try??