Migraine is generally defined as a severe headache, usually one-sided, that may be accompanied by nausea, vomiting, and visual or perceptual changes.

The symptoms vary greatly from one person to another, and there is considerable disagreement among doctors about what should or should not be described as migraine. This makes the design and interpretation of trials involving migraine especially difficult.

The most comprehensive and frequently quoted trial of migraine patients was carried out at Great Ormond Street Hospital for Sick Children in 1982-3. It involved 88 children with severe and frequent migraine, most of whom had other symptoms as well. Over two-thirds suffered from abdominal pain, diarrhoea and flatulence, and almost half showed disturbed behaviour, the majority being hyperkinetic. Aching limbs and runny or congested noses were also common, and some children also suffered epileptic fits, recurrent mouth ulcers, vaginal discharge, asthma or eczema. A few showed signs of permanent damage to the nervous system.

The majority of children with migraine do not show such a huge range of other symptoms, and in this sense the children studied were a ‘highly selected group’. Because Great Ormond Street is the major specialist centre for children’s diseases, their patients tend to be the most severely affected. This is the major criticism made of this study – that it is not generally applicable. Even so, it is of great interest, because of the high degree of response obtained.

The children were initially placed on a low-risk diet, consisting of one meat, one fruit, one vegetable and either rice or potatoes. Vitamin and calcium supplements were taken to compensate for any deficiencies in this diet. The children stayed on this diet for three to four weeks, and those that showed an improvement then began reintroducing other foods, one per week. Those who did not improve after four weeks were put on to another very simple diet, with a different selection of foods, to check whether they were sensitive to one of the components of the first diet.



Random Posts