Migraine and Covid 2023
The frequency of stress has increased due to Covid, and the frequency of Migraine in particular has also increased.
This is an article by Britt Talley Daniel MD, member of the American Academy of Neurology, migraine textbook author, podcaster, YouTube video producer, and blogger.
The pandemic has increased the amount of stress in the population, causing fear and anxiety. In addition, there have been economic losses, job failures, increased decisions regarding children of school age for working parents, and innumerable other situations that have aggravated life in general or the basic status quo of all persons in the world.
The important statement is that the main trigger driving Migraine is stress, and the amount of stress has gone up.
Related questions.
Is there any documented data showing increased headache during Covid?
One study, utilizing the cell phone app called Migraine Buddy, compared instances of Migraine headaches between 2018, 2019, and 2020. This was a study in Australia which showed an increase in Migraine occurrence but a decrease in Migraine triggers.
The triggers they reported were stress, lack of sleep, neck pain, and anxiety. In this study headache frequency in 2018 was about 4.9 headache days per month, 5.2 in 2019 and 5.4 in 2020.
Analysis of the Migraine Buddy report found that 84% of migraineurs stated that the pandemic had reduced access to medication (16%), resulted in cancelled appointments (26%), caused trouble maintaining their Migraine diets (25%), and decreased access to health and emergency services (17%).
Does COVID-19 cause headache by itself?
COVID-19 can cause meningitis, encephalitis, and cerebral infarction and all of these conditions can cause headache. Particularly, meningitis and encephalitis are associated with headache. Meningitis means inflammation of the meninges which are the covering of the brain lobes. Encephalitis means inflammation of the brain structure itself.
What would the symptoms of Covid-19 headache be?
The type of headache with COVID-19 would be a nonspecific, likely generalized, moderately severe headache with nausea and confusion. These likely would not be typical Migraine headaches, which are generally one-sided, throbbing, and associated with sensitivity to light and sound.
What about a patient with Migraine who gets Covid-19?
It probably would be difficult for a physician seeing a Migraine patient with COVID-19 to separate a Migraine headache from a COVID-19 induced headache.
Is the frequency of headache with Covid-19 known?
The World Health Organization (WHO) released a report on COVID-19 cases in which they noted the symptoms that people experience. According to the report, close to 14% of people with COVID-19 experience headaches.
The other situation is headache is one of man’s most common symptoms and is the number one side effect from any medication.
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What has been the effect of COVID-19 on headache practices?
Dr. Merle Diamond from the Diamond Headache Center in Chicago stated, "We're working from home, and oftentimes that makes it harder to have an on-switch and an off-switch," she said. “The change in work can be triggering because migraineurs have very sensitized nervous systems that don't like change." “Nor are we getting up and moving, stretching, hydrating or sleeping as we should, which can all be significant triggers” Dr. Diamond said.
She's the daughter of Dr. Seymour Diamond, who was renowned for shattering common medical assumptions that migraines were psychosomatic, a sign of depression or just an excuse to avoid chores or work.
"Lack of activity makes migraine worse. Change of schedule makes migraine worse. Sleep has been impacted, which always makes migraine worse. And if you get dehydrated, that certainly doesn't help," Dr. Diamond said.
The following article revealed the “real-world” impact of the pandemic on Migraine patients.
Jasem Y, et al, wrote in J Headache Pain in 2020 Sep 24;21(1):115 on “Impact of coronavirus disease 2019 (COVID-19) pandemic on patients with migraine: a web-based survey study.”
Abstract
Background: Since the declaration COVID-19 as a pandemic, healthcare systems around the world have faced a huge challenge in managing patients with chronic diseases. Patients with migraine were specifically vulnerable to inadequate medical care. We aimed to investigate the "real-world" impact of COVID-19 pandemic on migraine patients, and to identify risk factors for poor outcome.
Methods: We administered an online, self-reported survey that included demographic, migraine-related, COVID-19-specific and overall psychosocial variables between July 15 and July 30, 2020. We recruited a sample of patients with migraine from headache clinic registry and via social media to complete an anonymous survey.
Outcomes included demographic variables, change in migraine frequency and severity during the lockdown period, communication with treating physician, compliance to migraine treatment, difficulty in getting medications, medication overuse, symptoms of anxiety and/or depression, sleep and eating habits disturbance, screen time exposure, work during pandemic, use of traditional medicine, effect of Botox injection cancellation, and overall worries and concerns during pandemic.
Results: A total of 1018 patients completed the survey. Of the respondents, 859 (84.3%) were females; 733 (71.9%) were aged 20 to 40 years, 630 (61.8%) were married, and 466 (45.7%) reported working during the pandemic.
In comparison to pre-pandemic period, 607 respondents (59.6%) reported increase in migraine frequency, 163 (16%) reported decrease in frequency, and 105 (10.3%) transformed to chronic migraine. Severity was reported to increase by 653 (64.1%) respondents. The majority of respondents; 626 (61.5%) did not communicate with their neurologists, 477 (46.9%) reported compliance to treatment, and 597 (58.7%) reported overuse of analgesics.
Botox injections cancellation had a negative impact on 150 respondents (66.1%) from those receiving it. Forty-one respondents (4%) were infected with COVID-19; 26 (63.4%) reported worsening of their headaches amid infection period. Sleep disturbance was reported by 794 (78.1%) of respondents, and 809 (79.5%) reported having symptoms of anxiety and/or depression.
Conclusions and relevance: COVID-19 pandemic had an overall negative impact on patients with migraine. Several risk factors for poor outcome were identified. Long-term strategies should be validated and implemented to deliver quality care for patients with migraine, with emphasis on psychosocial well-being.
What are the common features of Covid-19?
According to information from the Centers for Disease Control and Prevention (CDC), common distinguishable symptoms for COVID-19 can appear 2–14 days after exposure to the SARS-CoV-2 virus and include fever, a dry cough, and shortness of breath.
Many others also experience fatigue, along with symptoms similar to those of other respiratory conditions, such as:
sore throat
sputum production
runny nose
stuffy nose
aches and chills
nausea
vomiting
diarrhea
headache
The bottom line here is that any great illness impacting world life situations as strongly as COVID-19 is going to have a deleterious effect on persons with the sensitive brains of those with Migraine.
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All the best.
Britt Talley Daniel MD