Migraine Comorbidities: Cutaneous Allodynia
If you've ever cringed in pain at the idea of pulling back your hair, washing your hair and scalp or shaving during a migraine attack or at any other time, you may have been dealing with a condition called cutaneous allodynia.
Cutaneous allodynia is commonly associated with migraine disease. The term is basically a fancy way of describing pain on the skin or scalp that results from exposure to something that doesn't ordinarily cause pain.
According to a 2008 research survey conducted by the National Headache Foundation, among people with migraine, cutaneous allodynia is more common among women and those with more frequent headaches, higher body mass indexes and who are disabled or depressed. Whether these factors are causes or effects or simply correlations, we don't know at this time.
The appropriate treatment for someone living with cutaneous allodynia varies from patient to patient.
For those living with migraine and cutaneous allodynia who only experience cutaneous allodynia during migraine attacks, the evidence suggests many patients can successfully treat both issues with triptans.
As is true with treatment of migraine generally, taking a triptan as soon as possible once an attack is imminent is advised for those who also deal with cutaneous allodynia.
Unfortunately, for patients who experience cutaneous allodynia even when not having a migraine attack, triptans are much less likely to help treat it.
For those patients who cannot successfully or safely use triptans, COX inhibitors are considered a good option. COX inhibitors are a special type of NSAID that avoids the stomach issues commonly associated with frequent use or misuse of NSAIDs. At this time the only medication available on the market in the US in this category is Celebrex. Two others, Vioxx and Bextra, were removed from the market in the early 2000s. Additional COX inhibitors are currently being developed.
Researchers studying the relationship between cuttaneous allodynia and migraine have been able to learn some important things about the common processes that occur in the body with both conditions. Both seem to involve something known as central sensitization. This simply means that the body starts to treat being in pain as its normal, default state, rather than the state of not being in pain.
For those who live with cutaneous allodynia, what helps you cope?
Can you tell when a migraine attack is coming?