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Sensory sensitivity in Migraine

Timothy C. Hain, MD, Chicago IL. •Page last modified: March 10, 2018

Patients with migraine (defined as individuals who meet the IHS criteria for migraine) are commonly intolerant of higher levels sensory inputs, and report pain from intensity of input that normal subjects find "under the radar screen" (Aurora and Wilkinson, 2007). The dislike for these stimuli are often called "phobias" for fear of the sensory input, as shown below. They are distinct from having lower thresholds (meaning ability to detect smaller levels of the input).

While those with extreme sensory intolerances are generally considered just idiosyncratic migraines, one might also reasonably argue that these groups could be considered as separate subvariants of migraine (such as hemiplegic migraine), or perhaps they are just genetic variants that are grouped into the rather broadly drawn and inclusionary criteria for "migraine". If so, they might actually reflect a different biochemical and neurological wiring arrangement. In other words, perhaps we are dealing with a lot of different diseases, put by the lumpers of the International Headache Society into one big pot called migraine. This is a problem with "committee illnesses", such as migraine and psychiatric disorders.

Although some patients are very certain that sensory input trigger their migraines, the Neurology headache establishment does not appear as certain about this. Pelligrino et al (2017), in a meta-analysis, reported an immense number of potential triggers. Our take on this is that "primary headache disorder" are not really a disease at all, but just a collection of symptoms with many different genetic substrates.

Nevertheless, at least some of these patients are "hard wired" for enhanced sensation as some authors report larger volumes of sensory brain tissue (e.g. Kim et al, 2014).

Sense Threshold Discomfort Measure
Light Light sensitivity Photophobia  
Sound Hyperacusis Phonophobia LDL
Smell Smell sensitivity Osmophobia UPSIT
Weather Barosensitivity ? Barophobia ?  
Pain Allodynia    
Motion sensitivity   Motion sickness, kinesophobia Various questionnaires
visceral hypersensitivity food, medication sensitivity    

There are separate pages on these topics (see links above).

References:

 

Copyright March 10, 2018 , Timothy C. Hain, M.D. All rights reserved. Last saved on March 10, 2018