Wednesday, September 5, 2012

Is it a Sjogren's Thing?

I brought this home as a souvenir from my urgent care visit the other day. Check out our clinic's version of a barf bag. 

Ooooo. And you can measure the barf and everything! As a nurse I think this is pretty spiff. As the one with it crammed into my face? Not so much...

Yesterday's migraine post elicited this comment by Annie:

.....I've recently been prescribed TOPOMAX for migraines, and I'm slowly increasing the dose as prescribed by my neurologist. I was having strange symptoms of near fainting and constant pain in the back of my head and neck. It could occur with some odors, sunlight or glare(fluorescent lights in doctors' offices) and I did not connect the dots until the doctor diagnosed me.
Is this a sjogren's thing?

"Is this a sjogren's thing?"

Ah. A question that I've been asking myself more and more these days as various strange physical ailments keep finding me.

About two years ago, I wrote a post entitled Sjogren's Syndrome and Headaches, and thought that a re-post of this entry was a good idea in answer to Annie's excellent question.

Check out the first paragraph in which I blithely comment that a recurrent headache "hasn't been a recurring issue.."for me.

Oh, brother.

It turns out that for some, yes, migraines ARE a Sjogren's thing. Here's the less-silly segments of my earlier post:

I was browsing some of the posts over at the Sjogren's World forums today, and noticed an interesting question. One of the readers had commented that she had frequent headaches and wondered if they could be related to Sjogren's syndrome or autoimmune disease. There were several responses by other sjoggies who agreed that frequent headaches were a problem for them. I hadn't considered this symptom in Sjogren's before since luckily for me, it hasn't been a recurring issue.

I did a literature search and was surprised to see that yes, indeed - headache in Sjogren's syndrome is a common symptom confirmed by several studies that looked at prevalence of headaches specifically related to Sjogren's syndrome. Headache is discussed in this very thorough article outlining neurological aspects of Sjogren's syndrome by by Stewart J. Tepper M.D.: "Headache can occur in Sjögren's, and in a study by Dr. Gibson in London, who looked at thirty-five patients with primary Sjögren's in his Sjögren's clinic, about forty-six percent (46%) met the International Headache Society classification criteria for migraine. It may be that the headaches are a manifestation of the Sjogren's."

Although several studies confirm the increased incidence of headache and migraines in Ss, it appears that the cause of the headaches can be varied. This study speculates that "The high prevalence of migraine in pSS patients might be explained by a vascular headache triggered by immuno-mediated disease activity without an obvious clinic or laboratory marker."

Another study, published in the Annal of Rheumatic Diseases, also showed a significant increase in prevalence of migraine and headache in patients with primary Sjogren's syndrome. The authors comment that causes could include stress and emotional upheavals that accompany the disease but also may be due to underlying disease processes similar to the headaches commonly associated with Lupus and other connective tissue disorders.

Other sources suggest that some headaches associated with Sjogren's syndrome may be the result of frequent sinus infections due to increased viscosity of mucous secretions.

Treatment of these headaches depend on underlying causes and severity of the pain, so talk to your doctor about treatment options for your headache.


cargillwitch said...

my own migraine pattern is undoubtedly due to hormonal fluctuations. I usually have one around day two of my cycle( lasting 24-36 hours) and over the passed two years often will get one day 12-14
( right as I would be ovulating). they are exacerbated by poor sleep, stress and too much caffeine and sugar . During these peak times I have to be diligent or I am in nauseating agony.

Michelle said...

I certainly have more headaches, but I wouldn't classify mine as migraines.

annie said...

Thank you Julia for doing so much research for me, and I will definitely read the articles to know more about headaches/migraines.

I never suffered from migraines until I got ill many years ago, and seeing that I had similar symptoms to those I have now, I presume migraines were the culprits all along, only now they've escalated to becomng more debilitating. Who knew pain in the back of the head, neck and along the shoulders was indicative of migraine...I just thought it was fibromyalgia or arthritic pain. Live and learn. Thanks again for all you do and keep well.

ShEiLa said...

Miss Julia...

I am not surprised with headaches & Sjogren's being related. I do know my Dad turned me onto something years ago... and I just didn't listen. However... I have been using it regularly since I can't use my muscle relaxers and drive... and Imitrex (Sumatriptan) is a no-no for me.

Pure Apple Cider Vinegar... 2 teaspoons in 1/2 cup of cold water at the onset of my migraine...Wow! It sure nips it in the bud. I know I am having neck issues and waiting for a cervical MRI... but the Apple Cider Vinegar is having a huge impact in my life right now. (A big Thank you to my DAD!) My sister Carma RN has been researching the benefits of this remedy and I guess there are other benefits as well.


Anonymous said...

Dear Julia,
I've suffered from migraines almost all of my life, but they have been much worse in the past year. I think the constant pain in the back of my neck and shoulders is exacerbating my migraines.
Another cause for continuous headaches could be that I have increased blood pressure from constant steroid use, while it helps inflammation, it can increase blood pressure and cause weight gain. I haven't been able to get off of steroids without causing a flare or ending up spending most of my days in bed. It's so frustrating! Arghhhhh!
Hope you are having a better day today!

Amy Junod said...

I've thought about my own experience with migraines since reading your post.
I too suffered for years before being diagnosed. Since being treated for Sjogren's the number of migraines have dropped significantly. I was also severely anemic back then. I can see both playing a roll in them.
Love the nifty pouch. Where were those years ago?
Hope you're feeling better!

Christine said...

I also have Sjogren's related migraines that just started about 6 months ago. They became very debilitating and Topamax has been a saving grace for me. I have had to work very hard on adjusting the dose to deal with the side effects of the med but it has been worth it.