Would you have a private MRI for migraine?

[TarquinsTurnips]

Just that really. I've always been an adhoc sufferer but they are worse and longer now.

Why are they worse now? Why are they longer?

I don't need there to be anything wrong but I would rather know there isn't.

The thing is, whenever you have a test, be it academic, practical or medical, you are asking a question. What are you going to do with the answer?

It's not uncommon for tests, including imaging, to throw up findings that are not standard but not harmful. Sometimes they are called "incidentalomas". Then you are in the position of having to decide whether to have further investigations or consider interventions when they may not change the outcome or add value.

You might find it useful to write down what you are specifically worried about - I would definitely discuss it with your GP

No, MRI doesn't form part of the investigation or management of migraine.

If you want to spend money then see a neurologist privately, best money I ever spent.

It's also normal for migraine to have periods of time where you are having a lot of them, and periods of time when you are having less.

If you are having a lot right now then it could well be the weather. High barometric pressure such you get with thunder storms, or the current heatwave is a very very common trigger. I used to work with a lot of migraineurs and we'd all be off sick on the same days depending on the weather.

What would it show? I didn't think it would show electrical impulses or changes in them and you would need to be having one at the time to show that sort of thing anyway. I thought MRI only shows physical changes, unless you are worried about a brain tumour or something.

Migraine can be linked to hormonal changes, diet, specific foods (are you eating differently), stress or even changes in sleep pattern. And probably other things too!

from experience, if you have the kind of headaches that hospitals think warrant an MRI they will ensure you get one. (Chronic migraine with chronic cluster headaches) It is often done to rule out some of the very rare possibilities but certainly does not show what type of migraine you have. If Cluster Headaches are suspected it’s normally done to check it’s just cluster headaches and not something presenting like them.

If you are concerned call the Migraine Trust for support and signposting to where to access medical help if your GP is not migraine aware.

Hi Thanks so much for these replies - they are all very useful and considered. I'm glad I posted as this question might also help other people in the same quandary.

I think it's because migraines can feel so debilitating, it's easy to think well there must be something tremendously wrong. But totally take on board points above.

I will have a look at Migraine Trust as that sounds like a useful source of information, and mention the concerns I have to my GP.

I requested headache clinic review on NHS when I was getting more frequent and unusual migraines, and they did me an MRI. Worth asking your GP.

FWIW this has helped massively: www.torbayandsouthdevon.nhs.uk/uploads/25396.pdf

The Migraine Trust has a lot of very helpful information - I found really understanding migraine helped me a lot. There are a lot of lifestyle changes that genuinely help (although you can do nothing about the weather unfortunately). And there are so many preventative treatments now.

I have severe chronic migraine - now seen 2 headache neurologists and never got near a CT scanner, let alone an MRI. Now very happy on preventative treatment - have gone from 4 day migraines every week to a mild one once a month.

I’ve had one to rule out anything sinister, and the reassurance was worth it given how horrendous the symptoms.

An MRI will not help with the diagnosis or treatment of migraine though, sadly.

Medication can be life changing though so a private migraine specialist would absolutely be my recommendation.

I had an MRI (privately) when I started getting migraines with aura and vomiting with no previous history of them, and having had one occurence of transient global amnesia the neurologist wanted to rule out anything sinister like a tumour.
Luckily there was nothing sinister. He concluded that they were down to stress and the onset of the menopause causing hormone fluctuations.

Interesting.

I do think I need to get a box of 30 vitamin gummies for periods when I know it's a high stress month at work.

I take vitamin D and K2 spray every day, and eat plenty of nuts and oily fish, and have a B vitamin that I take when I'm due on. And have an Epsom salts bath every week and eat spinach every day for magnesium.

I’m in the US and have been seen at a specialist headache clinic and am now under the care of a neurologist. I take the newest meds available, which work like magic. I’ve been through most of the other medication options.

None of my doctors has ever advised me to have a brain MRI for my migraines. They are just classic migraines, so we moved straight from diagnosis to treatment.

They got worse in my 40s. I’m in my mid 50s now and I hardly get any since I’ve been on Qulipta.

Could I ask which preventative treatment you’re taking please? And if you don’t mind, whether there are any side effects?

I had a CT scan on the NHS for migraine (it didn’t show anything). I’ve also tried a huge list of different preventative treatments and tablets to take on the day before settling on ones that work for me. Every few years they become ineffective I have a review with my GP and change it up. Currently taking candesartan, almotriptan, domperidone but I tried so many different things before settling on this combination.

Have you asked you gp to refer you? Most hospital neurology departments have a headache clinic. Ask to be referred to that.

I had an MRI scan to make sure that my migraines weren’t actually a stroke - my migraines are horrendous, I lose my speech and sight. By pure coincidence I got a migraine when I was having the scan. I was ‘pleased’ as I thought it would show what was going on. It showed absolutely nothing! So unfortunately I don’t think an MRI will provide any of the answers you’re looking for. I was told I needed to see a neurologist to get to the bottom of my migraines. The wait to see a neurologist on the NHS is years so if you have money to spend, that’s where you could spend it.

I'm not a very good example as I went through all the treatments and am now on Aimovig - and yes there are side effects even with that.

Honestly there are many many treatments now and what suits one person probably won't suit another.
When I had amitriptylline I was basically semi-comatose for 2 days and then gave up. But my best friend thinks it's a life saver.
A GP friend described topiramate as something she wouldn't prescribe to her worst enemy - I thought it was awesome.
And my first neurologist had migraine himself and took massive doses of beta blockers. When I tried them I just fainted all the time.

It is trial and error honestly but the key is to be persistent and keep going back if your meds aren't working (you might just need a bigger dose) or don't suit you.

I wasted so many years just being ill to the point I was in massive trouble at work, and really unwell because I didn't keep pushing.

Consider the mind/body link and the causes of chronic pain being held in the nervous system. The Curable app, Howard Schubiner, Alan Gordon, Nicole Sachs etc will explain. There’s a few free podcasts amongst them. You might find there’s a non-medical and very cheap way to reduce or even eliminate migraines.

Magnesium glycinate every day - make sure you take the maximum dosage. You can find it on Amazon (not sure about H&B). It’s important it’s glycinate form. Give it a try. I had terrible weekly (at least) migraines for about 2 years. Since getting pregnant I had to find something other than triptans to deal with them. Since taking magnesium glycinate every day I have had such a big decrease in migraines. I can’t say for sure it’s not pregnancy hormones quite yet, as I haven’t given birth yet (39 weeks currently), but I have a strong feeling it’s the magnesium that’s helped. Anyway, it’s worth a try.

As for MRIs: I too felt so convinced something would show up on an MRI so had one done in my husband’s home country. But nothing physiological was detected. It does feel strange to have such debilitating pain that doesn’t have an obvious physiological cause.

Thank you so much for that advice. It’s really great to hear that the Aimovig is working so well for you. I’m considering Ajovy at the moment and just wondering about side effects.

I had no idea there were so many treatments. I feel like I just accepted the symptoms for so long!

Asides the pain, I can't process auditory sound, looking at screens (i.e. doing my day job) makes them worse, verbal communication (putting together coherent sentences, answering questions) is really difficult - prefer silence during an attack, all of which makes working difficult.

More recently the GP gave me naproxen after quite a lot of complaining.

I'm not sure I can have triptans which due to interaction risk another medication interaction.

Lots of things to look into here. Glad I posted. 😊

Does anyone find that when positive things happen it can bring on a migraine?

If I have good news or am excited about something....I can feel a warm rush at the back of my head, then boom comes the visual disturbance and thump thump headache.

I also once tried Indian head massage at the end of the treatment I was already in complete agony for 24 hours as it bought on a migraine 😬

I’m a GP and a migraineur and I wouldn’t pay for a private scan OP.

It probably IS just migraine maybe worsening with perimenopause or stress or weather issues or similar, however if things are getting worse I understand why you might want a brain scan to be sure there is nothing new/serious going on. Sometimes it helps my patients to have that done so they can set that worry aside and focus properly on how we are going to manage their migraines, and me as well (though it’s maybe 95 percent for their and 5 percent for my reassurance!). Then we can both be sure nothing is being missed and avoid an unnecessary neurology referral.

Locally at least as a GP I can refer patients directly for a brain CT on the NHS (though sadly not MRI which avoids the radiation from CT). It may vary in different areas but worth asking your GP about this whole issue for sure.

There are downsides to a scan, high radiation for a CT, but as already mentioned any scan can find things you’d maybe rather not know about which might never cause you any problems and just create unnecessary worry… such as some benign tumours, odd cysts etc. Also things like brain aneurysms etc. which again may never cause you any bother but now you know about it you have to decide if you want to have brain surgery to prevent the possibility of them bursting etc.

It does sound like your GP doesn’t have a lot of knowledge about migraine management, it is unfortunately not generally that well taught to us as doctors (and if you haven’t experienced them yourself I think there is a general attitude of “it’s just a headache” just like the rest of society), and most of my own knowledge comes from being a migraineur myself and having done my own research with a background of having a medical degree. Sounds like you may need to explore preventative options. So ask reception to find out which GP is confident in migraine management and ask to see that GP. And if not getting anywhere ask for a neurology referral and/or use your money to see someone from the Migraine Trust privately rather than spending that money on a scan.

PS I personally use high dose aspirin to terminate a migraine and it works well and is in the guidelines! 600-900mg. I personally swear by Anadin Extra which also have a bit of caffeine and a small amount of paracetamol. Triptans work for me but leave ne feeling absolutely wiped out like I’ve had the flu for a week!

@TarquinsTurnips don’t get it with positive things as such but a “relaxation migraine” is definitely a thing and I do get this when finally managing to switch off on holiday from my work stress etc.