Migraine

Dear All,

I had my PFO closed last July '07, and for 8 glorious months my migraines were absent. Last month (March) i had a terrible Migraine. The PFO was closed to improve my Migraines and to stop a heart murmur! Has anyone else had a PFO closed and how have you been please.

I have also started Acupuncture 5 weeks now, and so far so good! Not even a daily headache anymore! The trouble is i'm also taking Propanolol and a mega multivitamin with extra Magnesium! So for me all these combined treatments are working!! But which one do you think is doing the trick? The Pfo being closed definately helped for 8 months, but the Migraine I had in March was the worst ever!

Your thoughts would be very much appreciated.

Thanks

Diane

Hi Diane,

I'm in the States. I'm participating in a study to determine the effectiveness of PFO closure on migraine frequency/intensity. I'm in a double blind, though, and I am not sure yet if I have had a closure or not.

I know I had increased aura for two weeks after surgery. For three months I still had steady migraines, punctuated by very severe migraines, and about a month after that I would go through two weeks without migraine, a few days with, and a couple more weeks without. Unfortunately after that I took a downturn and had more frequent migraines and more severe migraines.

I also take Toprol for my migraines, and a multivitamin, but I can't take magnesium. It makes me sick.

As far as PFO closures go, I don't know if you've read any of the research papers on the results of some of the studies or not. PFO closures don't necessarily "cure" migraine. Many patients get more frequent and severe migraines after closure, some don't have any change, and some may have up to or more than a 40% reduction in frequency. It's very rare for someone to have complete resolution of migraine after closure.

PFO is considered an exacerbating factor in migraine (from discussions with my doctor--this isn't necessarily a viewpoint all doctors share), so his thought is that if you patch the PFO then your actual triggers will become more apparent and allow physicians to treat the disease more effectively. Whether unfiltered blood is a true migraine trigger for individuals with PFO is still under debate. But closing a PFO and removing a condition that aggravates the nerves in the brain or cuts off oxygen flow may give the brain more time to recover from relentless attacks, therefore dropping the severity or number of attacks, since the brain is elastic and "remembers" each attack, making it easier to trigger each time...The longer and more resistant the attacks are the harder they are to treat unless something can give you a break and give your brain time to recover.

I wish you the best of luck with your closure, it sure sounds like you've had great success with it and I hope it continues to be the case!

Hi Leeloo.

Thank you so much for your advice, when my Pfo was closed I had increased Aura. I didn't have any pain, but just the Aura's, but I was taking 75mg of Asprin everyday.

My Cardiologist Has said I must have faith, so thats what i'm trying to do. The main reason for my closure was a Heart Murmur and I had a test called "Bubble Test" which discovered the hole, 18mm, which is quite big.

I have been praying that this would be a cure, but I was never promised that, just wishful thinking on my part!!! My Migraines have improved somewhat as i used to have 2 to 3 a week and i can go as often as 2 to 3 weeks now and just recently 5 weeks. Please let me know if you have had it shut, when you find out. I didn't have the Starflex device but a device called the Amplazter, which is also made in America.

Anyway thank you again for your help, take care

Diane x

Hi Diane!

I took 325 mg of aspirin everyday for 90 days after the procedure, along with Plavix. The aspirin definitely did not help me though! All patients of the study receive the same medications whether they got the device or not, to also study placebo.

Did your doctors inform you that your murmur was a result of your PFO? My bubble test also revealed a large hole (though I am not sure how large because my results are barred from me until my year is up, I do know I was on the 4th and 5th tiers, too many bubbles to count on both tests, both on resting and valsalva), I had 2 TCDs and 2 echos, all with bubbles to confirm. The reason I ask you about the murmur is because they discovered that I also had a heart murmur as well, and I have known since I was about 14 that I had an irregular heartbeat. We have another member on the boards who is interested in this subject and has gone through conflicts with her cardiologists over whether the presence of a significant shunt can cause murmur or other problems. When I was able to see my records before they closed them to me, the papers indicated that my murmur was due to the size of the shunt.

I was shown the Amplatzer but if I received a device it would be the Premere which St. Jude is looking to have approved for PFO closure. It's shaped kind of like an X.

Any feedback you have on the heart issue would be greatly appreciated! Some of us are definitely looking for better answers to the shunt/murmur question.

Take care!

Hi Leeloo,

God this all sounds so similar! My murmur was to do with my PFO, and like you my shunt was a heavy shunt even on resting. When the PFO was shut i was put on warfarin similar to Plavix for 7 months it wasn't the best drug in the world. I used to get a lot of irregular heart beats and did after the closure, but since being on Propanolol it has calmed down alot.

I haven't had another Migraine since the one 5 weeks ago which is good, i'm hoping I go another 8 months as I did when the PFO was closed. My device was the same shape as an umbrella.

Another reason they decided that the PFO must be shut is because i have had two Pulmorary Embolism's in the past which they are now sure was caused by the PFO, unfiltered blood escaping etc.

I had my bubble test in May last year and was taken into hospital in July, I had to stay in for 5 days as they also put me on Heparin immediately after the procedure and because it was a drip, they would not let me home until my inr's were at least 2.5.

I am really interested now to see if yours was deffinately closed? I will await your posting in 4 months time?????

Take care and good luck,

Diane