For Henry Schipper, 49, of Venice, Calif., the first warning signs are mild and almost pleasant--a giddy light-headedness that evolves into what he describes as a "happy series of energetic moments." Then for about 15 minutes his eyes play tricks on him, and a wall of shimmering light obscures his field of vision. "There's no pain at that point," says Schipper, who produces documentaries for the History Channel. "But once the shimmer starts, the countdown begins."
If Schipper can't get to his medication quickly or if it doesn't kick in, he will experience a neurological event that 28 million Americans know all too well--the tidal wave of headaches known as a migraine. For Schipper the pain is sudden and sharp. "The front quarter of my head begins to pound and throb," he says. In extreme cases, he vomits violently every 20minutes. His senses of smell and hearing become agonizingly acute. "All I want to hear is gentle white noise at most and no movement, please. If there's a car alarm that goes off nearby, it's unbearable."
It was not that long ago that migraine sufferers like Schipper had no choice butto retreat to their darkened bedroom and wait, often for days, until the agony passed. Doctors could prescribe heavy-duty painkillers, but regular use often triggered even more painful episodes. Making matters worse, friends and co-workers tended to treat headache sufferers as the punch line of a bad joke, as if they were having headaches on purpose to avoid work or sex or some deeply repressed memory.
That bleak state of affairs is changing rapidly. Now physicians have at their disposal a growing arsenal of headache drugs--medications that can stop an accelerating migraine in its tracks, reduce the risk of recurrence or, in some cases, keep one from happening in the first place--but scientists are starting to uncover subtle defects in brain chemistry and electrophysiology that lead not just tomigraines but to all kinds of headaches. Indeed, many neurologists now believe that mostseverely disabling headaches are actually migraines in disguise and so are more likely to respond to migraine medications than to standard analgesics such asaspirin, ibuprofen or acetaminophen.
What it all adds up to is a revolutionary view of extreme headaches that treats them as serious, biologically based disorders on a par with epilepsy or Alzheimer's disease. "Before, patients got shipped around from doctor to doctor until eventually they wound up at a psychologist," says Dr. Joel Saper, director of the Michigan Head-Pain and Neurological Institute in Ann Arbor. Now their headaches are seen as the result of wayward circuits and molecules, not personality disorders.