Hi Reader,
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Happy New Year to you all! I hope you had a wonderful holiday season and are ready for another great year ahead. This newsletter is all about vestibular migraine, so let's dive in. Here is what we will be discussing:

• 3 Migraine Updates you Want to Know About
• Updates to Migraine Medications in Canada
• Vestibular Migraine Workshop

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3 Migraine Updates you Want to Know About

In early October, I had the privilege of attending the Canadian Headache Conference, put on by the Canadain Headache Society. This conference was excellent, and provided a great update on the current research around migraine disorders, as well as a space for collaboration and growth in the medical community. There are three main highlights from that conference that stood out to me when it comes to helping those with vestibular migraine:

1. Gepants: These are a new classification of drugs that has a different action compared to traditional Triptans. What's really special about Gepants is that their mechanism of action allows them to work on acute migraines without causing a Medication Overuse Headache, and that they have the potential to actually prevent future migraines. This is a huge pro for Gepants, making this class of medication worth discussing with your MD.
2. Hypothalamus: More and more research is supporting the theory that the hypothalamus is the location first active in the brain at the start of a migraine attack. It is linked to Prodrome Symptoms (symtpoms that come on hours to days before a migraine attack) and include yawning, tiredness, mood changes, food cravings, and light/sound sensitivity. Recognizing these symptoms is key, as taking acute medication during this time stops a migraine attack for 50% of people!
3. Sensory Processing: Migraine is being recognized as a disorder of sensory processing. What does that mean? It means that people with migraine have a different response to sensory stimuli, such as light, sound and odor, than the average population. It also means that our sensory systems don't always communicate the same way as someone without a migriane would. This helps us understand interictal symptoms (symptoms between attacks), but also what is needed for a better migraine management beyond medication.

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Updates to Migraine Medication

The Canadian Headache Society released an updated Migriane Prevention Guidelines to help practitioners and patients understand the latest research for migraine treatment, especially around medication use. You can read the full guidelines or listen to a webinar discussing its implications. The below image is a great summary of the top migraine medications and their approval in different provinces across the country.

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What's Coming Up?

We are close to beginning the early-bird registration for the Vestibular Migraine Workshop! This is a live, 8-week virtual classes focused around vestibular migraine management, lifestyle changes and rehabilitation. But beyond the lessons, you will be in small groups and be able to connect with others on a similar path as yourself.

Join the waitlist to get first access to the workshop, along with a special early-bird rate!

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Thank you as always for being part of this amazing vestibular community!

Your vestibular physio,

~Cheryl