Caffeine is a double-edged sword.

咖啡因是一把雙刃劍。

"The best way to cure a hangover is hangover food."

"治療宿醉的最好方法是宿醉食品"。

The best cure for a hangover is time.

治療宿醉的最好方法是時間。

Oh, boy. "Migraines can be cured."

哦，孩子。"偏頭痛是可以治癒的。"

Migraines cannot be cured.

偏頭痛是無法治癒的。

And I am sorry to deliver this news today.

我很遺憾今天要傳遞這個消息。

I'm Dr. Deena Kuruvilla.

我是Deena Kuruvilla醫生。

I'm a neurologist and a headache specialist

我是一名神經科醫生和頭痛專家

with the Westport Headache Institute

與西港頭痛研究所合作

in Westport, Connecticut.

在康涅狄格州的西港市。

Hi, I'm Dr. Cynthia Armand.

你好，我是辛西婭-阿曼德博士。

I'm a neurologist and headache specialist

我是一名神經科醫生和頭痛專家

at the Albert Einstein College of Medicine

在阿爾伯特-愛因斯坦醫學院的

and headache fellowship director

和頭疼的研究金主任

at the Montefiore Headache Center.

在蒙特菲奧裡頭痛中心。

And today we'll be debunking myths

而今天我們將揭開神話的面紗

about headaches and migraine.

關於頭痛和偏頭痛。

Ugh. "Migraines are just headaches."

唉。"偏頭痛只是頭疼。"

That is just the most aggravating myth that I've ever seen.

這只是我所見過的最令人沮喪的神話。

And I'm sure many of my patients will say the same thing.

而且我相信我的許多病人也會說同樣的話。

I 100% agree.

我100%同意。

A headache is a very nonspecific term

頭痛是一個非常不具體的術語

for having discomfort or pain in the head.

因為頭部有不適或疼痛。

Migraine is a neurological disorder

偏頭痛是一種神經系統疾病

that's not only headaches, but is associated with nausea,

那不僅是頭痛，而且還與噁心有關。

with vomiting, with sensitivity to light,

伴有嘔吐，對光線敏感。

with sensitivity to sound, and so many other symptoms.

對聲音敏感，還有許多其他症狀。

It's a disease. Just like asthma, just like diabetes.

這是一種疾病。就像哮喘，就像糖尿病。

But within migraine disease, there are migraine attacks,

但在偏頭痛疾病中，有偏頭痛發作。

and an individual can have many or very little of them.

而一個人可以擁有很多或很少的這些東西。

It's very important to know

瞭解這一點非常重要

the difference between headache and migraine,

頭痛和偏頭痛之間的區別。

because the treatments are different.

因為治療方法是不同的。

"A nap will cure your headache."

"打個盹就能治好你的頭疼。"

Armand: There really isn't evidence to show that a nap

阿曼德。真的沒有證據表明小睡一下

is helpful for managing a headache or a migraine.

對控制頭痛或偏頭痛有幫助。

Many of my patients tell me that they take medication

我的許多病人告訴我，他們服用的藥物

and then they go take a nap,

然後他們就去打盹了。

and by the time that they wake up,

而到了他們醒來的時候。

the headache or the migraine attack has gone.

頭痛或偏頭痛發作已經消失。

That creates a false sense of treatment.

這就造成了一種錯誤的治療感覺。

I've certainly found that sleeping too much

我當然發現，睡得太多

or sleeping too little is a big trigger

或睡得太少是一個很大的誘因

for patients with migraine.

為偏頭痛患者。

So I always counsel patients: Keep your sleep times,

所以我總是勸告病人。保持你的睡眠時間。

your wake times the same every day

每天的起床時間都一樣

so that you don't end up triggering a migraine.

以便你不會最終引發偏頭痛。

Instead of napping, and this depends on the person,

而不是打盹，這也取決於人。

you can start with medication

你可以先用藥物治療

that your doctor had prescribed to you,

你的醫生給你開的藥。

some mindfulness and meditation,

一些正念和冥想。

and making sure that you keep your schedule consistent.

並確保你的日程安排保持一致。

"Caffeine causes headaches."

"咖啡因導致頭痛"。

Caffeine is a double-edged sword.

咖啡因是一把雙刃劍。

Yes, caffeine can be a trigger to headaches,

是的，咖啡因可能是引發頭痛的因素。

but caffeine can also be helpful for headaches.

但咖啡因也可以對頭痛有幫助。

Have fun, drink your latte,

玩得開心，喝你的拿鐵。

but it's really important to recognize

但認識到這一點真的很重要

increasing the amount of caffeine you take in

增加你的咖啡因攝入量

can trigger more headache attacks or migraine attacks.

可引發更多的頭痛發作或偏頭痛發作。

And also, right after the period that you increase

而且，在你增加的時期之後，也是如此。

and you decide, "Oh, I'm gonna try and cut it down,"

而你決定，"哦，我要試著把它切下來，"

suddenly that abrupt withdrawal

忽然間，突然間退出

can also trigger a migraine attack or a headache.

也可能引發偏頭痛發作或頭痛。

Now, caffeine can also be useful in treating headaches

現在，咖啡因對治療頭痛也有幫助

or migraine attacks as well.

或偏頭痛發作也是如此。

Like Excedrin, that can have caffeine in it,

像Excedrin，那裡面可能有咖啡因。

which is Excedrin Migraine.

這就是Excedrin Migraine。

Kuruvilla: Just remember, you're adding

庫魯維拉。只需記住，你要加入

that caffeine from Excedrin Migraine

偏頭痛藥中的咖啡因

to the caffeine you're already taking.

到你已經在服用的咖啡因。

That could certainly produce a worsening of headaches.

這當然可能產生頭痛的惡化。

Just something to be cautious about.

只是需要謹慎對待的事情。

"Dehydration is the most common cause of headaches."

"脫水是導致頭痛的最常見原因"。

That is definitely not true.

這絕對不是真的。

Dehydration is not the most common cause

脫水不是最常見的原因

for headaches in general.

對於一般的頭痛。

The part that annoys me about this is "cause."

讓我惱火的部分是 "原因"。

What you just talked about are triggers, right?

你剛才談到的是觸發器，對嗎？

So triggers are certain circumstances or situations

是以，觸發器是某些情況或處境

that lower one's threshold to have a migraine attack

降低一個人偏頭痛發作的閾值

in someone who's already susceptible.

在一個已經易受影響的人身上。

Kuruvilla: While dehydration is a common trigger for folks,

庫魯維拉：雖然脫水是鄉親們常見的誘因。

there are so many different triggers

有這麼多不同的觸發因素

that have been reported by patients.

患者所報告的。

The most common ones I hear about are alcohol,

我聽到的最常見的是酒精。

too much caffeine or suddenly stopping caffeine,

過多的咖啡因或突然停用咖啡因。

not getting enough sleep, and stress.

沒有得到足夠的睡眠，以及壓力。

Armand: It's really important to keep

阿曼德。這真的很重要，要保持

a headache diary or a migraine diary,

頭痛日記或偏頭痛日記。

because that allows you to know more about your body,

因為這能讓你更瞭解自己的身體。

and that allows you to put tabs on triggers

並允許你把標籤放在觸發器上

and when attacks happen.

以及攻擊發生的時間。

And that helps you decide with your doctor

而這有助於你與醫生一起決定

what really is triggering you,

真正觸發你的是什麼。

because what triggers one person

因為是什麼觸發了一個人

may not trigger someone else.

可能不會引發其他人的注意。

Oh, boy. "Migraines can be cured."

哦，孩子。"偏頭痛是可以治癒的。"

Migraines cannot be cured.

偏頭痛是無法治癒的。

And I am sorry to deliver this news today.

我很遺憾今天要傳遞這個消息。

Essentially, migraine disease is managed.

基本上，偏頭痛疾病是可以控制的。

Migraine management consists of preventive treatments,

偏頭痛的管理包括預防性治療。

which may be a daily medication, a monthly injectable,

這可能是一種日常用藥，每月注射一次。

or a procedure or treatment with a device,

或用一個設備進行的程序或治療。

which is a very popular non-pharmacological option now.

這是一個現在非常流行的非藥物治療選擇。

We always recommend as-needed treatments

我們總是建議按需治療

to limit your disability with each individual attack.

以限制你的殘疾與每個人的攻擊。

And then we also talk about non-medication options.

然後我們也談一下非藥物治療的選擇。

We talk about meditation, mindfulness,

我們談論冥想、正念。

acupuncture, vitamins.

鍼灸，維生素。

There are so many options available now

現在有這麼多的選擇

that you can seek help to really get your life back.

你可以尋求幫助，以真正找回你的生活。

"The best way to cure a hangover is hangover food."

"治療宿醉的最好方法是宿醉食品"。

There's no cure for hangovers.

宿醉是無法治癒的。

The best cure for a hangover is time.

治療宿醉的最好方法是時間。

The duration really varies per person.

持續時間確實因人而異。

I've heard 24 to 72 hours.

我聽說是24到72小時。

That sounds like a really long time,

這聽起來是一個非常長的時間。

but everyone's body is different.

但每個人的身體是不同的。

Headaches are usually a symptom for hangovers

頭痛通常是宿醉的一個症狀

because of two things.

因為有兩件事。

The first thing is, we know alcohol to be a trigger

第一件事是，我們知道酒精是一個觸發器

for migraine attacks and headache in general.

用於偏頭痛發作和一般的頭痛。

The body actually releases histamine

身體實際上會釋放組胺

with alcohol intake in general,

與一般的酒精攝入量有關。

and that can certainly also cause a migraine attack.

而這當然也能引起偏頭痛發作。

And the other portion is the dehydration of the alcohol.

而另一部分是酒精的脫水作用。

Dehydration is a trigger for migraine attacks and headache.

脫水是偏頭痛發作和頭痛的一個誘因。

Kuruvilla: You could aggressively

庫魯維拉：你可以積極地

hydrate yourself with water,

用水為自己補充水分。

or you can receive fluids through an IV.

或者你可以通過靜脈注射接受液體。

You can take acetaminophen or an anti-nausea medication.

你可以服用對乙酰氨基酚或抗噁心的藥物。

These are all options that are out there

這些都是現有的選擇

to use before a night of drinking,

在晚上喝酒前使用。

but certainly not proven enough for that purpose.

但肯定沒有被證明足以達到這個目的。

"Taking Advil will always treat headaches and migraines."

"服用Advil總是可以治療頭痛和偏頭痛"。

Advil is an as-needed over-the-counter medication

Advil是一種按需使用的非處方藥。

which is meant to be used as-needed only

這意味著只在需要時使用

less than two days a week

每週少於兩天

and is not used as a preventive treatment.

並不作為一種預防性治療。

This is the bane of my existence,

這是我生存的禍根。

because when I see patients for the first time,

因為當我第一次見到病人的時候。

they're always on an over-the-counter

他們總是在服用非處方藥。

anti-inflammatory medication.

抗炎藥物。

What we call NSAIDs, the nonsteroidal anti-inflammatories.

我們稱之為NSAIDs，即非甾體類抗炎藥。

And these NSAIDs, like Advil,

還有這些非甾體抗炎藥，如Advil。

treat the inflammation portion.

治療發炎部分。

However, migraine involves all sorts of chemicals,

然而，偏頭痛涉及各種化學品。

and they wouldn't so respond

而他們不會如此迴應

to the over-the-counter anti-inflammatories.

到非處方藥的消炎藥。

If medications such as Advil are used more frequently,

如果更頻繁地使用Advil等藥物。

they can produce medication-overuse headache.

它們可以產生藥物過度使用的頭痛。

The newer term for it is medication-adaptation headache.

較新的說法是藥物適應性頭痛。

How I explain this is that

我如何解釋這個問題是

your body kind of gets used to it,

你的身體就會習慣它。

so you take more of the medication,

所以你要服用更多的藥物。

and you get more headache,

而且你會得到更多的頭疼。

and it's just this vicious cycle.

而這只是這種惡性循環。

If you find out that you're using your

如果你發現你在使用你的

as-needed medications like Advil too frequently,

過於頻繁地使用像Advil這樣的按需用藥。

please talk to your doctor about a preventive option

請與你的醫生討論預防方案

that will overall cut down on your headaches

這將全面減少你的頭疼

so you don't have to use so much as-needed medications.

所以你不必使用那麼多的按需用藥。

Ooh.

哦。

"All migraines are the same."

"所有的偏頭痛都是一樣的"。

No, not all migraine attacks are the same.

不，不是所有的偏頭痛發作都是一樣的。

Migraines come in all different flavors,

偏頭痛有各種不同的味道。

and we can differentiate them

而我們可以將它們區分開來

in terms of how often the migraine occurs,

在偏頭痛發生的頻率方面。

like chronic migraine versus episodic migraine.

如慢性偏頭痛與發作性偏頭痛。

So chronic means any attack that occurs 15 or more days,

是以，慢性意味著任何發生在15天或更長時間內的攻擊。

and then episodic means less than 15.

然後偶發的意思是小於15。

And then we can differentiate them

然後我們可以將它們區分開來

on the symptoms that individuals have.

在個人所具有的症狀上。

There can be something called hemiplegic migraine,

可以有一種叫做偏癱性偏頭痛的東西。

where individuals have weakness on one side.

其中個人有一側的弱點。

There can be migraine with and without aura.

可以有偏頭痛的先兆和無先兆。

And what aura is, is a transient neurologic symptom,

而先兆是什麼，是一種短暫的神經系統症狀。

which could be something that you see

這可能是你看到的東西

in your vision that comes along.

在你的視野中，出現了。

It could be numbness on one side of your body.

它可能是你身體一側的麻木。

It can be difficulty talking.

這可能是說話的困難。

And then there can be other specific ones

然後可以有其他具體的

like retinal migraine. That's specific to the eye.

如視網膜偏頭痛。那是針對眼睛的。

Kuruvilla: The different types of migraine

庫魯維拉：偏頭痛的不同類型

have different risks and different management patterns.

有不同的風險和不同的管理模式。

For example, people who have migraine with aura

例如，有先兆的偏頭痛患者

may be at a slightly higher risk of stroke.

可能會有稍高的中風風險。

There may be a specific treatment that works

可能有一種特定的治療方法是有效的

for that type of migraine.

對於這種類型的偏頭痛。

So for counseling purposes and treatment purposes,

所以出於諮詢和治療的目的。

we really need to know what type of migraine you have.

我們真的需要知道你有哪種類型的偏頭痛。

"Migraines and headaches only happen

"偏頭痛和頭疼只發生在

on one side of the head."

在頭部的一側。"

It's definitely false,

這絕對是假的。

but we always like a textbook definition of things.

但我們總是喜歡對事物進行教科書式的定義。

If we look up what migraine is,

如果我們查一下什麼是偏頭痛。

most commonly you'll find that it says

最常見的是，你會發現它說

it's one-sided throbbing headache

一面倒的頭疼

that has nausea, vomiting.

即有噁心、嘔吐。

But actually, again,

但實際上，再次。

every individual with migraine is different.

每個患有偏頭痛的人都是不同的。

Kuruvilla: Migraine pain can be in the forehead,

Kuruvilla：偏頭痛的疼痛可能在前額。

sides of the head, back of the head,

頭部兩側，後腦勺。

the face, the nose, and the neck.

臉部、鼻子和頸部。

Around 80% or more of patients with migraine

約有80%或更多的偏頭痛患者

also have neck pain.

也有頸部疼痛。

There are more rare headache disorders

有更多罕見的頭痛病症

that only occur on one side of the head.

只發生在頭部的一側。

Cluster headache happens

群集性頭痛的發生

on only one side of the head, classically.

只在頭部的一側，經典的。

So, the location of your pain

那麼，你疼痛的位置

doesn't necessarily pinpoint what your diagnosis is.

並不一定能確定你的診斷是什麼。

What I really find is it's a compilation of symptoms,

我真正發現的是它是一個症狀的彙編。

which is why I always talk about the diary.

這就是為什麼我總是談及日記。

"Having a headache means something is wrong with your body."

"有頭痛意味著你的身體出了問題。"

Oh, that's a very interesting question.

哦，這是個非常有趣的問題。

Having a headache doesn't necessarily mean

頭痛並不一定意味著

there's something wrong with your body.

你的身體出了問題。

Headaches can signal more dangerous things going on

頭痛可能預示著更危險的事情正在發生

in the brain, like a stroke, like a tumor,

在大腦中，像中風，像腫瘤。

like a tear within one of the arteries of the head or neck.

如頭部或頸部的一條動脈內的撕裂。

But there are everyday things that can cause headache.

但有些日常事務也會引起頭痛。

Ponytail headaches, for example, are very common.

例如，馬尾辮的頭痛是非常常見的。

You're tying your hair back in that really tight bun.

你把你的頭髮綁在那個非常緊的髮髻上。

Armand: Braids. Kuruvilla: Braids, yes!

阿曼德。辮子。庫魯維拉：辮子，是的!

Armand: Braids do the same thing.

阿曼德。辮子做同樣的事情。

Kuruvilla: Swim caps. There's ice cream headache,

庫魯維拉：游泳帽。有冰激凌頭疼。

where you eat that ice cream

你在哪裡吃冰激凌

and you notice that headache that comes on right away.

而且你注意到那種馬上就會出現的頭痛。

And that's because you're kind of

這是因為你是一種

stimulating the upper part of your palate

刺激你的上顎部分

with that cold temperature.

在這種寒冷的溫度下。

So, important to know the red flags

是以，瞭解紅旗的重要性

of when something may signal something more dangerous.

的東西可能是更危險的信號。

If you already have headaches or migraine disease,

如果你已經有頭痛或偏頭痛疾病。

you might want to pay attention to

你可能要注意的是

if there's a changing pattern,

如果有一個變化的模式。

if it's still responsive

如果它仍然有反應

to the usual treatments that you take,

對你所採取的常規治療。

if you are having extra symptoms added to the migraine

如果你在偏頭痛的基礎上又出現了額外的症狀

that you haven't had before.

你以前沒有過的。

Those are indications you need to see a provider

這些跡象表明你需要去看醫生

to make sure to do some sort of workup

以確保做一些工作檢查

for any other secondary cause.

為任何其他次要原因。

Ooh.

哦。

"Mental health has nothing to do with migraines."