What Is Migraine?
There are several different types of headaches, including tension and cluster headaches, and migraines. A migraine is a throbbing, intensely painful headache, usually beginning on one side of the head. It is sometimes preceded by distinct early warning symptoms, collectively called an aura. Pain may range from mild to incapacitating and can last for hours to days. The frequency of episodes may vary from several times a week to once every few years.
Migraines afflict about 10 percent of the population, usually first appearing during childhood or adolescence, and are more common among women than men. In some women, migraines can be more likely to occur just before or during the menstrual cycle. The pain of a migraine usually moderates with age, but auras often continue to occur and may be confused with transient ischemic attack (TIA) or stroke. There is no cure, but symptoms can be prevented or controlled with proper treatment.
Who Gets Migraine?
Nearly 25 million American suffer from migraines annually. Migraines are intense and throbbing, typically affecting one side of the head and accompanied by nausea or vomiting, sensitivity to light or sound, and visual disturbances. Both children and adults can develop headaches, including migraine. According to the Migraine Research Foundation, an estimated 10 percent of school children experience migraine. However, headaches and migraines are more common among women and may be associated with hormonal fluctuations.
- Severe, throbbing pain, usually beginning on one side of the head, lasting a few hours up to two days.
- Nausea and vomiting.
- Sensitivity or aversion to light.
- Early warning symptoms (aura): temporary blind spots or blindness and other visual disturbances, such as seeing patterns of flashing lights; dizziness; numbness on one side of the face; weakness of an arm or leg; fatigue and listlessness.
The cause of migraines is unknown. One theory holds that abnormal constriction followed by
dilation of arteries supplying the brain and scalp may be involved. Another possibility is a shift in the brain’s electrical activity that triggers pain. Risk factors for headache and migraine include:
- Family history
- Stress, anxiety
- Caffeine withdrawal
- Skipping meals and diet. Nitrites found in bacon and cured meats, and, possibly, foods containing the chemical tyramine like pepperoni, red wine, chicken livers, active yeast preparations, and cheddar and other aged cheeses, may trigger an attack. Chocolate and dried fruit have also been linked.
- Inadequate sleep
- Hormone fluctuations including the menstrual cycle and oral contraceptive use
- Vasodilating drugs or consuming alcohol which dilates blood vessels
- Sensitivity to bright lights or viewing certain visual patterns.
- Environmental triggers, such as changes in barometric pressure, altitude or high winds.
Although lifestyle and environment may trigger migraines, researchers believe migraine may be due to genetic changes in the brain that have led to neurological abnormalities.
What If You Do Nothing?
Headaches and migraine can be treated at home, and tend to resolve on their own, usually within 24 to 72 hours. If migraines recur regularly, consult a doctor about possible treatments.
- A physical examination and medical history is conducted by a doctor. The doctor will be ask about lifestyle, diet, medications and other conditions.
- Brain imaging tests, usually a computed tomography scan or magnetic resonance imaging scan, are not necessary unless apparent migraine coexists with seizures, stroke, or vision problems upon neurological exam.
According to the National Institute of Neurological Disorders and Stroke, drugs including antidepressants and those developed to treat epilepsy and high blood pressure have demonstrated promise in treating migraine. Other treatments include:
- Keep a diary. Record daily activities, changes in diet, sleep habits, and other exposures to identify and limit triggers.
- Lie down in a dark, quiet room.
- Apply an ice pack on the forehead to ease symptoms.
- Over-the-counter pain relievers such as acetaminophen, ibuprofen or aspirin for adults may help ease symptoms for a mild migraine attack.
- Prescription medications are available that can abort the symptoms of a migraine. They include sumatriptan (Imitrex) and other triptans, which act to constrict blood vessels in the brain. These drugs come in tablet form and some are available as an injection or nasal spray. DHE (Migranal) is another type of drug specifically used to treat acute migraine.
- Some research suggests that acupuncture performed by a trained specialist may help minimize the severity and frequency of migraine.
- Stress management techniques or biofeedback may be advised if stress is a trigger.
- Scientists are looking at new ways to prevent and interrupt migraine attacks, and are investigating specific nutrients associated with nerve function including magnesium, coenzyme Q10, vitamin B12, and riboflavin. Researchers are also studying potassium ion channels, which help with nerve cell function. There is also interest in the effects of the herbal remedies fever-few and butterbur.
Knowing what triggers headache and migraine is the best way to prevent them. Following a healthy lifestyle that includes a balanced diet, exercise, and plenty of sleep and relaxation may also reduce headaches and migraine.
- Reduce stress and allow time for relaxation and recreation.
- Keep a daily record of food and drink intake—and of migraine headaches—to help identify possible triggers for migraines, and then avoid any suspected triggers.
- Avoid oversleeping, which may lead to a migraine.
- Several types of prescription medications are used to help prevent migraine. These include beta-blockers, calcium channel blockers, antidepressants, and anticonvulsants.
- Botulinum toxin A or “Botox” has been approved by the U.S. Food and Drug Administration to help prevent migraines in those who are affected by migraine more than 15 days each month.
When To Call A Doctor
Call a doctor if headaches are severe, frequent, or persist for more than 24 hours, if there is a change in the pattern of your headaches, or if you experience speech difficulty, weakness, or double vision.
Reviewed by Joseph V. Campellone, M.D., Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network.