Migraines are recurring attacks of moderate to severe pain. The pain is throbbing or pulsing, and is often on one side of the head. During migraines, people are very sensitive to light and sound. They may also become nauseated and vomit.
Migraine is three times more common in women than in men. Some people can tell when they are about to have a migraine because they see flashing lights or zigzag lines or they temporarily lose their vision.
Many things can trigger a migraine. These include
- Anxiety
- Stress
- Lack of food or sleep
- Exposure to light
- Hormonal changes (in women)
Doctors used to believe migraines were linked to the opening and narrowing of blood vessels in the head. Now they believe the cause is related to genes that control the activity of some brain cells. Medicines can help prevent migraine attacks or help relieve symptoms of attacks when they happen. For many people, treatments to relieve stress can also help.
Causes
A migraine headache is caused by abnormal brain activity. This activity can be triggered by many things. But the exact chain of events remains unclear. Most medical experts believe the attack begins in the brain and involves nerve pathways and chemicals. The changes affect blood flow in the brain and surrounding tissues.
Migraine headaches tend to first appear between the ages of 10 and 45. Sometimes, they begin later in life. Migraines may run in families. Migraines occur more often in women than men. Some women, but not all, have fewer migraines when they are pregnant.
Migraine attacks may be triggered by any of the following:
- Caffeine withdrawal
- Changes in hormone levels during a woman’s menstrual cycle or with the use of birth control pills
- Changes in sleep patterns
- Drinking alcohol
- Exercise or other physical stress
- Loud noises or bright lights
- Missed meals
- Odors or perfumes
- Smoking or exposure to smoke
- Stress and anxiety
Migraines can also be triggered by certain foods. Most common are:
- Baked goods
- Chocolate
- Dairy foods
- Foods with monosodium glutamate (MSG)
- Foods with tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and certain beans
- Fruits (avocado, banana, citrus fruit)
- Meats containing nitrates (bacon, hot dogs, salami, cured meats)
- Onions
- Peanuts and other nuts and seeds
- Processed, fermented, pickled, or marinated foods
True migraine headaches are not a result of a brain tumor or other serious medical problem. Only a health care provider who specializes in headaches can determine if your symptoms are due to a migraine or other condition.
Symtoms
There are two common types of migraines:
- Migraine with aura
- Migraine without aura
An aura is a group of nervous system (neurologic) symptoms. These symptoms are considered a warning sign that a migraine is coming. Most often the vision is affected and can include any or all of the following:
- Temporary blind spots or colored spots
- Blurred vision
- Eye pain
- Seeing stars, zigzag lines, or flashing lights
- Tunnel vision (only able to see objects close to the center of the field of view)
Other nervous system symptoms include yawning, difficulty concentrating, nausea, trouble finding the right words, dizziness, weakness, numbness and tingling.
An aura often occurs 10 to 15 minutes before the headache, but can occur just a few minutes to 24 hours beforehand. A headache does not always follow an aura.
The headaches usually:
· Start as a dull ache and get worse within minutes to hours
· Are throbbing, pounding, or pulsating
· Are worse on one side of the head with pain behind the eye or in the back of the head and neck
· Last 6 to 48 hours
Other symptoms that may occur with the headache include:
· Chills
· Increased urination
· Fatigue
· Loss of appetite
· Nausea and vomiting
· Sensitivity to light or sound
· Sweating
Symptoms may linger, even after the migraine goes away. This is called a migraine hangover. Symptoms can include:
· Feeling mentally dull, like your thinking is not clear or sharp
· Needing more sleep
· Neck pain
Diagnosis
Each person responds differently to treatment. Some people have migraines only rarely and need little to no treatment. Others need to take several medicines or even go to the hospital sometimes.
Migraine headache is a risk factor for stroke. Risk is higher in people who have migraines that occur with aura. People with migraines should avoid other risk factors for stroke. These include:
- Smoking
- Taking birth control pills
- Eating unhealthy foods
Treatment
There is no specific cure for migraine headaches. The goal is to treat your migraine symptoms right away, and to prevent symptoms by avoiding or changing your triggers.
A key step is learning how to manage your migraines at home. A headache diary can help you identify your headache triggers. Then you and your doctor can plan how to avoid these triggers.
If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. You need to take the medicine every day for it to be effective. Medicines may include:
- Antidepressants
- Blood pressure medicines
- Seizure medicines
TREATING AN ATTACK
Other medicines are taken at the first sign of a migraine attack. Over-the-counter (OTC) pain medicines, such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. Be aware that:
- Taking medicines more than 3 days a week may lead to rebound headaches. These are headaches that keep coming back due to overuse of pain medicine.
- Taking too much acetaminophen can damage your liver.
- Too much ibuprofen or aspirin can irritate your stomach or kidneys.
- If these treatments do not help, ask your doctor about prescription medicines. These include nasal sprays, suppositories, or injections.
Some migraine medicines narrow the blood vessels. If you are at risk for having a heart attack or have heart disease, talk with your doctor before using these medicines. Some migraine medicines should not be used by pregnant women. Talk with your doctor about which medicine is right for you if you are pregnant or planning to become pregnant.
Other medicines treat symptoms of migraine, such as nausea and vomiting. They may be used alone or along with the other drugs that treat the migraine itself.
Feverfew is a herb for migraines. It can be effective for some people. Before using feverfew, make sure your doctor approves. Herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.
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