Migraine

Migraine is a type of recurring headache that involves blood vessels, nerves, and brain chemicals. Sensations such as visual changes, called auras, may precede a Migraine. A migraine occurring with an aura is called classic and without aura is called common. Patients may experience a migraine several times a week or once every couple of years. Migraines may be so severe that they interfere with a patient's ability to work and carry on normal activities.

Causes

The precise cause of Migraines is unknown. A combination of factors appears to contribute, including:
  • Nerves
  • Blood vessels
  • Chemicals in the brain
  • Environmental triggers
An internal or external trigger sets the process in motion. It is possible that the nervous system reacts to the trigger by conducting electrical activity that spreads across the brain. This electrical activity leads to the release of brain chemicals that make blood vessels swell and become leaky. Scientists think that it is this inflammatory process that causes the pain and other symptoms of a Migraine headache.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.
  • Sex: female
  • Family members with migraines
  • Youth
  • Medications including:
    • Birth control pills
    • Hormone replacement therapy
    • Drugs to dilate blood vessels
  • Menstruation
  • Fatigue
  • Lack of sleep or changing sleep patterns
  • Stress or relief from stress
  • Skipping meals
  • Alcohol, especially red wine
  • Altitude or weather changes
  • Time zone changes
  • Exertion that is sustained or excessive
  • Glaring or flashing light
  • Perfumes or other odors
  • Eating foods known to trigger migraines

Symptoms

Migraines occur in phases that may include:
A Warning
A warning may precede a migraine. In the hours or days before the headache, symptoms may include:
  • A change in mood
  • Fatigue
  • Bloating
  • Tense muscles
  • Yawning
  • Food craving
An Aura
An aura occurs with classic migraines. The aura lasts about 15 to 30 minutes and may produce the following sensations:
  • Flashing lights or spots
  • Temporary, partial loss of vision
  • Speech difficulties
  • Weakness in an arm or leg
  • Numbness or tingling in the face and hands
  • Restlessness
  • Confusion
The Migraine Headache
Migraine pain starts within an hour of the aura ending. Symptoms include:

  • A headache, usually on one side but may involve both sides. Typically, the headache feels:
    • Intense
    • Throbbing or pulsating
    • More severe with movement
  • Nausea or vomiting
  • Diarrhea
  • Sensitivity to light or sound
  • Sore or achy muscles
  • Lightheadedness or dizziness
A Post-headache Period
Migraines usually last from four to 72 hours. They often go away with sleep. After the headache, you may experience:
  • Food intolerances or cravings
  • Trouble concentrating
  • Fatigue
  • Sore muscles

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. You may also be given a neurological exam. In some situations, a CT scan or magnetic resonance imaging (MRI) may be performed to rule out other conditions. The doctor may order blood tests or other tests before starting treatment.

Treatment

Migraine therapy aims to:
  • Prevent headaches
  • Reduce headache severity and frequency
  • Restore your ability to function
  • Improve quality of life
Treatment options include: Medications
Drugs may be taken at the start of the headache to ease or stop the pain. Over-the-counter pain pills may ease mild symptoms. Continuous use of some over-the-counter medication may create rebound pain when you stop taking the drug. Prescription medications include drugs that:
  • Quiet nerve pathways
  • Reduce inflammation
  • Stimulate receptors for the brain hormone serotonin
Other drugs can help prevent migraines for people suffering from frequent migraines. Preventive drugs are taken every day, even if you do not have a headache. Self Care During the Migraine
  • Apply cold compresses to painful areas of your head.
  • Lie in a dark, quiet room.
  • Massage your scalp and temples.
  • Try to fall asleep.
Lifestyle Changes
  • Keep a diary to help identify what triggers migraines and what helps relieve them.
  • Learn stress-management and relaxation techniques.
  • Consider talking with a counselor to learn new coping skills and relaxation techniques.
  • Exercise regularly.
  • Avoid foods that trigger migraines.
  • If low blood sugar precedes your migraines, eat small meals more often.
  • Do not change your regular sleep pattern on the weekend or during vacation.

Prevention

Methods for preventing migraine include avoiding those things that trigger the headache and establishing other healthy habits. Suggestions include:
  • Maintain regular sleep patterns.
  • Learn stress-management techniques.
  • Do not skip meals.
  • Avoid red wine and other alcohol.
  • Exercise regularly.
  • Avoid foods known to trigger migraines. These may include:
    • Yogurt
    • Nuts and peanut butter
    • Beans - lima, navy, pinto and others
    • Aged or cured meats
    • Processed or canned meat
    • Caffeine
    • Canned soup
    • Chocolate
    • Buttermilk or sour cream
    • Meat tenderizer
    • Brewer's yeast
    • Avocados
    • Onions
    • Pickles
    • Red plums
    • Sauerkraut
    • Snow peas
    • Soy sauce
    • Anything with MSG (monosodium glutamate), tyramine, or nitrates