WHAT IS A MIGRAINE? CAUSES, SYMPTOMS AND TREATMENT

WHAT IS A MIGRAINE?   

In simple words, a migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.     

A migraine is much more than a bad headache. This neurological disease can cause debilitating throbbing pain that can leave you in bed for days! Movement, light, sound, and other triggers may cause symptoms like pain, tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking, temporary loss of vision, and many more.

WHAT DOES A MIGRAINE FEEL LIKE?   

In general, migraine pain is described as: 

• Pulsating 
• Throbbing 
• Perforating  
• Pounding 
• Debilitating 

It can also feel like a severe, dull, steady ache. The pain may start as mild. But without treatment, it can become moderate to severe.   

Migraine pain most commonly affects the forehead area. It's usually on one side of the head, but it can occur on either side or shift.  

Most migraine attacks last about 4 hours. If they're not treated or don't respond to treatment, they can last for as long as 72 hours to a week. In migraine with aura, pain may overlap with an aura or may never occur at all.

WHAT ARE THE TYPES OF HEADACHES? WHAT TYPE OF HEADACHE IS A MIGRAINE?   

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn't caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there's no blood test or imaging study to diagnose this. A secondary headache is a symptom of another health issue.

What are the types of migraines? 

There are several types of migraines, and the same type may go by different names:

• Migraine with aura (complicated migraine): Around 15% to 20% of people with migraine headaches experience an aura 
• Migraine without aura (common migraine): This type of migraine headache strikes without the warning an aura may give you. The symptoms are the same, but that phase doesn't happen  
• Migraine without head pain: "Silent migraine", as this type is also known, includes the aura symptom but not the headache that typically follows. 
• Hemiplegic migraine: You'll have temporary paralysis (hemiplegia) or neurological or sensory changes on one side of your body. The onset of the headache may be associated with temporary numbness, extreme weakness on one side of your body, a tingling sensation, a loss of sensation, and dizziness or vision changes. Sometimes it includes head pain, and sometimes it doesn't 
• Retinal migraine (ocular migraine): You may notice the temporary, partial, or complete loss of vision in one of your eyes, along with a dull ache behind the eye that may spread to the rest of your head. That vision loss may last a minute, or as long as months. You should always report a retinal migraine to a healthcare provider because it could be a sign of a more serious issue  
• Chronic migraine: A chronic migraine is when a migraine occurs at least 15 days per month. The symptoms may change frequently, and so may the severity of the pain. Those who get chronic migraines might be using headache pain medications more than 10 to 15 days a month and that, unfortunately, can lead to headaches that happen even more frequently 
• Migraine with brain-stem aura: With this migraine, you'll have vertigo, slurred speech, double vision, or loss of balance, which occur before the headache. The headache pain may affect the back of your head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears, and vomiting 
• Status migrainosus: This is a rare and severe type of migraine that can last longer than 72 hours. The headache pain and nausea can be extremely bad. Certain medications, or medication withdrawal, can cause you to have this type of migraine 

What is the aura?  

An aura is a group of sensory, motor, and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.   

Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include: 

• Seeing bright flashing dots, sparkles, or lights 
• blind spots in your vision
• Numb or tingling skin 
• Speech changes 
• Ringing in your ears (tinnitus) 
• Temporary vision loss 
• Seeing wavy or jagged lines 
• changes in smell or taste 
• A "funny" feeling

WHAT CAUSES MIGRAINES?  

Researchers do not yet understand all the factors that cause migraines. It appears they may be caused in part by changes in the level of a body chemical called serotonin. Serotonin plays many roles in the body and affects blood vessels. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems. Another cause being studied is that migraine headaches go along with a spreading pattern of electrical activity in the brain.    

Some research suggests there could be a heredity factor for migraines, meaning they may run in families. Researchers have identified some genes associated with migraines. They are unsure why these genes impact some people more than others. The American Migraine Foundation reports that if one of your parents has migraines, there is a 50% chance that you will, too. If both of your parents have migraines, your chances jump up to 75%. Ultimately, migraines seem to be caused by a combination of factors: genetic, environmental, and lifestyle.     

Women are more likely to have chronic migraines (migraines that occur 15 days a month or more). This is likely linked to hormones. Hormones fluctuate each month around the time of your period. They can also fluctuate if you are pregnant or going through menopause. 

WHAT ARE SOME MIGRAINE RISK FACTORS AND TRIGGERS? 

Some risk factors make you more likely to get migraine headaches. Other things may trigger a migraine.

Common migraine risk factors include the following: 

• Family history: You are much more likely to have migraines if one or both of your parents had migraines 
• Gender: Women are more likely than men to have migraines   
• Age: Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40  

Common migraine triggers include the following:   

• Food and drink: Certain food and drink (see list below) may cause migraines. Dehydration and dieting or skipping meals may also trigger migraines 
• Hormone changes: Women may experience migraines related to their menstrual cycles, to menopause, or to using hormonal birth control or hormone replacement therapy 
• Stress: Stress may trigger migraines. Stress includes feeling overwhelmed at home or work. But you can also become stressed by exercising too much or not getting enough sleep 
• Senses: Loud sounds, bright lights (such as flashing lights or sunlight), or strong smells (such as paint fumes or some perfumes) may trigger migraines 
• Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine 
• Illness: Infections, such as the cold or the flu, may trigger migraines, especially in children  

Foods that may trigger migraines: 

• Aged, canned, cured, or processed meat (including bologna, game, ham, herring, hot dogs, pepperoni, and sausage)   
• Aged cheese 
• Alcoholic beverages (especially red wine) 
• Aspartame  
• Avocados  
• Beans (including pole, broad, Italian, navy, pinto, and garbanzo) 
• Brewer's yeast (including fresh yeast coffee cake, donuts, and sourdough bread) 
• Caffeine (in excess) 
• Canned soup or bouillon cubes 
• Chocolate, cocoa, and carob 
• Cultured dairy products (such as buttermilk and sour cream) 
• Figs 
• Lentils 
• Meat tenderizer 
• Mono sodium glutamate (MSG) 
• Nuts and peanut butter 
• Onions (except in small amounts for flavoring) 
• Papaya 
• Passion fruit 
• Pea pods 
• Pickled, preserved, or marinated foods (such as olives and pickles, and some snack foods) 
• Raisins 
• Red plums 
• Sauerkraut 
• Seasoned salt 
• Snow peas 
• Soy sauce  

HOW ARE MIGRAINES DIAGNOSED?   

Your doctor can diagnose migraines by the symptoms you describe. If the diagnosis is not clear, your doctor will perform a physical exam. Your doctor might want to do blood tests or imaging tests, such as an MRI or CAT scan of the brain. These tests can ensure there are no other causes of headaches. You may also be asked to keep headache records/history/journal. This can help your doctor identify the things that might cause your migraines.  

CAN MIGRAINES BE PREVENTED OR AVOIDED? 

Medicine to prevent migraines may be helpful if your headaches happen more than 2 times a month. You may want to consider this medicine if your headaches make it hard for you to work and function. These medicines are taken every day, whether you have a headache or not. 

Preventive medications for migraines can include prescription drugs often used to treat other ailments. Anti-seizure medicines, antidepressants, medicines to lower blood pressure, and even Botox injections are some preventive medications your doctor may prescribe. Calcitonin gene-related peptide (CGRP) inhibitors can also help prevent migraines. They do so by blocking a gene-related peptide in your sensory nerves. This peptide is known to increase during a migraine attack, so blocking it can help prevent migraines. 

There are also several nonmedical treatments designed to help minimize migraine pain and frequency. One is an electrical stimulation device, which has been approved by the FDA. It is a headband that you wear once a day for 20 minutes to stimulate the nerve linked to migraines. Another nonmedical treatment is counseling aimed at helping you feel in more control of your migraines. This counseling works best when paired with medical prevention of migraines as well.  

WHAT ELSE CAN I DO TO PREVENT MIGRAINES?

While there are no sure ways to keep from having migraine headaches, here are some things that may help: 

• Eat regularly and do not skip meals   
• keep a regular sleep schedule    
• Exercise on a regular basis: Aerobic exercise can reduce tension and keep your weight in check. Obesity can contribute to migraines 

Keep a migraine record/journal to track what triggers your migraines and what treatments are the most helpful 

MIGRAINE TREATMENT  

There are 2 types of medicines for migraine treatments. One type, called "abortive," focuses on stopping the headache from becoming severe and relieving the headache pain. You should start this type of treatment as soon as you think you're getting a migraine. The other type, called "prophylactic or preventive" includes medicines that are taken every day to reduce how often headaches occur.

Talk to your doctor about which of these two types of medicine is best for you. Some people use both types. Nonprescription and prescription medicines that are used often or in large doses may cause other problems. 

WHAT MEDICINES HELP RELIEVE MIGRAINE PAIN? 

For mild to moderate migraines, over-the-counter medicines may help relieve migraine pain. It is better to consult your doctor about the medication. Try to avoid self-medication.

WHAT ELSE CAN I DO? 

To help manage your migraine pain, try the following:

• Lie down in a dark, quiet room 
• put a cold compress or cloth over your forehead or behind your neck   
• massage your scalp using a lot of pressure 
• put pressure on your temples 
• have some caffeine 

LIVING WITH MIGRAINES 

Symptoms can come on quickly, many times without warning. They can ruin your day or even several days at a time. They can make you miss work, miss important events, and miss out on the fun. If you have recurring migraines, you probably feel like you don't have total control of your life. 

Work with your doctor to take back control. Keep a migraine records/journal. Document when you get migraines and what you were doing and eating. Keep a record of what the weather was like and if you were exposed to unusual smells or environments. Knowing your triggers can help you prevent migraines. Your doctor also may prescribe different medicines or combinations of medicines. Doing this helps sort out which will be most effective for preventing migraines or stopping them when they start