Migraine Headaches: Symptoms, Diagnosis and Treatment

Migraine Headaches

Mayhem and Migraine Headaches

Don’t just seek shelter from migraine attacks. Learn how to avoid them – by avoiding triggers – and get the facts about treatment.

For anyone who has had a migraine, it can be hard to describe the pain and other effects of this troublesome headache. For centuries, artists afflicted with migraines have created works to convey the unbearable pain, chaos, and suffering many people with migraines endure. Many still struggle with these headaches today. But now there is effective treatment to help reduce or even prevent migraine attacks.

The origin of the migraine

The exact cause of migraines remains a bit of a mystery. Research suggests that changes in blood flow, shifting levels of brain chemicals (such as serotonin), inflammation in blood vessels, or an overreaction of nerve cells may all play a role. A genetic link is also likely.

Although both men and women get migraines, the condition is nearly 4 times more common in women. Kids can also get them.

Symptoms

While there are some common symptoms of migraine, the way that the headaches play out tends to vary from person to person. Typically, migraines are characterized by mild-to-severe throbbing pain on one or both sides of the head. The pain may last from 4 to 72 hours and is often accompanied by:

  • Nausea and vomiting
  • Sensitivity to light, noise, smells, and/or movement

The aura

Some, but not all, people who have migraines have an “aura” within an hour or two before the headache starts. Most aura symptoms resolve within about 1 hour. Symptoms are commonly vision-related. They might include flashing lights and zigzag lines.

Sometimes an aura may involve weakness or numbness, trouble speaking, or sensitivity to smell. Some of these symptoms can also be present in a stroke. Call 9-1-1 if you have new weakness, numbness, confusion, or trouble speaking.

Some people report having symptoms 24 to 48 hours before the headache. These symptoms, called prodromal symptoms, can occur with or without an aura. They can include:

  • Hyperactivity
  • Food cravings
  • Mood changes
  • Fatigue
  • Frequent yawning

Migraine triggers and your headache diary

Triggering factors play a role in migraine headaches for many people with migraines. When exposed to a “trigger,” a migraine may soon follow. Common migraine triggers include:

  • Hormonal changes (especially linked with menstruation and oral contraceptive use)
  • Sudden changes in weather conditions
  • Certain foods or food additives, especially preservatives, MSG, caffeine, chocolate, cheese, and corn products
  • Strong odors, glaring lights
  • Cigarette smoke
  • Emotional factors
  • Changes in sleep patterns

Keep track of your migraine triggers in a headache diary. In some cases, especially with food triggers, learning your triggers can help you to avoid migraines. Write down details of your migraines, including the triggers, when they start, how long they last, and other symptoms. Take this headache diary with you when you see the doctor to help with diagnosis and treatment.

How is a migraine diagnosed?

Your doctor can diagnose most migraines with a history and physical exam. If your headache is sudden, unusual, or very severe, your doctor may order a head CT or brain MRI. These imaging tests show detailed images of brain structure and can help find a tumor, blood vessel abnormality, bleeding, or other problems that can cause symptoms similar to a migraine.

How are migraine headaches treated?

Nonprescription pain medicines, such as ibuprofen (Motrin or Advil), may help for minor, infrequent migraines. For more severe, frequent migraines, your doctor may suggest that you take migraine medicines. There are two types of migraine medicines: abortive and preventive.

Abortive medicines. These are taken to stop a migraine attack from getting worse. You will need to take this medicine when you first feel a migraine coming on. These drugs include the triptans, such as sumatriptan (Imitrex), naratriptan (Amerge), zolmitriptan (Zomig), and rizatriptan (Maxalt). Another type of abortive medicine is the ergotamine, such as dihydroergotamine (Migranal). Your doctor may also prescribe something to treat the nausea. If the pain lasts despite the abortive medicine, your doctor may suggest adding a nonsteroidal anti-inflammatory drug (NSAID) pain reliever.

Preventive medications. These are prescribed for people with frequent migraines or when headaches occur despite abortive medicines. Examples of these drugs include:

  • Beta-blockers
  • Calcium channel blockers
  • Tricyclic antidepressants
  • Anticonvulsants

Many drugs used to treat migraine attacks can have side effects. Take these medications only when they are prescribed and monitored by your doctor.

Other treatments for migraine attack

Medications for the treatment of migraines are sometimes combined with biofeedback or relaxation training.

Biofeedback involves monitoring your body functions using a special machine with sensors. Feedback from the machine lets you recognize and control your body’s responses. Through biofeedback, some people reduce the number and severity of migraine attacks.

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