Migraines

MigrainesMigraines are painful, sometimes debilitating headaches often accompanied by nausea, vomiting, and sensitivity to light, noise and smell. These headaches often occur on only one side of the head, but the pain can shift to the other side of the head or can occur on both sides simultaneously. Migraines involve changes in chemicals and blood vessels in the brain, which trigger pain signals leading to headaches and other symptoms. The more inflammation there is, the more intense the migraine.

Risk Factors

  • Family history of migraines increases risk of developing migraines.
  • Women are three times more likely to develop migraines than men.
  • Migraines commonly begin during the adolescent or young adult years.
  • Risk increases if diagnosed with depression, anxiety disorder, asthma or epilepsy.

Symptoms

The symptoms of migraines can occur in various combinations and include:

  • Throbbing headache on one side of the head
  • Nausea
  • Vomiting
  • Sensitivity to light, noise and smells
  • Headache worsened by physical activity
  • Headache lasts anywhere from 4 to 72 hours
  • Blind spots, wavy lines or flashing lights (aura)
  • Have numbness or a “pins-and-needles” sensation in either the left or right hand
  • Loss of appetite
  • Dizziness
  • Fever (rare)

Triggers

Migraines may be triggered by food, stress and changes in daily routine, although it is not clear how or why these changes lead to migraines.

  • Food containing chocolate, monosodium glutamate (MSG), red wine and caffeine
  • Getting too much or not enough sleep
  • Fasting or skipping meals
  • Changes in the weather or barometric pressure
  • Stress or intense emotions
  • Strong odors or cigarette smoke
  • Bright lights or reflected sunlight

Detection and Diagnosis

Tests include:

  • MRI: used to rule out tumors or bleeding in the brain
  • CT Scan: used to rule out tumors or bleeding in the brain
  • Lumbar puncture: may be performed if doctor suspects another condition such as bleeding in the brain or meningitis
  • Thyroid hormone tests: used to determine if improper thyroid functioning is causing the headaches
  • Sedimentation rate: helps to determine whether another condition is causing inflammation
  • Prolactin level testing: helps to determine whether there is a problem with the pituitary gland that could be causing headaches

Treatment Options

Abortive headache medications — used to stop a migraine attack — include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): aspirin or ibuprofen
  • Triptans (serotonin receptor agonists)
  • Ergotamine derivatives
  • Midrin

Prophylactic headache medications — used to prevent migraine attacks — include:

  • Beta-blockers
  • Calcium channel blockers
  • Antidepressants
  • Anticonvulsants

Complementary therapies — help reduce symptoms and frequency of headaches:

  • Acupuncture: helps to reduce headache and muscle aches associated with migraines
  • Biofeedback: helps to reduce stress
  • Feverfew: herb that may help prevent migraines. More research is needed to prove its benefits.
  • Relaxation techniques: help reduce stress

Common Facts

  • Sinus headaches are overdiagnosed; migraines are underdiagnosed.
  • Headache pills for sinus headaches can make migraines worse.
  • No evidence that chronic, ongoing sinus infections are linked to recurring headaches; such headaches probably are migraines
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