Migraines

People with migraines experience a severe, throbbing pain, often on one side of the head. Nausea, vomiting, and extreme sensitivity to light and sound often accompany the pain. Migraines have a certain arc, going through a few phases, and can be experienced anywhere from rarely to several times a month.

You can identify a migraine headache by one that is marked by these five stages:

• Warning signs: About two days before, there are changes in behavior, mood, energy, and/or appetite.
• Beginning symptoms: There are changes in vision, hearing, or smell. About one-third of migraine sufferers experience a warning symptom known as an “aura” just before the headache appears. This is characterized by seeing flashes of light, having blind spots, or feeling a tingling sensation on one side of the face, leg, or arm. Sometimes your speech can be affected, or you might have the sensation of being touched, or hear music or noises. This stage can last between 20 and 60 minutes.
• Headache: The headache is experienced as dull pain in the temple and side of the head that becomes throbbing, and can cause nausea, blurred vision, and sensitivity to light and sound.
• Pain ends: Headaches can last anywhere from a few hours to three days.
• Fatigue: After an attack, many sufferers feel fatigue that may last for hours or days. Others become elated. Moodiness, confusion, and continued sensitivity to light and sound are also part of this syndrome.

Close

No cause has yet been attributed to migraines, but migraines tend to run in families. Researchers are investigating the possibility of genetic mutations that result in neurological differences. Understanding the causes will allow for the development of specifically targeted treatment and preventive medicines.

While these factors are being determined, we know this: migraines are associated with certain trigger factors. These include stress, changes in the weather, bright or glaring lights, altitude, and certain foods and medications.

Prevention

There is no way of preventing a first migraine, since the cause is as yet unknown. However, once you have experienced one, there are things you can do to be prepared.

Writing a list of the events that surrounded your migraine is very important. Were you under stress? Eating certain foods, such as cheese, alcohol, chocolate, or those that contained nitrates or MSG? (All of these have been associated with migraines.) Had you experienced a change in weather or altitude?

If you’re a woman, there is an additional factor: were you about to have your period? Migraines have been associated with changes in estrogen levels. If you notice a relationship between the appearance of migraines and your menstrual cycle, talk to your physician about estrogen management.

There are types of medical preventive treatment that involve rounds of medicines or injections. See Treatments section below. Your doctor at the St. Luke’s Headache Center can review these with you to determine the best solution for you.

Close

Healthy living is important for everyone; for migraine sufferers, it is critical. Proper sleep, nutrition, hydration, and exercise can help keep these kinds of headaches at bay. Stress reduction is also vital.

Sleep: Consistent wake and sleep times are to your benefit. Sleep in a cool, dark room, and resist using your cellphone or computer for at least an hour before bed.

Nutrition: Know your triggers, and stay away from them. You can supplement your diet with vitamin B2 (riboflavin) and magnesium, as these have been shown to be helpful in lessening the symptoms of migraines.

Hydration: Drink plenty of water, and avoid alcohol and caffeine. Caffeine can be both a trigger and a cure, so it is best to keep your intake low or at least consistent.

Exercise: Work out at least three times a week for at least a half-hour each time. Walking is perfect for both relaxation and headache prevention, say the experts at St. Luke’s Headache Center.

Stress reduction: Meditation, yoga, and massage can help you manage stress. You can also do simple muscle relaxation exercises, such as slowly tensing, then releasing, the muscles in your body individually before you go to sleep at night. Incorporate massage and acupuncture into your schedule. Another easy way to ease stress? Hug a friend or family member, and pet your dog: both of these actions release endorphins into your blood stream, which helps to lower stress.

Of course, if you are taking medication for your migraines, always remember to take it on schedule.

Close

At the St. Luke’s Headache Center, your physician will be sure to take a complete medical history, including a family history, as well as performing a physical. Certain tests may be administered on a “rule out” basis. For example, based on what your history or exam shows, your doctor may want to do blood tests to see if there are any blood vessel problems, toxins, or infections.

Other tests include imaging tests such as an MRI or CT scan, to determine whether there are any brain bleeds or tumors, or the evidence of stroke or brain damage. A spinal tap (lumbar puncture) may also be found necessary, if there is a suspicion of low or high intracranial pressure.

Close

Treatment for migraine headaches can be categorized into two types. One is pain relieving, and the other is preventive.

Pain Relief

Pain relief medication includes over-the-counter medicines like aspirin, ibuprofen, and acetaminophen, which can relieve mild migraines. These kinds of medicines are not advisable for the long term, because they can cause both overuse, or rebound, headaches, and, with prolonged use, can cause gastrointestinal issues and ulcers.

Other kinds of pain-relieving medicines include triptans, which make blood vessels constrict to block pain, and ergots, which seem to be effective for sufferers whose headaches last longer than two days. These medicines require prescriptions, and your doctor at the St. Luke’s Headache Center will advise you as to their efficacy for your condition.

A homeopathic over-the-counter medicine to try is a severe headache and migraine nasal spray called Ausanil. Once a headache starts, this spray, which uses capsicum annuum — the raw extract of the chili pepper plant — can help stop the pain with no adverse drug interactions in under 10 minutes, according to some patients who have used it.

Methods of pain relief include icing your neck or the part of your head that’s affected, if you can. Even pulling your hair — gently — can help, as it improves blood circulation to the scalp and may alleviate tension in your head.

Preventive Treatments

The other type of treatment is preventive. You might want to consider this kind of treatment or medication if you get four or more migraines a month, your symptoms include protracted auras and weakness, and pain relievers are not working.

Cognitive behavior therapy (CBT) has had success with migraine patients, especially children. This practical, goal-oriented therapy helps patients find the attitudes, thinking, and behavior behind their difficulties, change those patterns, and so change the way they feel. With migraines, CBT strives to lessen the sphere of influence of a migraine. Often, patients who have migraines experience great stress, for example, in just making plans, because they don’t know when an attack will strike. This therapy can help modify that fear and anxiety, making it easier to participate in social commitments, work, and special occasions.

Classes of medications in the preventive category include beta blockers and calcium channel blockers, both of which are more commonly used to treat high blood pressure and coronary artery disease; one medication from the tricyclic class of antipressants; and anti-seizure medicines. Botox has also proven effective for migraines; the treatment involves an injection into the neck about every three months.

Close