Migraine Headache

A migraine is a very bad headache that tends to recur. With a migraine, you may feel nauseated and might vomit. The pain is usually on one side of your head and you may be very sensitive to bright lights and noises. Moving around can make the headache feel worse. There are many forms of migraine headaches. Classic and common are the two major varieties.

Symptoms of migraine

The basic difference between the two types of migraine is the appearance of an “aura.” The aura is the occurrence of neurological symptoms 10-30 minutes before the classic migraine attack. You may see flashing lights, zigzag lines or may temporarily lose vision. Other symptoms of classic migraine include speech difficulty, confusion, weakness of an arm or leg and tingling of face or hands.

The pain of a classic migraine headache is described as an intense throbbing or pounding felt in the forehead/temple, ear/jaw or around the eyes. Classic migraine starts on one side of the head, but may eventually spread to the other side. An attack may last one to two pain-racked days.

The common migraine - a term that reflects the disorder’s more frequent occurrence in the general population - is not preceded by an aura. Some people do experience a variety of vague symptoms before common migraines - mental fuzziness, mood changes, fatigue, and unusual retention of fluid. During the headache phase of a common migraine, you may have abdominal pain and diarrhea, increased urination, nausea and vomiting. Both classic and common migraines can strike as often as several times a week or rarely as once every few years.

What causes migraine?

Doctors think migraines may be caused by a chemical or electrical problem in certain parts of the brain. A key element of a migraine headache is blood flow change in the brain. According to theory, the nervous system responds to a trigger such as stress by creating spasms in the nerve-rich arteries at the base of the brain. The spasms constrict several arteries supplying blood to the brain, including arteries from the scalp and neck. As these arteries constrict, the flow of blood to the brain is reduced. At the same time, platelets clump together and release a chemical called serotonin. Serotonin acts as a powerful constrictor of arteries further reducing blood and oxygen supply to the brain. In reaction to the reduced oxygen supply, certain arteries within the brain dilate to meet the brain’s energy needs. Doctor’s believe this dilation causes the pain of migraine. “Migraine headaches tend to run in families, suggesting that genetic factors contribute to a person’s susceptibility to migraines.” (UpToDate, 2006).

Some things can trigger a migraine or make it worse. Headache triggers can be things you eat, smell, hear or see.

Foods that might trigger a migraine

Medicines that Might Trigger a Migraine

Women and migraines

Both men and women are affected by migraines but the condition is most common in adult women, about three times more commonly in women than in men. Both sexes may develop migraines in infancy, but most often the disorder begins between the ages of five and 35.

Hormones seem to influence migraine development. Some women who take oral contraceptives or estrogen experience worsening headaches while others improve. Similarly, some women have an increasing headache pattern during pregnancy while others have diminished headache intensity. Other women develop migraines for the first time when they are pregnant. Headaches may increase in some women in the days before their menstrual period. Women who do not have migraines may develop migraines as a side effect to using Combined Oral Contraceptives (COC).

How is a migraine headache treated?

There are many things you can do to reduce the pain of migraine. The most common methods of preventing and controlling migraines and other vascular headaches include:

Drug therapy

In migraines, drug therapy can be used in two ways: to prevent the attack or to relieve symptoms after the headache occurs.

If you suffer infrequently from migraines, drugs can be taken at the first sign of a headache to stop or ease the pain. People who get occasional mild migraines may benefit from taking aspirin or acetaminophen at the start of an attack. A small amount of caffeine may be useful if taken in the early stages of a migraine.

If you suffer frequently from migraines, both pain relief and prophylactic measures may be used. For many years ergotamine was the only drug available to address severe migraine pain relief. Now there are newer, more effective drugs available - Imitrex, Zomig, Maxalt, are some choices for relief of the pain of migraine. For headaches that occur three or more times a month, preventive treatment is often recommended. Drugs used to prevent classic and common migraines are available by prescription.

Organizations/Contact Information

American Headache Society (AHS)
19 Mantua Road, Mt. Royal, NJ 08061
Phone: (856) 423-0043
Fax: (856) 423-0082
www.ahsnet.org
ahshq@talley.com

The Excedrin Headache Resource Center
“Headache Center Resources” including a headache diary and prevention techniques
Internet address: www.excedrin.com
Toll Free: 1-800-580-4455

The Migraine Relief Center
Enroll in the MigraineCare Program or take the Headache Quiz.
Internet address: www.migrainehelp.com
Toll Free: 1-888-825-5249

National Headache Foundation
Info@headaches.org
Internet address: www.headaches.org
Phone (773) 388-6399
Toll Free: 1-888-643-5552
Fax: (773) 525-7357

References


Bajwa, Z.H., Wootton, R.J. (2006). Patient information: Managing headaches. UpToDate at: www.utdol.com
Bajwa, Z.H., Wootton, R.J. (2006). Patient information: Causes and diagnosis of headaches. UpToDate at: www.utdol.com