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Item ID: tp0032   Source ID: 2

Description: Migraine

Definition

Migraine is a type of recurring headache that involves blood vessels, nerves, and brain chemicals. Sensations such as visual changes, called auras, may precede a migraine. The International Headache Society recently developed a new system that classifies migraines as one of two types: migraine occurring with an aura (formerly called “classic”)... More

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Migraine

Definition

Migraine is a type of recurring headache that involves blood vessels, nerves, and brain chemicals. Sensations such as visual changes, called auras, may precede a migraine. The International Headache Society recently developed a new system that classifies migraines as one of two types: migraine occurring with an aura (formerly called “classic”) and migraine occurring without an aura (formerly called “common'). Patients may experience a migraine several times a week or once every couple of years. Migraines may be so severe that they interfere with a patient's ability to work and carry on normal activities.

Causes

The precise cause of migraines is unknown. Among the suspected causes are:

* Environmental triggers
* Genetic predisposition

An internal or external trigger sets the process in motion. It is possible that the nervous system reacts to the trigger by conducting electrical activity that spreads across the brain. This electrical activity leads to the release of brain chemicals that make blood vessels swell and become leaky. Scientists think that it is this inflammatory process that causes the pain and other symptoms of a migraine headache. Risk Factors

A risk factor is something that increases your chance of getting a disease or condition. Risk factors for migraines include:

* Alcohol, especially red wine
* Altitude or weather changes
* Eating foods known to trigger migraines
* Exertion that is sustained or excessive
* Family members with migraines
* Fatigue
* Glaring or flashing light
* Lack of sleep or changing sleep patterns
* Medications including:
      o Birth control pills
      o Drugs to dilate blood vessels
      o Hormone replacement therapy
* Menstruation
* Perfumes or other odors
* Sex: female
* Skipping meals
* Stress or relief from stress
* Time zone changes
* Youth

Symptoms

Migraines occur in phases that may include: A Warning

A warning may precede a migraine. In the hours or days before the headache, symptoms may include:

* A change in mood
* Bloating
* Fatigue
* Food craving
* Tense muscles
* Yawning

An Aura

Some migraines are preceded by an aura. The aura lasts about 15 to 30 minutes and may produce the following sensations:

* Confusion
* Flashing lights or spots
* Numbness or tingling in the face and hands
* Restlessness
* Speech difficulties
* Temporary, partial loss of vision
* Weakness in an arm or leg

The Migraine Headache

Migraine pain starts within an hour of the aura ending. Symptoms include:

* A headache, usually on one side but may involve both sides. Typically, the headache feels:
      o Intense
      o More severe with movement
      o Throbbing or pulsating
* Diarrhea
* Lightheadedness or dizziness
* Nausea or vomiting
* Sensitivity to light or sound
* Sore or achy muscles

A Post-headache Period

Migraines usually last from four to 72 hours. They often go away with sleep. After the headache, you may experience:

* Fatigue
* Food intolerances or cravings
* Sore muscles
* Trouble concentrating

Diagnosis

The doctor will ask about your symptoms and medical history, and perform a physical exam. You may also be given a neurological exam. In some situations, a CT scan or magnetic resonance imaging (MRI) scan may be performed to rule out other conditions. The doctor may order blood tests or other tests before starting treatment. Treatment

Migraine therapy aims to:

* Improve quality of life
* Prevent headaches
* Reduce headache severity and frequency
* Restore your ability to function

Treatment options include: Medications

Pain medications are often required to ease or stop the pain. Over-the-counter pain pills may ease mild symptoms. Warning! Continuous use of some over-the-counter medications may cause what is called a 'rebound headache' when you stop taking the medication.

Some prescription medications act directly to stop the cause of the migraine headache. These include drugs that:

* Quiet nerve pathways
* Reduce inflammation
* Stimulate receptors for the brain hormone serotonin

Other drugs can help prevent migraines for people suffering from frequent migraines. Preventive drugs are taken every day, even if you do not have a headache. Self Care During the Migraine

* Apply cold compresses to painful areas of your head.
* Lie in a dark, quiet room.
* Massage your scalp and temples.
* Try to fall asleep.

Lifestyle Changes

* Avoid foods that trigger migraines.
* Consider talking with a counselor to learn new coping skills and relaxation techniques.
* Do not change your regular sleep pattern on the weekend or during vacation.
* Exercise regularly.
* If low blood sugar precedes your migraines, eat small meals more often.
* Keep a diary to help identify what triggers migraines and what helps relieve them.
* Learn stress-management and relaxation techniques.

Prevention

Methods for preventing migraine include avoiding those things that trigger the headache and establishing other healthy habits. Suggestions include:

* Avoid foods known to trigger migraines. These may include:
      o Aged or cured meats
      o Anything with MSG (monosodium glutamate), tyramine, or nitrates
      o Avocados
      o Beans - lima, navy, pinto and others
      o Brewer's yeast
      o Buttermilk or sour cream
      o Caffeine
      o Canned soup
      o Chocolate
      o Meat tenderizer
      o Nuts and peanut butter
      o Onions
      o Pickles
      o Processed or canned meat
      o Red plums
      o Sauerkraut
      o Snow peas
      o Soy sauce
      o Yogurt
* Avoid red wine and other alcohol.
* Do not skip meals.
* Exercise regularly.
* Learn stress-management techniques.
* Maintain regular sleep patterns.

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