Migraine is different from other types of headache. It causes a very intense, often throbbing pain in one side of the head and is accompanied by other symptoms such as sensitivity to light, sound, or smell; and weakness.
Migraines affect people of all ages, races, and sex. But they are three times more common in women, and seem to be linked to hormonal changes, especially before menstruation, during pregnancy, and at menopause.
Symptoms
Migraine is more than a headache – it’s a complex condition with many symptoms ranging from light sensitivity to body chills. It can affect people of all ages and is more common in females than males. It tends to run in families, and research suggests that a mix of different genes may determine whether someone gets migraines.
Symptoms include a painful throbbing headache often felt on one side of the head and is made worse by movement; nausea (feeling sick) and vomiting (being sick); blurred vision; difficulty thinking; and sensitivity to light, smell and sound. In some cases, a person will have a warning sign called an aura before or during the headache phase. This is not a normal part of a migraine attack and can involve things like seeing flashing lights, blind spots or a pattern of lines such as zigzags. Some people also feel a prickly sensation or muscle weakness on one side of their body; slurred or jumbled speech; and numbness in the arms or legs.
The headache phase of migraine usually lasts hours or days and is often very severe, especially if it’s untreated. Other symptoms during this period include neck pain; a sense of pressure on the head or forehead; and a feeling of being drained and fatigued. The postdrome phase, which happens after the headache, includes changes in mood ranging from depression to euphoria; and fatigue and a ‘hangover’ type feeling.
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It isn’t known what triggers a migraine but most experts think that it is due to chemical changes in the brain. Overactive nerve cells send signals that cause blood vessels to swell and release chemicals that lead to inflammation and pain. People assigned female at birth are about three times more likely to experience migraine episodes than those who are male.
Most people find it helpful to rest during a migraine, especially in a dark quiet room. This helps with the recovery of symptoms and may even stop them occurring in the first place. Taking painkillers can sometimes help but it’s important to take them sparingly as too much will make the migraine attack worse.
Triggers
Migraine triggers are different for everyone, but they can include foods, stress, hormone changes, sleep patterns, light or smells. They can also be caused by specific medications (including some over-the-counter migraine drugs), certain physical activities, or even certain weather conditions such as rain storms or very hot days. In addition, migraines tend to run in families and up to 80% of people who suffer from the condition have a first-degree biological relative with the disorder.
Stress is one of the most common triggers and can cause headaches in many people, especially women. This is thought to be because the body releases chemicals during stress that cause muscle tension and stretch blood vessels, resulting in migraines. Stress can also affect the way we respond to food and drink, which is why it’s important to try to reduce stress in your life as much as possible.
Other common triggers of migraine are skipping meals, especially breakfast and lunch, or eating at irregular times, which can lead to peaks and troughs in blood sugar levels and make the migraine symptoms worse. Some people have a sensitivity to foods and preservatives, including the natural compound tyramine found in aged cheeses, some alcohols, cured or processed meats, MSG, nitrates, and some vegetables and tropical fruits.
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Bright lights, loud noises or strong smells can also trigger migraine in some people and may also make the symptoms worse during an attack. Keeping a migraine diary and tracking your symptoms can help you identify what triggers you.
Caffeine is another known trigger, and it is important to be careful about how much you consume each day. If you have to lower your caffeine intake, do it gradually and talk to your doctor first. Some over-the-counter migraine medications can contain caffeine as well, so check the labels and always take medication as prescribed by your doctor.
Treatment
There is no cure for migraine, but there are treatments that can help prevent attacks or relieve symptoms. They are usually prescription medicines. Other things that can help are avoiding triggers, managing stress, and getting enough sleep. It is important to talk to your doctor or a headache specialist about the best treatment for you.
There are two kinds of medications used for treating migraines: pain-relieving drugs, and preventive medicines. Pain-relieving drugs, also called abortive therapy, are taken during a migraine attack to stop it. Preventive medicines are taken regularly to stop migraines from happening in the first place.
The most common pain-relieving medicines for migraine include a group of drugs called triptans. These drugs work by blocking the pain signals in your brain and can be taken as pills, nasal sprays, or injections. They are very effective and can be taken at the first sign of a migraine. However, they can cause dangerous side effects like heart problems and high blood pressure. They can also interact with some drugs that increase serotonin, including antidepressants and certain antibiotics.
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Another kind of pain-relieving medicine is a group of drugs called ergot alkaloids. These are similar to triptans but work better in the early stages of a migraine. They can be taken as nasal sprays, injections, or pills and are often combined with a painkiller. They can cause side effects like low blood circulation, nausea, vomiting, and tingling or numbness in the hands and feet.
Other headache treatments include a procedure called a neurectomy. This involves cutting the end of a nerve in the area where the pain starts. Other options include acupuncture and biofeedback. These are techniques that can be taught by a trained professional and can help reduce stress, which is a common trigger for migraines. Migraine can also be helped by taking dietary supplements, such as riboflavin, coenzyme Q10, butterbur, magnesium, and melatonin.
Other types of treatment for migraine include a CT scan, which uses X-rays to make detailed cross-sectional images of your brain and can help find the cause of your migraines. There are also procedures that can be done, such as a nerve block or a shunt, which may relieve your symptoms if you have nerve issues that cause migraines.
Prevention
Migraine can be prevented by taking medicine or by following healthy lifestyle habits. A combination of both is the best way to avoid migraine pain.
Some people are more prone to migraines than others. Age, a family history of migraines and certain medical conditions increase your risk for getting them. These include depression, anxiety, bipolar disorder and sleep disorders. Other factors that can trigger migraines include yawning, change in mood or irritability, fatigue, neck pain and light sensitivity. Hormone changes can also cause migraines. Women tend to get migraine headaches more often than men. They may be more frequent around their periods, during pregnancy or when they are ovulating. They can also be tied to hormonal birth control methods or hormone replacement therapy for menopausal symptoms.
Most doctors think that migraines start when nerve cells send out signals that cause blood vessels to swell and shrink. This triggers inflammation and leads to the pain in your head and neck. Migraines can be made worse by some foods, drinks and stress.
While many people believe that caffeine is a trigger, the latest research suggests it plays only a small part in migraines. Rather, it’s the change in your body’s balance of serotonin and calcitonin gene-related peptide (CGRP) that’s linked to headaches.
A consistent sleep schedule and eating pattern can help prevent migraines, as can keeping hydrated. You should drink plenty of water, especially when exercising and when you’re ill or hot. A diet rich in fruits and vegetables is also important.
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Keeping a migraine diary can help you identify your own personal triggers. You should write down the date and time of each migraine episode, its severity, and any other symptoms you experience. The diary can also help you track patterns and see what seems to prevent your headaches.
Your doctor might recommend a number of different medicines to treat your migraines. These can include anticonvulsants, beta-blockers, calcium antagonists and neurostabalizers. He or she might also prescribe an antidepressant, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRI) or other types of medications. Most migraine drugs are started at a low dose and gradually increased, so that you reach an optimal effective level.
