Migraine Headaches

Overview

A migraine is a severe, recurring headache that is usually accompanied by nausea, vomiting, and sensitivity to light. Migraines can last for a long time and often cause people to miss work, school, or other activities. Migraines sometimes have warning signs, called an aura, that include flashes of light, blind spots, and tingling in the arm or leg. Migraines can occur at any point, but usually begin between the ages of 10 and 45. Many people get migraines that are triggered by something specific, such as a certain food, stress, or perfumes. There is no cure for migraines, but medications and self-care techniques can help manage symptoms.

Symptoms and Diagnosis

There are often symptoms that signal onset of a migraine that are separate from the migraine itself. Some people experience constipation, depression, food cravings, neck stiffness, irritability, and uncontrollable yawning a few days before a migraine. Right before a migraine, some people get an aura, or nervous system symptoms such as visual disturbances, tingling in arms and legs, or speech problems. A migraine attack is usually characterized by throbbing pain on one or both sides of the head, sensitivity to light and sound, nausea and vomiting, blurred vision, and lightheadedness. After the migraine has ended, many people feel exhausted and unable to resume normal activities.

Migraines can last from 4 to 72 hours, with frequency that changes from person to person. Many people do not seek treatment for migraines, so it is likely underdiagnosed and undertreated. Those who seek treatment can see a neurologist, who will usually diagnose migraine headaches based on the patient’s symptoms, medical history, family history, and a physical exam that includes neurological evaluation. Other headache-causing conditions can be ruled out through blood tests, CT scan, MRI, or spinal tap. These tests can exclude infections, tumors, brain damage, and other neurological issues that cause severe headaches.

Causes

It is not fully understood what causes migraines, but it is believed that abnormal brain function is involved. Serotonin imbalances and changes in the way the brainstem communicates with the trigeminal nerve, a major pain nerve, could contribute to migraine pain. Genetics and environment are also thought to play a role. Migraines seem to run in families and are more common in women than men. Although the exact cause of migraines is not known, it is known that there are many different triggers that can bring on migraines. Triggers vary from person to person, but the most common are foods, drinks, stress, smells, physical activity, and sleep patterns. Common foods known to trigger migraines include chocolate, processed foods, dairy products, and meats containing nitrates. Alcohol, caffeine, and smoking can also be triggers. In women, migraines are often associated with changes in estrogen that occur during periods, pregnancy, and menopause. Continue reading for Prevention and Treatment Information . . .

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