ALL ABOUT MIGRAINES
- A migraine can cause severe throbbing pain or a pulsing sensation, usually on one side
of the head. - It's often accompanied by nausea, vomiting & extreme sensitivity to light & sound.
- Migraine attacks can last for hours to days & the pain can be so severe that it interferes
with your daily activities. - For some people, a warning symptom known as an aura occurs before or with the
headache. - An aura can include visual disturbances, such as flashes of light or blind spots or other disturbances, such as tingling on one side of the face or in an arm or leg & difficulty
speaking. - Medications can help prevent some migraines & make them less painful.
- The right medicines, combined with self-help remedies & lifestyle changes, might help.
Symptoms
- Migraines, which often begin in childhood, adolescence or early adulthood, can progress through four stages: prodrome, aura, attack & post-drome.
- Not everyone who has migraines goes through all stages.
Prodrome
One or two days before a migraine,
you might notice subtle changes that warn of an upcoming migraine, including:
- Constipation
- Mood changes, from depression to euphoria
- Food cravings
- Neck stiffness
- Increased thirst and urination
- Frequent yawning
Aura
- For some people, aura might occur before or during migraines.
- Auras are reversible symptoms of the nervous system.
- They're usually visual, but can also include other disturbances.
- Each symptom usually begins gradually, builds up over several minutes & lasts for 20
to 60 minutes.
Examples of migraine aura include:
- Visual phenomena, such as seeing various shapes, bright spots or flashes of light
- Vision loss
- Pins & needles sensations in an arm or leg
- Weakness or numbness in the face or one side of the body
- Difficulty speaking
- Hearing noises or music
- Uncontrollable jerking or other movements
Attack
- A migraine usually lasts from four to 72 hours if untreated.
- How often migraines occur varies from person to person.
- Migraines might occur rarely or strike several times a month.
During a migraine, you might have:
- Pain usually on one side of your head but often on both sides
- Pain that throbs or pulses
- Sensitivity to light, sound & sometimes smell & touch
- Nausea & vomiting
Post-drome
- After a migraine attack, you might feel drained, confused & washed out for up to a day.
- Some people report feeling elated.
- Sudden head movement might bring on the pain again briefly.
When to see a doctor
- Migraines are often undiagnosed & untreated.
- If you regularly have signs & symptoms of migraine, keep a record of your attacks &
how you treated them. - Then make an appointment with your doctor to discuss your headaches.
- Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.
See your doctor immediately or go to the emergency room
if you have any of the following signs & symptoms,
which could indicate a more serious medical problem:
- An abrupt, severe headache like a thunderclap.
- Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness,
numbness or trouble speaking. - Headache after a head injury, especially if the headache worsens.
- A chronic headache that is worse after coughing, exertion, straining or a sudden movement.
- New headache pain after age 50.
MigraineI
- Though migraine causes aren't fully understood, genetics & environmental factors appear
to play a role. - Changes in the brainstem & its interactions with the trigeminal nerve, a major pain pathway, might be involved.
- So might imbalances in brain chemicals, including serotonin, which helps regulate pain in
your nervous system. - Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).
Migraine triggers
- There are a number of migraine triggers, including Hormonal changes in women.
- Fluctuations in estrogen, such as before or during menstrual periods, pregnancy &
menopause, seem to trigger headaches in many women. - Hormonal medications, such as oral contraceptives & hormone replacement therapy,
also can worsen migraines. - Some women, however, find their migraines occurring less often when taking these
medications. - Drinks. These include alcohol, especially wine & too much caffeine, such as coffee.
- Stress. Stress at work or home can cause migraines.
- Sensory stimuli. Bright lights & sun glare can induce migraines, as can loud sounds.
Strong smells, including perfume, paint thinner, secondhand smoke & others trigger
migraines in some people. - Sleep changes. Missing sleep, getting too much sleep or jet lag can trigger migraines
in some people. - Physical factors. Intense physical exertion, including sexual activity, might provoke
migraines. - Weather changes. A change of weather or barometric pressure can prompt a migraine.
- Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
- Foods. Aged cheeses & salty & processed foods might trigger migraines. So might
skipping meals or fasting. - Food additives. These include the sweetener aspartame & the preservative monosodium glutamate (MSG), found in many foods.
Risk factors
Several factors make you more prone to having migraines, including:
- Family history. If you have a family member with migraines, then you have a good chance
of developing them too. - Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s & gradually become less severe & less frequent
in the following decades. - Sex. Women are three times more likely to have migraines.
- Hormonal changes. For women who have migraines, headaches might begin just before
or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.
Complications
- Taking combination pain killers, such as Excedrin Migraine for more than 10 days a month
for 3 months or in higher doses can trigger serious medication-overuse headaches. - The same is true if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than
15 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt), for
more than nine days a month. - Medication-overuse headaches occur when medications stop relieving pain & begin to
cause headaches. You then use more pain medication, which continues the cycle
.
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