Headache / MigrainePain / Anesthetics

Everything you need to know about migraines

Headaches are serious, chronic, and painful. Sensory warning signs and other symptoms may precede or follow these.

The intense pain caused by migraines can last for hours, or even days.

They bother 36 million Americans, or about 12 percent of the population, according to the American Migraine Association.

Migraines can follow an aura of sensory disturbances followed by a severe headache that often appears on one side of the head. They tend to affect people aged 15 to 55 years.

Fast facts on migraines:

  • Some people who experience migraines can clearly identify triggers or factors that cause the headaches, such as allergies, light, and stress.
  • Some people get a warning symptom before the start of the migraine headache.
  • Many people with migraine can prevent a full-blown attack by recognizing and acting upon the warning signs.
  • Over-the-counter (OTC) medications can eliminate or reduce pain, and specific medications can help some people with migraine.
  • People who have severe attacks can take preventive medicines.

Triggers

It is not yet clear what causes migraines.

It is believed that they are the product of abnormal brain activity. It can influence both the manner in which nerves interact and the chemicals and blood vessels in the brain. Genetics may make someone more prone to the migraine-causing triggers.

The following causes are likely to set migraines off, though:

  • Hormonal changes: Women may experience migraine symptoms during menstruation, due to changing hormone levels.
  • Emotional triggers: Stress, depression, anxiety, excitement, and shock can trigger a migraine.
  • Physical causes: Tiredness and insufficient sleep, shoulder or neck tension, poor posture, and physical overexertion have all been linked to migraines. Low blood sugar and jet lag can also act as triggers.
  • Triggers in the diet: Alcohol and caffeine can contribute to triggering migraines. Some specific foods can also have this effect, including chocolate, cheese, citrus fruits, and foods containing the additive tyramine. Irregular mealtimes and dehydration have also been named as potential triggers.
  • Medications: Some sleeping pills, hormone replacement therapy (HRT) medications, and the combined contraceptive pill have all been named as possible triggers.
  • Triggers in the environment: Flickering screens, strong smells, second-hand smoke, and loud noises can set off a migraine. Stuffy rooms, temperature changes, and bright lights are also possible triggers.

Treatment

There is no clear treatment for migraines at this moment. Treatment is intended to avoid a full-blown assault, and to relieve the symptoms.

Alterations in lifestyle that may help minimize migraine incidence include:

  • getting enough sleep
  • reducing stress
  • drinking plenty of water
  • avoiding certain foods
  • regular physical exercise

Some people also feel that special diets like gluten-free, can help.

Suggest seeking additional care if improvements noted above do not alleviate migraine symptoms or frequency. Migraine symptoms diagnosis is based on avoiding causes, managing symptoms and taking medication.

Surgery

The last decade witnessed the emergence of new approaches to migraine care. A doctor may give the trigeminal and cervical spinal nerves an injection of botulinum toxin, or Botox, into the extracranial sensory branches. These are a group of nerves connected to migraine reactions in the face and back.

A 2014 study also found that surgical decompression of these nerves in patients who do not respond to first-line treatment may minimize or remove migraines.

Medications

Migraines are also treated over a drug cycle. Migraine medicine has several different forms, including painkillers.

Painkillers should be taken early in migraine development, instead of allowing headache to intensify.

Active over – the-counter (OTC) medications for treating migraines include:

  • naproxen
  • ibuprofen
  • acetaminophen

Other painkillers, such as caffeinated aspirin and acetaminophen, are also able to relieve headache or rising pain.

Most painkillers, including naproxen, acetaminophen, and aspirin with caffeine, are available for purchase online. Please speak to the doctor before you take some new medicine.

Drugs that treat nausea

Any people who have migraines will need to take medications to relieve the symptoms to come with them.

Metoclopramide can be used to manage certain symptoms, including nausea and vomiting. Serotonin agonists, including sumatriptan, can also be prescribed for serious migraines or migraines not reacting to OTC medications.

Selective serotonin reuptake inhibitors (SSRIs) and antidepressants, such as tricyclics, are used to alleviate the effects of migraine although they are not licensed for this reason in all countries.

Preventive medications

Preventing migraines starts by minimizing causes. The key aims of preventive therapies are to reduce migraine headaches frequency, pain intensity, and length and improve the efficacy of other therapies.

Several drugs and supplements are available that help avoid migraine attacks including:

  • antidepressants
  • coenzyme Q10
  • herbal extracts, such as feverfew
  • magnesium citrate
  • vitamin B-12 supplements
  • riboflavin

Some supplements, including vitamin B-12, and feverfew, can be purchased in any medical store. When buying, make sure these supplements are administered safely alongside other medicines.

This is worth noting that certain people can experience headache overuse (MOH) medicine, or headache rebounding. It can happen in an effort to avoid migraine attacks after taking so many drugs.

Types

There are two main types of migraine. The distinction depends on whether the patient experiences any sensory symptoms that contribute to a migraine. Those are called the auras.

Migraine with aura

Migraine with aura
This picture is an illustration of what a person experiencing migraine with aura might see.

The auras serve as a warning for many people with migraine, telling them a headache is coming soon. Might involve the effects of an aura:

  • confusing thoughts or experiences
  • the perception of strange, sparkling or flashing lights
  • zig-zagging lines in the visual field
  • blind spots or blank patches in the vision
  • pins and needles in an arm or leg
  • difficulty speaking
  • stiffness in the shoulders, neck, or limbs
  • unpleasant smells

If the following symptoms for the person with migraine are rare they should not be ignored:

  • an unusually severe headache
  • visual disturbance
  • loss of sensation
  • difficulties with speech

When Aura migraines impair vision, the patient can see objects that are not there, such as transparent object strings. Often, they can not see portions of the object in front of them or even feel as if part of their field of vision appears, disappears and then returns.

People who encounter an aura may describe the visual disturbance as similar to the subsequent sensation of exposure to a very bright camera flash.

Migraine without aura

More generally, without any sensory disruption leading up to the attack, a person may experience a migraine. Migraines occur between 70 and 90 percent without an aura.

Other types

There are other types of migraine related to specific syndromes or triggers, including:

  • Chronic migraine: refers to any migraine that induces attacks on more than 15 days of the month.
  • Menstrual migraine: It is when the attacks take place in a sequence similar to the menstrual cycle.
  • Hemiplegic migraine: It triggers acute duration of weakness on one side of the body.
  • Abdominal migraine: This is a condition that ties migraine attacks to abnormal gut and abdominal function. It occurs mainly in children under the age of 14 years,
  • Migraine with brainstem aura: This is a uncommon form of migraine that can cause serious neurological symptoms, such as speech impaired.

Having detected a migraine pattern in any headaches encountered, talk to a doctor. They will be in a position to advise the form and recommend adequate care.

Symptoms

Migraine symptoms can begin a while prior to headache, immediately prior to headache, during headache, and after headache. However if not all migraines are similar, common signs include:

  • moderate to severe pain, usually confined to one side of the head but capable of occurring on either side of the head
  • severe, throbbing, or pulsing pain
  • increasing pain during physical activity or when straining
  • inability to perform regular activities due to pain
  • feeling sick and physically vomiting
  • increased sensitivity to light and sound, relieved by lying quietly in a darkened room

Some people experience other symptoms including nausea, changes in temperature, stomach ache and diarrhea.

Migraine vs headache

Understanding the difference between a migraine attack and a headache is important.

Headaches may differ greatly in the amount of time they last, how bad they are, and why they happen. These can not occur as migraine attacks do, in a recognizable pattern.

MIgraine attacks that occur with other symptoms, such as nausea and vomiting, can present as mild to extreme headaches on one side of the brain. Headaches of migraine and non-migraine are distinct, and may suggest multiple causes.

For order to better diagnose a migraine headache, it might be helpful to maintain a symptom log that records the time of onset, any causes, the length of headaches, any visible indications or auras that contribute to a migraine attack, and any other symptoms.

Ideally, a diary of headache should be used for at least 8 weeks, and record:

  • the frequency, duration, and severity of headaches
  • any associated symptoms
  • all prescribed and OTC medications taken to relieve headache symptoms
  • possible triggers
  • the relationship of headaches to menstruation

The International Headache Society suggests the criterion “5, 4, 3, 2, 1” for diagnosing migraines without having an aura.

This stands for:

  • 5 or more attacks with a duration of 4 hours to 3 days
  • At least two of the following qualities: Occurring on one side of the head, a pulsating quality, moderate-to-severe pain, and aggravation by routine physical activity
  • At least one additional symptom, such as nausea, vomiting, sensitivity to light, or sensitivity to sound.

During initial migraine treatment, the doctor can recommend a series of tests to rule out any other causes of a headache. Which can involve scans with electroencephalography (EEG), CT, and MRI, or a spinal tap.

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