Migraine Headaches - American Medical Centers (Lviv)

Migraine Headaches

Migraine Headaches

Migraine headaches are a specific type of headache that often results in recurring episodes for those that experience them. Migraines are different from other headaches because they also often occur with symptoms such as acute nausea, vomiting, or sensitivity to light. Those that experience migraines may have warning symptoms, called an aura, before the actual headache begins. Most people, however, do not have such warning symptoms and endure what is often a debilitating headache.

Causes, incidence, and risk factors:

Over six in one hundred individuals experience migraines. The headaches tend to start between the ages of 10 and 46, years of age, often runs in families, and interestingly effect more women than men.
Migraines are classified as either “common” or “classic”. Common migraines do not have any warning symptoms, while classic migraines do have a warning (the aura). Most migraine patients have the common type.
The exact cause of migraines is not known. Migraine headaches are related to problems with blood flow through parts of the brain. At the start of a migraine, blood vessels in certain areas of the brain constrict (narrow), leading to symptoms like visual disturbances, difficulty speaking, weakness, or numbness. Minutes to hours later, the blood vessels dilate (enlarge), leading to increased blood flow in the brain and a bad headache.
Why these changes in blood vessels and blood flow occur in the brain is not fully understood. Certain triggers, however, make it more likely for you to get migraines:
• Allergic reactions
• Bright lights, loud noises, and certain odors or perfumes
• Physical or emotional stress
• Changes in sleep patterns
• Smoking or exposure to smoke
• Skipping meals
• Alcohol or caffeine
• Menstrual cycle fluctuations, birth control pills
• Tension headaches
• Foods containing tyramine also may trigger a migraines’ onset: red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami) and other foods such as chocolate, nuts, peanut butter, avocado, bananas, citrus, onions, dairy products, and fermented or pickled foods may also trigger the onset of a migraine.

Symptoms:

Migraine headaches, which can be dull or severe, usually:
• Feel throbbing, pounding, or pulsating
• Are worse on one side of the head
• Last 6 to 48 hours
Symptoms accompanying migraines include:
• Nausea and vomiting
• Sensitivity to light or sound
• Loss of appetite
• Fatigue
• Numbness, tingling, or weakness
Warning signs that a migraine is coming may include seeing stars or zigzag lines, having tunnel vision, or temporary blind spot.
Symptoms that may linger even after the migraine has gone away include:
• Feeling mentally dull, like your thinking is not clear or sharp
• Increased need for sleep
• Neck pain

Signs and tests:

Migraine headaches may be diagnosed by your doctor based on your symptoms, history of migraines in the family, and your response to treatment. Your doctor will take a detailed history to make sure that your headaches are not due to tension, sinus inflammation, or a more serious underlying brain disorder. On physical examination, your doctor is likely to find nothing wrong with you.
Treatment:
There is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or altering triggers. When you do get migraine symptoms, try to treat them right away. The headache may be less severe. A good way to identify triggers is to keep a headache diary. When migraine symptoms begin:
• Rest in a quiet, darkened room.
• Drink fluids to avoid dehydration (especially if you have vomited).
• Try placing a cool cloth on your head.
Over-the-counter pain medications like acetaminophen, ibuprofen, or aspirin are often helpful, especially when your migraine is mild. If these don’t help, ask your doctor about prescription medications. Your doctor will select from several different types of medications, including:
• Ergots like ergotamine, dihydroergotamine, or ergotamine with caffeine (Cafergot)
• Triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), and zolmitriptan(Zomig); these are available as a tablet, nasal spray, or self-administered injection
• Isometheptene (Midrin)
• Stronger pain relievers like narcotics
Many of the prescription medications for migraines narrow your blood vessels. Therefore, these drugs should not be used if you have heart disease, unless specifically instructed by your doctor. Several studies support using feverfew for treating migraines as an alternative treatment. If you are interested in trying feverfew, make sure your doctor approves. Also, know that herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.
Prevention:
• Avoid smoking, caffeine, and alcohol.
• Exercise regularly.
• Get enough sleep each night.
• Learn to relax and reduce stress. Try progressive muscle relaxation (contracting and releasing muscles throughout your body), meditation, biofeedback, or joining a support group.
If you get at least three headaches per month, your doctor may prescribe medication for you to prevent recurrent migraines.
World Health Organization, 2007
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