Migraine is more common than asthma, diabetes and coronary artery disease combined. In fact, some 28 million Americans – approximately 13 percent of the population – suffer from migraines. Roughly three out of four migraine sufferers are female.
Attacks occur sporadically and can last anywhere from 4 to 72 hours. They may occur only once or twice a year or as often as daily. Severe, often debilitating pain may be accompanied by a variety of symptoms, including nausea, vomiting, dizziness, fatigue, and extreme sensitivity to light and sound.
While the exact cause of migraine is unknown, migraine symptoms may result from a series of reactions in the central nervous system caused by changes in the body or in the environment. Sensitivity to certain triggers produces inflammation in the blood vessels and nerves around the brain, causing pain. Migraine sufferers often have a family history of the disorder.
Migraine Headache: Symptoms
Among the most distinguishing features is the potential disability accompanying the headache pain of a migraine. Other common symptoms include:
- Throbbing or pulsing pain on one side of the head
- Nausea, with or without vomiting
- Heightened sensitivity to light and sound
- Prodrome – A warning that can occur 24-48 hours before the headache. It may include mood changes, yawning, fatigue, or food cravings.
- Postdrome – Post pain symptoms, a feeling of being “washed out,” that can occur 24-48 hours after the headache is gone.
About one in five migraine sufferers experiences an “aura” before the migraine begins. This means they may have blurry or partial loss of vision; may “see stars,” spots or wavy lines; or may experience vertigo, confusion or even a tingling in their arms or face. This aura usually lasts 15-20 minutes, but no more than 60 minutes.
Common migraine headache triggers include:
- Aged cheese
- Citrus fruits
- Cured meats
- Artificial sweeteners
- Skipped meals
- Salty foods
- Excess caffeine
- Eyestrain or other visual triggers
- Weather changes
- Loud noises
- Physical exertion
Migraine Headache: Diagnosis
Accurate diagnosis is critical to successful headache treatment. That being said, both you and your physician need to communicate clearly to effectively diagnose and treat your disorder. Ask your doctor direct and specific questions and make sure you understand the answers. The more clearly and specifically you can communicate your symptoms to your physician, the more likely you are to find relief.
Headaches are diagnosed by matching symptoms to typical headache classifications. Keeping a headache diary can help your doctor identify triggers and isolate precipitating factors that may either contribute to or aggravate your condition. In addition, knowing your family medical history can help your doctor to accurately diagnose a disorder.
At NeuroHealth, we use a multi-disciplinary program to study the whole person and begin the diagnostic process. Led by neurologist Gary A. L’Europa, MD, our evaluation process starts with an in-depth discussion with you about your headaches, when they began, their location, frequency, duration, severity, associated symptoms, and triggers. We review past treatment failures as well as successes.
Diagnosis continues with complete neurological and musculoskeletal exams and any appropriate diagnostic tests. These tests may include blood work, Electroencephalography (EEG), (CT) and Magnetic Resonance Imaging (MRI). At times, we may refer you to an affiliated specialist if further evaluation is needed.
Once diagnosed, educating yourself on the type of headache you have and appropriate treatment for it can help you effectively manage it. For many headaches sufferers, some combination of stress management therapy and medication is often an effective way to manage their disorder. Because people react differently to various medications and therapies, you and your physician will need to find the right combination to help you prevent and effectively manage emerging headaches.
The good news is that headache research and treatment are evolving specialties. New and increasingly successful therapies are emerging every day.
Migraine Headache: Treatment
Once a diagnosis is made, treatments vary depending on the type of headache and frequency. The NeuroHealth team will develop a customized and comprehensive treatment plan that employs physical, environmental, nutritional, behavioral, and pharmacological measures to help you alleviate your headaches. Example components of our treatment plans include:
- Education in prevention techniques
- Coping skills to enhance well-being
- Pain and stress management training
- Relaxation therapy biofeedback
- Education in mind, body, spirit connection
- Education in lifestyle, nutritional and health issues
- Strengthening exercises
- Pharmacological abortive, preventive, and rescue remedies
- Botulinum toxin injection therapy
- Trigger point injection therapy
- Alternative therapies
Over time, we follow and evaluate your treatment plan together with you to determine the most effective course of action and tools to help you reduce your headache suffering, even prevent it, and take control of your life.
Migraine Headache: Resources
NIH Neurological Institute
P.O. Box 5801
Bethesda, MD 20824
Voice: (800) 352-9424 or (301) 496-5751
TTY (for people using adaptive equipment): (301) 468-5981