SLIDESHOW
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Migraine vs. Headache (
courtecy;- nedicine net )
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What does a migraine feel like? Learn to spot the differences
between headaches and migraines. Read more...
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What Is a Migraine?
A migraine is a
throbbing painful headache, usually on one side of the head, that is often
initiated or "triggered" by specific compounds or situations
(environment, stress, hormones, and many others). They occur more often in
women (75%, approximately) and may affect a person’s ability to do common
tasks.
Migraine Symptoms
Migraine
symptoms, throbbing pain, usually on one side of a person's head, can be
intense enough to cause a person to be unable to do simple tasks or to work.
The headache pain may radiate toward the eyes, forehead, or temple and make a
person develop nausea, vomiting, vision problems, and sensitivity to normal
light or mild exertion.
Migraine With Aura
"Classic"
migraines begin with an aura such as seeing visual field changes (dots, wavy
lines, blurriness) about an hour or less before the pain begins. Approximately
20% of people with migraines have this "classic" type.
Migraine Warning Signs
"Classic"
auras do not occur in all patients, but about 25% of migraine patients can have
a prodromal phase. The prodromal phase occurs as long as 24 hours before migraine
pain develops; the prodromal phase consists of mood changes (depressed,
excited, irritable) and sensations of odd smells or tastes, while others may
feel tired or tense.
What Causes a Migraine?
The
neurological causes of migraines are not understood but researchers speculate
something may initiate a mix of blood vessel permeation and brain chemicals to
interact with brain cells to cause the migraine.
Trigger: Flashing Lights
Migraine
headaches are often triggered to occur when the person is exposed to a specific
set of circumstances. One of the most common triggers is strong flickering
light. For example, faulty fluorescent lights, a television picture rapidly
going on and off, or sunlight reflected off of waves in a lake or the ocean are
all potential triggers.
Trigger: Anxiety and Stress
As mentioned,
stress is sometimes a trigger for migraines. While it is unlikely that people
can live stress-free lives, many people can reduce their stress and avoid
triggering migraines by using relaxation techniques, deep breathing, and other
biofeedback techniques.
Trigger: Lack of Food or Sleep
Regular daily
patterns of meals and sleep work well for some individuals to avoid migraines.
Sleep interruptions and lack of adequate fluid and/or food intake and even some
food binges may trigger a migraine.
Trigger: Hormonal Changes
Many women's
migraines are linked to their menstrual cycle. The hormonal increases and
decreases are thought to be responsible for triggering migraines in some women.
However, patterns differ from person to person so one type of hormonal therapy
may benefit one woman, but it may be unhelpful or even increase migraine
symptoms in other women
Trigger: Headache Foods
Although
studies have not proven that any food is a migraine trigger, patients often suggest
certain foods trigger their migraines. Common food or food ingredients cited by
patients are red wine, cheese, chocolate, soy sauce, processed meat, and MSG.
Trigger: Tyramine
Tyramine,
produced from the amino acid tyrosine, may be a trigger for migraines because
it can cause blood vessel constriction and expansion. Many aged and fermented
foods that are associated with migraines like cheeses, soy sauce, pickles, or
aged meats like pepperoni contain tyramine.
Caffeine: Help or Hindrance?
The caffeine in
coffee may help relieve migraines when used with some medications. However,
when the caffeine levels drop, the patient may then be prone to develop
headaches. Consequently, it may be both a help and a hindrance for people with
migraines.
Tracking Personal Triggers
Individuals
should keep a diary or list of things that act as warning signs or triggers of
an oncoming migraine. This information may help migraine sufferers to avoid
future migraine
Who Gets Migraines?
Migraines occur
in women about three times more often than in men; people with relatives who
get migraines are more likely to get them. In addition, migraines more often
occur in people with epilepsy, depression, stroke, asthma, anxiety, and in
individuals with neurologic and hereditary (genetic) disorders.
Who Gets Migraines?
Migraines occur
in women about three times more often than in men; people with relatives who
get migraines are more likely to get them. In addition, migraines more often
occur in people with epilepsy, depression, stroke, asthma, anxiety, and in
individuals with neurologic and hereditary (genetic) disorders.
Diagnosing Migraines
Migraines are
usually diagnosed by the clinical history of symptoms; however, most doctors
will do a CT or MRI brain scan to determine if other causes of headaches (brain
tumor or bleeding into the brain, for example) are present.
Calculating Your Headache Burden
Some doctors
like to estimate how much migraines disrupt normal activities before treatment
begins. A questionnaire is given to the patient to estimate how often they miss
various functions (school, work, family activities) because of migraines.
Treatment: Over-the-Counter Drugs
There are many
types of over-the-counter (OTC) medicines for headache pain. Some of the most
common are aspirin, naproxen sodium, ibuprofen, and acetaminophen; some OTCs
are marketed as treatments for migraines. Although all of these OTCs may be
helpful, people should not overuse them to avoid toxicity, ulcers, and other
gastrointestinal problems. In addition, overuse may make migraines worse.
Treatment: Triptans
Triptans
(Amerge, Axert, Frova, Imitrex, Maxalt, Relpax, Treximet, and Zomig) are the
most commonly prescribed medication for the treatment of migraines. However,
people with hypertension, heart disease, stroke, and those who take certain
medications may not be able to take triptans; your doctor can help with
medication choices. Unfortunately, side effects of nausea, dizziness, chest
pain, and paresthesia may occur with triptans.
Treatment: Ergotamines
Ergotamines
(Cafergot, Migergot, or Migranal) are used to treat migraines although they are
usually not as effective as triptans. However, they have side effects such as
nausea, dizziness, muscle pain, or an unusual or bad taste in the mouth and may
interact with other drugs. These side effects and drug interactions may limit
the patient’s use of the drug.
Is Your Treatment Working?
Sometimes the
initial treatments for migraines either do not reduce the symptoms or only
marginally reduce them. If, after trying the prescribed treatment(s) about two
or three times and getting little or no relief, you should ask your doctor to
change the treatment. However, patients are urged to treat the migraines early
(within about 2 hours) to get full benefit of treatments.
Limits of Medication Use
Some chronic
headaches are due to overuse of medicine; avoid using migraine prescribed
medicines more than twice per week. Using and tapering medicine for migraines
should proceed under your doctor’s supervision. Narcotics are used as a last
resort for migraines because they can be addictive.
Treatment: Preventive Medicines
If your
migraines are frequent and severe, your doctor may prescribe medication(s) to
lessen the frequency or to prevent the headaches. Medicines that are used in
this manner include Timolol (Blocadren), divalproex sodium (Depakote),
propranolol (Inderal), and topiramate (Topamax), although the drugs were
designed to reduce hypertension or prevent seizures.
Alternative Therapy: Biofeedback
Other methods
that may reduce or prevent migraines include biofeedback techniques to reduce
migraine triggers like stress and early symptoms such as muscle tension
Alternative Therapy: Acupuncture
Although
studies on acupuncture are not definitive, some patients may respond well to
this Chinese method of inserting needles into specific body locations to reduce
or stop pain. Because the results are so variable, some doctors do not
recommend this treatment; but because some patients benefit, it is another
treatment method to consider.
An Advantage of Aging
The peak
intensity and frequency of migraines occur between ages of about 20 to 60 years
of age. As you age past 60, migraine intensity and frequency decrease and in
some patients, migraines cease
When You Need Quick Care
Most people
know the pattern of their migraines (triggers, auras, and pain intensity).
However, new headaches, in people with or without a migraine
history, that last about 2 or more days should be checked by a doctor. However,
if a headache develops with other symptoms such as fever, stiff neck,
confusion, or paralysis, the person or their relative, friend, or caretaker
should be examined emergently
Reviewed by Joseph Carcione, DO on Wednesday, May 11, 2016
Migraine or Headache?
Migraine Symptoms, Triggers, Treatment
This tool does not
provide medical advice.
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