Migraine Head Ache |
Migraine headaches are one of the most common problems seen in emergency departments and doctors' offices. Migraines are due to changes in the brain and surrounding blood vessels.
Migraine headaches typically last from 4-72 hours and vary in frequency from daily to fewer than 1 per year. Migraine affects about 15% of the population. Three times as many women as men have migraines. More than 80% of people with migraines (called migraineurs) have other members in the family who have them too.
Different types of migraine headaches :
- Common migraine accounts for 80% of migraines. There is no "aura" before a common migraine.
- People with classic migraines experience an aura before their headaches. Most often, an aura is a visual disturbance (outlines of lights or jagged light images). Classic migraines are usually much more severe than common migraines.
- Status migrainosus is a migraine that does not go away by itself.
Triggers of migraine headaches are different for each person. Triggers include changes in daily routine, foods, hormones, medicines, lights, odors, or other things in the environment.
The most common migraine triggers are :
- Stress (either during a stressful time or right after stress subsides).
- Menstrual cycle in women.
- Changes in your routine, such as how much you exercise or how much you sleep.
- Fasting or skipping meals.
- Changes in the weather, heat, or high humidity.
- Bright lights, glare, or reflected sunlight.
- Foods, such as chocolate.
- Alcohol—all alcohol, or one type of alcohol in particular, like beer or wine.
- Odors such as perfume, paint, dust, and certain flowers.
The diagnosis of migraine headache rests solely on what a patient describes to a doctor. A doctor's physical examination of a migraineur typically reveals nothing out of the ordinary; however, a neurological examination will be performed to rule out other causes of headache.
Other causes include stroke, tumor, inflammation of a blood vessel, and infection of the brain's coverings (meningitis) or of the sinuses.
In such cases, the following tests may also be performed :
- Blood tests
- X-rays
- CT scan or MRI of the head to look for bleeding, stroke, or tumor.
- A spinal tap (also called a lumbar puncture) to look for evidence of infection or bleeding
Self-Care at Home
- Most migraineurs can manage mild-to-moderate attacks at home with the following strategies:
- Using a cold compress to the area of pain
- Resting with pillows comfortably supporting the head or neck
- Resting in a room with little or no sensory stimulation (light, sound, odors)
- Withdrawing from stressful surroundings
- Sleeping
- Drinking a moderate amount of caffeine
- Trying certain over-the-counter headache medications
- Nonsteroidal anti-inflammatory drugs (NSAIDS) : These include medications like aspirin, ibuprofen (Motrin, Advil), naproxen (Naprosyn, Aleve), and ketoprofen (Orudis). Stomach ulcers and bleeding are serious potential side effects. This type of medication should not be taken by anyone with a history of stomach bleeding. A doctor or pharmacist should be asked about possible medicine interactions if the migraineur is taking other drugs.
- Acetaminophen (Tylenol): Acetaminophen may be safely taken with NSAIDs for an additive effect. Taking acetaminophen by itself is usually safe, even with a history of stomach ulcers or bleeding. Acetaminophen should not be taken if the migraineur has liver problems or has 3 or more alcohol drinks a day.
- Combination medications : Some over-the-counter pain relievers have been approved for use with migraine. These include Excedrin Migraine, which contains acetaminophen and aspirin combined with caffeine. A similar effect can be achieved by taking 2 aspirin or acetaminophen tablets with a cup of black coffee.
- Drink water
- Drink Caffeine
- Tying a headband around the head
- Fish oil
- Peppermint oil
- Eat Ginger or Take Ginger capsules
- Magnesium
- Vitamin B2(Riboflavin) : In doses of 400 milligrams a day, vitamin B2 can also act as a preventative for migraines, It can cause some people to urinate more frequently or have darker urine, so the dosage may have to be adjusted.
- CoEnzymeQ10 : Grosberg said that taking 300 milligrams per day has proven to be effective in reducing head pain.
- Butterbur : The most effective "natural medicine," Grosberg said, is called butterbur, or petasites.
- Cold (or hot) compress.
Migraine triggers should be identified and avoided. Making individual lifestyle changes is very important. Changes may include avoiding certain types of foods and certain emotional situations. If missing meals triggers headaches, the migraineur should make every effort to eat on a regular basis. In some instances, the use of biofeedback may help reduce the severity and frequency of attacks.
Outlook :
After the headaches are under control, the prognosis is very good. However, patience is the key. As noted previously, it may take several attempts before an effective treatment plan is found.
Treating migraine is an art more than a science. No "cookbook" recipe is effective for every person. A drug that works well for one migraineur may not provide any relief for another. A combination of different medications is sometimes needed to treat resistant headaches.