A migraine is a severe, painful headache that can be preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound.
The excruciating pain that migraines bring can last for hours or even days. Migraine is a common problem affecting 36 million Americans, about 12% of the population.
Symptoms of migraine
Symptoms of migraine can occur a while before the headache, immediately before the headache, during the headache and after the headache. Although not all migraines are the same, typical symptoms include:
- Moderate to severe pain, usually confined to one side of the head during an attack, but can occur on either side of the head
- The pain is usually a severe, throbbing, pulsing pain
- Increasing pain during physical activity
- Inability to perform regular activities due to pain
- Feeling sick and physically being sick
- Increased sensitivity to light and sound, relieved by lying quietly in a darkened room
- Some people experience other symptoms such as sweating, temperature changes, tummy ache and diarrhea.
Treatments for migraines
There is currently no cure for migraine, so treatment is aimed at preventing a full-blown attack, and alleviating symptoms if they come. Different people respond to different treatments.
Some lifestyle alterations might help reduce migraine frequency, says Mayo Clinic doctor, Robert Sheeler MD. These include:
- Getting enough sleep
- Reducing stress
- Drinking plenty of water
- Avoiding certain foods
- Regular physical exercise.
Migraine treatment (abortive therapies) and prevention (prophylactic therapies) focus on avoiding triggers, controlling symptoms and taking medicines.
Over-the-counter medications such as naproxen, ibuprofen, acetaminophen (paracetamol), and other analgesics like Excedrin (aspirin with caffeine) are often the first abortive therapies to eliminate the headache or substantially reduce pain
Painkillers should be taken early rather than allowing the headache to develop.
Metoclopramide may also be used to control symptoms such as nausea and vomiting.
Sumatriptan may also be prescribed for severe migraines or for migraines that are not responding to the over-the-counter medications
Another class of abortive treatments is called ergots, which are usually effective if administered at the first sign of a migraine.
Prophylactic therapies (prevention)
Migraine prevention begins with avoiding things that trigger the condition.
The main goals of prophylactic therapies are to reduce the frequency, painfulness and duration of migraine headaches and to increase the effectiveness of abortive therapies.
There are several categories of preventive migraine medicine, ranging from diet changes and exercise to prescription drugs. Some of these include:
- Prescription beta blockers
- Anticonvulsants (Topiramate)
- Antidepressants (Tricyclics and SSRIs)
- Botulinum toxin A (Botox)
- Herbs and vitamins such as butterbur, cannabis, coenzyme Q10, feverfew, magnesium citrate, riboflavin, B12, melatonin
- Spinal cord stimulator implantation
- Hyperbaric oxygen therapy
- Vision correction
- Exercise, sleep, sexual activity
- Visualization and self-hypnosis
- Chiropractic care or acupuncture.
Some people find that special diets such as gluten-free can help.
It is possible for people to get a medication overuse headache (MOH) – or rebound headache – when taking too many medications in an attempt to prevent migraine.
In the last decade, novel approaches to the treatment of migraines have been developed. Botulinum toxin (Botox) injection and surgical decompression of the extracranial sensory branches of the trigeminal and cervical spinal nerves have been shown to reduce or eliminate migraines in patients who are incompletely treated by traditional medical management.