Migraine Is Much More Than Just A Headache
There are different types of migraine that involve different symptoms. There are many features or symptoms that are a part of migraine. There are also differences in how severe a symptom might be.
The most common symptoms of a migraine attack include:
- throbbing headache
- sensitivity to light, noise and smell
Comparing The Sensory Processing Abilities Between Children With Migraine And Healthy Controls
Children with migraine had lower scores than healthy controls in SSP total scores and in all SSP subtests. This difference was significant only in regards to taste/smell sensitivity .
Table 2. Comparing the Short Sensory Profile scores between children with Migraine and healthy controls using MannWhitney test.
Based on Chi square analysis, significantly higher percentage of children with migraine was found in the definite difference performance range in the taste/smell sensitivity and in the SSP total score , representing sensory processing difficulties expressed in hypersensitivity.
Table 3. Comparing differences between groups in the percentage of children found in each of the SSP performance range using Chi square analysis.
The Role Of Hyperosmia
In contrast, hyperosmia is when disease, pregnancy, nutritional deficiencies, or an adverse reaction to a medication causes smell hypersensitivity.
Hyperosmia and osmophobia can work together to induce a migraine attack. Because hyperosmia causes smell hypersensitivity, it can induce a psychological response in the form of osmophobia.
Having hyperosmia does not necessarily mean you will get a migraine even if you are prone to them. The same may not be true for osmophobia in which the anxiety induced by a smell serves as a direct trigger for the attack.
Scent hypersensitivity from hyperosmia could be related to the size of the olfactory bulb .
Some studies have suggested that people who get migraines are more likely to have a smaller olfactory bulb than people don’t. Others have reported that people with migraines and osmophobia have an even smaller olfactory bulb volume.
Some researchers suggest that diminished blood flow to the olfactory bulb could be the cause of shrinkage of this organ. However, these structural changes are subtle, and measuring your olfactory bulb is not a standard procedure.
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Migraine Is More Than A Headache Learn About Other Symptoms Of Migraine Including Uncommon And Surprising Signs
How do you know if your symptoms add up to migraine? A migraine attack typically involves moderate to severe head pain, often on one side of the head. Headache is a general term to describe head pain and is a common symptom of migraine. However, not all headaches are caused by migraine, and not all migraine involves head pain.
For the 39 million people living with migraine in the U.S., attacks usually involve other symptoms besides head pain. Some common symptoms are nausea, vomiting and sensitivity to light, smells and sounds. But other signs are less common or overlooked. Many people who experience these symptoms may not realize they are related to migraine.
Knowing all the symptoms of migraineeven the uncommon onesis important for getting the proper diagnosis and treatment. Weve outlined nine surprising symptoms of a migraine attack to help guide you.
Polarized Sunglasses And Cutting Glasses
I do not go outside without extremely dark polarized sunglasses. This is the one accessory where my husband and I will spend a significant amount to make sure the glasses work for me. At one point, I wore cutting safety glasses as sunglasses because they blocked out even more levels of lights than regular polarized sunglasses. The only issue with the cutting glasses was that they were not safe for driving because the glasses canceled out the red lights, from brake lights to the words on the Amber Alert signs.
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Complications And Associated Conditions
Hyperosmia is sometimes caused by migraines. One study found that between 25 to 50 percent of the 50 patients in their study experienced some version of hyperosmia during their migraine attacks. 11 of the patients experienced hyperosmia before the actual migraine.
Severe cases of hyperosmia can disrupt your life by causing anxiety and depression, especially if youre unsure what smells might trigger the discomfort. This can be isolating because it may be difficult for you to attend certain events or go to certain places.
Causes Of Retinal Migraine
In retinal migraine, only one eye is affected at a time. This type of migraine is associated with a problem with blood vessels in the optic nerve or the eye itself, rather than the occipital cortex. A constriction of blood flow in the central retinal artery may cause the condition. There is also speculation that the condition is caused by a spreading depression in neurons in the retina. This phenomenon resembles a cortical spreading depression but is more localized.
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The Senses That Can Trigger Migraines
Migraines are often very sensitive to sensory stimulation for some people. Certain wavelengths of light seem to provoke migraines for some people, certain smells seem to promote migraines. For some people, even loud sounds can provoke migraines, says Sylvia Mohen, MD, neurologist in New York City.
To make it worse, people who have frequent migraines seem to be increasingly sensitive to lights, smells, and odors.
It is estimated that 90 percent of people who experience migraines are sensitive to light. This is called photosensitivity. Sometimes people who become more chronic migraineurs or have a higher burden of migraine headaches become very sensitive to light overall, just as a result of their migraines, says Dr. Mohen.
Another common indicator of migraines is osmophilia, or sensitivity to odors. This is estimated to occur in about 95 percent of people with migraines. If you find that your coworkers strong perfume, cigarette smoke, car exhaust, cleaning products, and certain foods trigger a migraine, you may be sensitive to certain smells.
People with migraines also sometimes develop something called phantosmia, which is olfactory hallucinations of smells that can be associated with migraines, says Dr. Mohen. That can be actually the sign that the migraine is about to occur. Many people who experience this report that the smells they notice are pretty foul, like the smell of a wet dog.
When Should I Seek Immediate Help Or Contact My Healthcare Provider
- You are experiencing the worst headache of my life.
- You are having neurologic symptoms that youve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
- Your headache comes on suddenly.
- You have a headache after experiencing a head injury.
Schedule a visit with your healthcare provider if:
- The number or severity of your headaches increase or your headache pattern changes.
- Your medications no longer seem to be working or youre experiencing new or different side effects.
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Other Therapies For Photophobia
Therapeutic products can also significantly cut down on the wavelengths and/or intensity that triggers and worsens light sensitivity. TheraSpecs blue light glasses for migraine and headache disorders remove more blue light at 480nm than similar tinted glasses, making them a highly-effective remedy for photophobiawithout side effects. TheraSpecs are also available as dark blue light sunglasses that are better than other high-quality sunglasses.
If you cant try TheraSpecs, you definitely want dark and polarized sunglasses that eliminate 100% UVA/UVB light for outdoor use. And if you find that light coming in from the top or sides is problematic, you should look for eyewear that adds wraparound side protection, large lens coverage, and additional anti-reflective lens coatings. You may also want to avoid translucent or see-through frames in which light can pass through it, and a non-glossy matte finish on the frame might help lower the reflectiveness.
Behavioral changes can also enhance your overall comfort with certain light sources, although their effectiveness can be highly variable, such as:
With the right combination of professional guidance, prescription therapeutics and products, and lifestyle modifications, you can lower the impact of light-sensitive headaches.
Stages Of A Migraine Attack
It is often difficult to know when a migraine attack is going to happen. However, you can often tell the pattern of each attack as there are well defined stages.
It is these stages and their symptoms that distinguish a migraine from a headache.
However, not everyone will experience all of the symptoms of each stage and the stages can overlap. In adults, we can divide a migraine attack into four or five stages that lead on from each other.
Learning to recognise the different stages of a migraine attack can be useful. You might get one, all, or a combination of these stages, and the combination of stages may vary from attack to attack. Each stage can vary in how long and how bad it is. Recognising different symptoms at different times during your attack can give your doctor information which may help them make a diagnosis. Taking medication as soon as you notice the pain may stop or shorten an attack.
Migraine attacks in children are often much shorter than in an adult. It may be easier to tell the different headache stages in a child.
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Concussion Not Needing Imaging
A traumatic brain injury , or concussion, happens when a bump, blow, jolt, or other head injury causes damage to the brain. Every year, millions of people in the U.S. suffer brain injuries. More than half are bad enough that people must go to the hospital, and the worst injuries can lead to permanent brain damage or death.
Top Symptoms: dizziness, irritability, depressed mood, difficulty concentrating, trouble sleeping
Symptoms that always occur with concussion not needing imaging: head or face injury
Symptoms that never occur with concussion not needing imaging: recent fall from 6 feet or higher, severe vomiting, posttraumatic amnesia over 30 minutes, slurred speech, fainting, moderate vomiting
Urgency: Primary care doctor
How Are Migraines Treated
Migraine headaches are chronic. They cant be cured, but they can be managed and possibly improved. There are two main treatment approaches that use medications: abortive and preventive.
- Abortive medications are most effective when you use them at the first sign of a migraine. Take them while the pain is mild. By possibly stopping the headache process, abortive medications help stop or decrease your migraine symptoms, including pain, nausea, light sensitivity, etc. Some abortive medications work by constricting your blood vessels, bringing them back to normal and relieving the throbbing pain.
- Preventive medications may be prescribed when your headaches are severe, occur more than four times a month and are significantly interfering with your normal activities. Preventive medications reduce the frequency and severity of the headaches. Medications are generally taken on a regular, daily basis to help prevent migraines.
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Why Does Sensitivity To Smell Occur With Migraine
Doctors do not understand why sensitivity to smell is linked to migraine attacks. Migraine may activate brain cell pathways that change sensory processing, and this may change how people perceive smells.4
Processing of smells involves the limbic system of the brain, the area that controls emotions and hunger and sex drives. People with migraine show more activity in the limbic system during a migraine attack than in between attacks.2
How Is Hyperosmia Diagnosed
A doctor can rule out a treatable causes for your sensitivity to smell by reviewing your health history and doing a physical exam, says Dr. Sindwani. A nasal endoscopy is the gold standard test to rule out anything physical going on in your nose like a mass, polyps or infection.
During this minor procedure , your doctor:
With this type of endoscopy, we can actually see the area where the smell receptors live high up in the nasal cavity, explains Dr. Sindwani.
If your nose gets the all clear, your doctor may do a scratch and sniff smell test. If that points to an increased sense of smell, hyperosmia is usually the diagnosis.
Smell and taste are also closely linked. For that reason, a smell disorder can initially seem like a taste problem. Often, people come in and say, Things dont taste right to me, when over time, we learn its a smell problem. You can have one, the other or both of those things in play.
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Chronic Migraine And Abnormal Sense Of Smell Linked
Patients with chronic migraine are often hypersensitive to stimuli, including light, sound, and odors. In fact, some researchers believe the aversion to odors, osmophobia, is particularly helpful in a differentiating migraine from other headache disorders. Now, new research suggests that patients with chronic migraine do not experience a significant change in their sense of smell between migrainous and non-migrainous periods, but they appear more likely to have an abnormal sense of smell at baseline compared to their peers who do not experience migraine.
Alexander Whiting, MD, of the Department of Neurology at Thomas Jefferson University Hospital in Philadelphia, and colleagues studied the sense of smell in 50 individuals with chronic migraine and 50 controls. To test olfactory acuity, researchers employed the University of Pennsylvania Smell Identification Test .
They found that migraineurs performed worse than their peers without migraine. Among migraineurs, 42 of 50 people were bothered by odors compared with only 9 of 50 controls. Additionally, 41 of the 50 migraineurs found more than one listed odor to be extremely bothersome, compared with only 10 of the 50 in the control group. On days when they did not report a migraine, 18 of 48 subjects experienced abnormalities with their sense of smell. During a migraine attack, 14 of 42 experienced such abnormalities. In the control group, however, fewer individuals, reported problems with their olfactory sense.
Sensitivities Turned Migraine Triggers
While these sensitivities started as symptoms of my migraine, as time went on they became triggers for my migraine as well. Never did I imagine having so many intense sensitivities or weaknesses so young in life. But as with most elements of chronic migraine, I have to push through and adapt as my body changes.
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Why Do I Get Headaches When I Smell Scents
Why can perfume cause a headache? Fragrances contain a variety of chemicals to achieve a specific scent. When inhaled, the chemicals irritate your sinuses and can cause your sinuses to swell. Your sinuses do not drain properly once they are swollen and the resulting pressure build-up can cause a headache.
Whats A Migraine Journal
- Keeping a migraine journal is not only beneficial to you, but it helps your healthcare provider with the diagnosis process. Your journal should be detailed and updated as much as possible before, during and after a migraine attack. Consider keeping track of the following:
- The date and time of when the migraine began specifically when the prodrome started, if youre able to tell its happening. Track time passing. When did the aura phase begin? The headache? The postdrome? Do your best to tell what stage youre in and how long it lasts. If theres a pattern, that may help you anticipate what will happen in the future.
- What are your symptoms? Be specific.
- Note how many hours of sleep you got the night before it happened and your stress level. Whats causing your stress?
- Note the weather.
- Log your food and water intake. Did you eat something that triggered the migraine? Did you miss a meal?
- Describe the type of pain and rate it on a one to 10 scale with 10 being the worst pain youve ever experienced.
- Where is the pain located? One side of your head? Your jaw? Your eye?
- List all of the medications you took. This includes any daily prescriptions, any supplements and any pain medication you took.
- How did you try to treat your migraine, and did it work? What medicine did you take, at what dosage, at what time?
- Consider other triggers. Maybe you played basketball in the sunlight? Maybe you watched a movie that had flashing lights? If youre a woman, are you on your period?
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Tips For Dealing With Smells When You Have Fragrance Sensitivity
I wish I could share with you a long checklist of action steps to take to keep overwhelming odors to a minimum. The truth is, theres only so much you can do. If youre sensitive to fragrances, youre often going to find yourself in situations where you cant control how the people, places, or activities around you smell.
But there are steps I take to minimize getting overwhelmed by fragrances. Here are five strategies that help me, and if you have fragrance sensitivity, may help you too:
Alice In Wonderland Syndrome
Alice in Wonderland syndrome is a disorder marked by changes in how you see the world, especially your own body. It can happen when you have a migraine or another health condition. Doctors think it might be a type of migraine aura.
Alice in Wonderland syndrome involves changes to parts of your brain that deal with sensory information — what you see and hear. Strange things may happen when you have an episode, including:
- Your body parts or things around you look bigger, smaller, closer, or farther away than they really are.
- Straight lines look wavy.
- Things that are still seem to move.
- Three-dimensional objects look flat.
- Things change colors or tilt to the side.
- Faces look distorted.
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Helping To Reduce Migraines
Although TMJ treatment will probably not help combat your sensitivity to odors, it can help reduce your tendency to develop migraines for other reasons. This can reduce the burden of your migraines and potentially make it easier to get accommodations for scents and other workplace migraine triggers.
If you would like to learn how TMJ treatment might be able to help your migraines in Columbia, SC, please call today for an appointment with a TMJ dentist at Smile Columbia Dentistry.