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How To Diagnose Migraine Headaches

Describe The Pain For Me

Headache Relief & Diagnosis : How to Diagnose Migraine Headache Symptoms

Migraine pain is typically throbbing or pulsating. A dull, nagging, persistent pain is more characteristic of tension-type headache. This pain is sometimes described as tight and constricting or as a feeling of pressure. The pain of cluster headache is deep penetrating, as though a hot poker were driven into the eye.

Women With Menstrual Migraine

Approximately 8% of women with migraine experience migraine attacks that are exclusively related to their menstruation, referred to as pure menstrual migraine,. If optimized acute medication therapy does not suffice for these patients, initiation of perimenstrual preventive treatment should be considered. This approach typically involves daily intake of a long-acting NSAID or triptan for 5 days, beginning 2 days before the expected first day of menstruation,,,. Some women with pure menstrual migraine without aura benefit from continuous use of combined hormonal contraceptives. By contrast, combined hormonal contraceptives are contraindicated in women with migraine with aura regardless of any association with their menstrual cycle, owing to an associated increase in the risk of stroke.

Do You Get Any Warning That A Headache Is Coming On

About 15 % of all migraine sufferers will have a warning called an aura before the headaches strikes. The aura often takes the form of the disturbances in vision, such as seeing zig-zag lines and twinkling lights. Numbness in the hands or face is another common aura. The aura usually lasts less than an hour and goes away as the headache begins. An aura that continues beyond headache should be brought to your physicians attention.

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To Make A Diagnosis You Doctor May:

  • Take a detailed history of your headaches and other symptoms, including gathering information on the features of the headaches. Your doctor may ask how often attacks happen, how severe the pain, how long the attack lasts, and what symptoms go with your attacks. Your doctor may ask about your family history relating to headaches and migraines.
  • Perform a thorough examination, including a neurological assessment. Your doctor will ask for detailed information about your attacks and will likely ask you to keep a migraine diary. This might include details of triggers, treatments, and symptom emergence.

Whats A Migraine What Does A Migraine Feel Like

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A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that its the sixth most disabling disease in the world.

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Types Of Migraines And Their Symptoms

You may have one or more types of migraine headache. Each type has its own features. For example, some people get migraines with an aura. Some get them without an aura. Some women get menstrual migraines, which happen before, during, or shortly after their menstrual period.

It can be hard to tell the difference between a migraine and another type of headache, such as a tension or sinus headache. You may think that you have sinus headaches. But it’s more likely that they are migraine headaches if they happen often and interfere with your daily life.

Migraines can occur along with many other health problems, such as asthma or depression. More serious conditions, such as tumours or infections, can also cause migraine symptoms. But most headaches are not caused by serious health problems.

What If My Symptoms Change

Dont worry, says the Migraine Trust. According to the research organization, a change in the pattern of your headaches or other symptoms might be the result of the naturally changing course of migraine symptoms vary over time as well. Women, for example, may have different patterns of attacks when hormonal changes occur. However, these pattern changes should still be checked by your doctor, as this can help rule out any other causes, especially if your migraine attacks get worse or develop unusual symptoms.

In addition, many migraine sufferers also experience other types of headache, such as tension-type headache, which means that they need to be identified, treated, and prevented appropriately. Putting other headaches under control can drop the number of frequent migraine attacks one may suffer.

-Additional reporting by Steven Aliano

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Sinus Headaches Are Often Misdiagnosed Migraines

Dr. Cooper also notes that “most ‘sinus headaches’ that are bad enough to take you to a doctor’s office are actually migraines. They just feel like a sinus headache because of where the pain is and how sick you feel.”

So don’t self-diagnose or misdiagnose your migraine as a sinus headache. The analysis is best left to a professional.

A Process Of Elimination

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Why all the questions? Doctor want to rule out other types of head pain, such as sinus headaches and cluster headaches, as well as other potential causes. Red flags that something else is going on include fever, weight loss, runny nose, eye tearing or sudden onset of headaches. Doctors use a method called SNOOP to elicit whether any of these worrisome symptoms could be a sign of a serious health situation such as a brain aneurysm or brain tumors . Your physical exam will include vital signs and simple neurologic tests to help rule out those possibilities. In the rare case that your doctor finds cause for concern, blood tests and/or imaging studies will be ordered to pinpoint the root cause, says Dr. Seng.

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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?

Migraine And Other Vascular Disease

People who suffer from migraine headaches are more likely to also have cardiovascular or cerebrovascular disease . Reliable evidence comes from the Women’s Health Study, which found that migraine with aura raised the risk of myocardial infarction by 91% and ischemic stroke by 108% and that migraine without aura raised both risks by approximately 25%. Migraines during pregnancy are also linked to stroke and vascular diseases. A 2017 analysis of the Women’s Health Study found that women who experience migraine headaches, particularly migraine without aura, may be at increased risk for hypertension. Compared with women without a history of migraine, those who experienced migraine with aura had about a 9% increased risk for hypertension while those who experienced migraine without aura had about a 21% increased risk.

Migraine with aura for women in midlife has a statistically significant association with late-life vascular disease in the cerebellum. This association is not seen in migraine without aura.

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Migraines Do Not Respond To Over

For me, taking a Tylenol or Advil or Excedrin was akin to popping a placebo. It did nothing more than upset my stomach if I took multiple pills.

Dr. Murray Grossan noted that a migraine does not respond to Tylenol or Motrin but does respond to Imitrex or other tryptophans. I can attest that once I started taking prescribed Imitrex, my headaches would go away. Prior to Imitrex entering my life and my bloodstream, I had to wait it out for days at a time, leading to decreased productivity and lots of wasted time.

What Medications Are Used To Relieve Migraine Pain

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Over-the-counter medications are effective for some people with mild to moderate migraines. The main ingredients in pain relieving medications are ibuprofen, aspirin, acetaminophen, naproxen and caffeine.

Three over-the-counter products approved by the Food and Drug Administration for migraine headaches are:

  • Excedrin® Migraine.
  • Advil® Migraine.
  • Motrin® Migraine Pain.

Be cautious when taking over-the-counter pain relieving medications. Sometimes overusing them can cause analgesic-rebound headaches or a dependency problem. If you’re taking any over-the-counter pain medications more than two to three times a week, report that to your healthcare provider. They may suggest prescription medications that may be more effective.

Prescription drugs for migraine headaches include:

Triptan class of drugs :

  • Sumatriptan.
  • Butterbur.
  • Co-enzyme Q10.

Drugs to relieve migraine pain come in a variety of formulations including pills, tablets, injections, suppositories and nasal sprays. You and your healthcare provider will discuss the specific medication, combination of medications and formulations to best meet your unique headache pain.

Drugs to relieve nausea are also prescribed, if needed.

All medications should be used under the direction of a headache specialist or healthcare provider familiar with migraine therapy. As with any medication, it’s important to carefully follow the label instructions and your healthcare providers advice.

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Migraines Can Interrupt Daily Life

While an intense headache is annoying and disruptive, a migraine can interrupt the sufferer’s daily life, incapacitating them and grinding their usual routines to a halt. “With migraine, sufferers may have difficulty performing their regular daily activities and typically prefer to rest in a dark and quiet area,” said Dr. Grosberg.

“This is in contrast to the most common type of ‘regular’ headache that people experience which is tension-type headache. This type of headache can last from 30 minutes to one week and often affects both sides of the head in a ‘band-like’ distribution. The pain may be a pressure or ache, mild to moderate in intensity, and is not associated with light and sound sensitivity or nausea. With tension-type headache, people can often function during their daily activities.”

Morgan furthered, “Many people with migraines cannot function during an episode whereas with other headaches, you can rally and get through your day.”

Diagnosis Of Migraine Without Aura

Most people with migraine have migraine without aura. To be diagnosed with migraine without aura, you doctor will look for:1

  • At least 5 attacks
  • Head pain that lasts 4 hours to 3 days, if untreated
  • Head pain on 1 side of the head that feels throbbing or pulsing, is moderate to severe, and gets worse with routine activity such as walking or climbing stairs
  • Nausea, vomiting, or both
  • Sensitivity to light and sound

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Here’s How To Manage Your Migraines

More than just a headache, migraine is a neurological condition that can cause intense head pain along with a variety of other symptoms, including nausea, vomiting, sensitivity to light and sound, numbness or tingling, difficulty speaking, temporary vision loss, and seeing shapes or flashing lights.

The causes of migraine arent fully understood, but they may have something to do with changes in brain chemicals and the brains interaction with the trigeminal nerve, as well as genetics and environmental factors.

If you get migraines, you should work with your doctor to develop a personalized treatment plan. In the meantime, here are some tips that can help you manage the condition and relieve your symptoms.

If you get a sudden, severe headache or any new or unusual symptoms such as fever, confusion, or problems seeing or speaking, head to the emergency room right away. You may be having a stroke or another medical emergency.

Other Things To Think About

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  • Even with treatment, you may still get migraines.
  • It may take some time to find the right medicines to help you.
  • Using medicines too often can cause rebound headaches. These are different from migraine headaches. They occur after pain medicine has worn off, which leads you to take another dose. After a while, you get a headache whenever you stop taking the medicine. Be sure to take your medicine only as your doctor prescribes.
  • If you think your headaches could be caused by depression or anxiety, be sure to let your doctor know. Treatment for these health problems may get rid of your headaches or reduce how often you have them.
  • If you think your headaches are related to stress, talk to your doctor about getting help to cope better with stress.

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What Are The Common Symptoms Of Migraine

How can you tell if your head pain is actually migraine? The symptoms vary from person to person. But if you agree with some or many of the statements below, your head pain may be migraine and you should think about seeing a doctor.

  • Your head pain is moderate or severe and often intense. The pain may be hard to endure and may be unbearable.
  • The pain may be on one side of the head or both. It could be in the front or in the back. Some patients experience migraine in or around their eyes and behind their cheeks.
  • Your head pain causes a throbbing, pounding, or pulsating sensation.
  • Your head pain gets worse with physical activity or any movement.
  • You experience nausea and/or vomiting
  • You are sensitive to light, noise and/or smells.
  • Your head pain is severe enough to make you miss school, work or other activities .
  • A migraine attack lasts anywhere from four hours to several days.

Some people have migraine with aura. The most common type of aura is visual . Aura can also cause blurred vision or loss of vision. Typically, aura occurs before the head pain of the attack begins, and fully resolves in an hour or less.

Migraine can be classified as episodic or chronic. People with episodic migraine have 14 or fewer headache days per month. People with chronic migraine experience more than 15 headache days per month with at least eight that include migraine features . In some people, episodic migraine can become chronic, which may happen if its not recognized and treated correctly.

How Long Does The Headache Attack Last

A typical migraine headache lasts less than 24 hours. Less commonly, a migraine can be as brief as 20 minutes or last for weeks. Generally, a migraine sufferer has headache-free periods between attacks. Tension-type headache can persist for days, weeks, or sometimes years. Cluster headaches are very intense but brief, usually lasting 30-90 minutes and repeating two to six times a day during a cluster episode.

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Gathering Your Medical History

Your doctor will need to gather a lot of information about your personal medical history and your family medical history to diagnose migraine.

Theyll ask you to provide as many details as you can about your symptoms. Theyll also want to know about any other medical conditions youve been diagnosed with and about any other symptoms youve been having recently.

Youll be asked about your diet, stress levels, activity levels, and other aspects of your lifestyle.

Your doctor might ask you to keep a migraine journal until your next appointment. In the journal, youll record every time you have pain and describe what that pain feels like.

You can also record anything you do for the pain at home and whether it helps at all. For example, you might want to make note of whether certain over-the-counter medications help.

Youll need to provide as much family health history as you can. Since migraine tends to run in families, its important for the doctor to know whether you have any relatives whove been diagnosed with migraine. Its also important to let them know about any other conditions that run in your family.

Find Out The Symptoms Causes And Treatments Of This Disabling Neurological Disease

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Migraine is not just a bad headache. Its a disabling neurological disease with different symptoms and different treatment approaches compared to other headache disorders. The American Migraine Foundation estimates that at least 39 million Americans live with migraine, but because many people do not get a diagnosis or the treatment they need the actual number is probably higher.

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What Are Migraine Headaches

Migraines are painful, throbbing headaches that last from 4 to 72 hours. When you have a migraine, it may be so painful that you are not able to do your usual activities. But even though migraines make you feel bad, they don’t cause long-term damage.

Migraines are a health problem that can be treated. Talk to your doctor about your migraines.


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