What Else Can I Do To Prevent Migraines
While there are no sure ways to keep from having migraine headaches, here are some things that may help:
Eat regularly and do not skip meals.
- Keep a regular sleep schedule.
- Exercise regularly. Aerobic exercise can help reduce tension as well as keep your weight in check. Obesity can contribute to migraines.
- Keep a migraine journal to help you learn what triggers your migraines and what treatments are most helpful.
Diagnosing Migraine With Aura
ICHD III criteria for migraine with aura is:
A) At least 2 attacks fulfilling criteria B and C
B) 1 or more of the following fully reversible aura symptoms:
2) No motor or retinal symptoms.
Not all symptoms are listed here but brainstem auras can cause what feels like very strange outer body experiences. Sometimes it is referred to as Alice in Wonderland syndrome which is a rare but distinctive distortion of body image and perspective. This syndrome can occur at any age and is thought to be more common amongst children.
Types Of Migraine With Aura
Aura can happen in four types of migraine:
- Migraine with aura . This is also called a classic migraine.
- Migraine with brainstem aura. This is when the aura starts in the base of your brain or both sides of your brain.
- Hemiplegic migraine. In this rare type, aura causes weakness on one side of your body .
- Retinal migraine. You have vision changes in one eye before the migraine begins.
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What About Treating Aura Specifically
Evidence suggests magnesium can help control pain symptoms in migraine with aura. Some health professionals recommend taking magnesium to help with migraine prevention as well, but you should speak with your doctor about your medical history before starting any supplements.
In May 2018, the U.S. Food and Drug Administration approved the first medication developed specifically to prevent migraine headaches, a biologic drug calledAimovig .
Aimovig, a once-monthly subcutaneous injection, blocks the transmission of pain signals by targeting a protein in the brain and nervous system called calcitonin gene-related peptide . It also dilates blood vessels outside and inside of the skull.
What Is A Migraine With Aura
About a quarter of all migraines happen with auras. But you may not have one with every migraine. Some children and older adults may get an aura but no pain.
Though they can hurt a lot and make you feel “off,” these headaches aren’t life-threatening. There are things you can do as well as medications and devices that can treat the symptoms and prevent migraine with aura.
What is aura?
“Aura” is the term for any of the sensory changes that happen before a migraine headache. They can affect your vision, hearing, or ability to speak. You could also have muscle weakness or tingling.
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What Are Some Migraine Risk Factors And Triggers
Some things make you more likely to get migraine headaches . Other things may bring on a migraine .
Common migraine risk factors include the following:
- Family history: You are much more likely to have migraines if one or both of your parents had migraines.
- Sex: Women are more likely than men to have migraines.
- Age: Most people have their first migraine during adolescence, but migraines can start at any age, usually before age 40.
Common migraine triggers include the following:
- Food and drink: Certain food and drink may cause migraines. Dehydration and dieting or skipping meals may also trigger migraines.
- Hormone changes: Women may experience migraines related to their menstrual cycles, to menopause, or to using hormonal birth control or hormone replacement therapy.
- Stress: Stress may trigger migraines. Stress includes feeling overwhelmed at home or work, but your body can also be stressed if you exercise too much or dont get enough sleep.
- Senses: Loud sounds, bright lights , or strong smells may trigger migraines.
- Medicines: Certain medicines may trigger migraines. If you think your migraines might be related to your medicine, talk to your doctor. Your doctor may be able to prescribe a different medicine.
- Illness: Infections, such as the cold or the flu, may trigger migraines, especially in children.
Foods that may trigger migraines:
- aged, canned, cured, or processed meat
- aged cheese
- soy sauce
When You Get A Migraine
Try to treat your symptoms right away. This may help make the headache less severe. When migraine symptoms begin:
- Drink water to avoid dehydration, especially if you have vomited
- Rest in a quiet, dark room
- Place a cool cloth on your head
- Avoid smoking or drinking coffee or caffeinated drinks
- Avoid drinking alcoholic beverages
- Try to sleep
Over-the-counter pain medicines, such as acetaminophen, ibuprofen, or aspirin, are often helpful when your migraine is mild.
Your health care provider may have prescribed medicines to stop a migraine. These drugs come in different forms. They may come as a nasal spray, rectal suppository, or injection instead of pills. Other medicines can treat nausea and vomiting.
Follow your provider’s instructions about how to take all of your medicines. Rebound headaches are headaches that keep coming back. They can occur from overuse of pain medicine. If you take pain medicine more than 3 days a week on a regular basis, you can develop rebound headaches.
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What Symptoms Must You Have To Be Diagnosed With A Migraine
Migraine with aura . This is a headache, plus:
- Visual symptoms or vision loss.
- Sensory symptoms .
Migraine without aura . A common migraine is a headache and:
- The attacks included pain on one side of your head.
- Youve had at least five attacks, each lasting between four and 72 hours.
Plus, youve experienced at least one of the following:
- Nausea and/or vomiting.
- Lights bother you and/or you avoid light.
- Sounds bother you and/or you avoid sounds.
Can You Prevent Complex Migraine
If you can link your migraine to environmental triggers like the smell of cigarette smoke or drinking red wine you can usually avoid these to prevent complex migraine. Stress may be more difficult to avoid, but not impossible.
To treat complex migraine, doctors may also prescribe medications that may help brain chemistry. You may need to try different treatments or combinations of treatments before you find one that may help reduce migraine days.
Examples of preventive treatments may include:
- antiseizure medications
- calcium channel blockers
If you rarely have migraine, doctors dont usually recommend the above treatments. Preventive medications are usually reserved for people who have migraine days frequently, which interfere with their daily activities.
Researchers have detected changes in three genes that may cause hemiplegic migraine or those that lead to weakness on one side if your body. Specifically, these genes are:
These genes help with nerve cell function in your brain. However, doctors havent defined how changes in these genes lead to migraine.
If you have a family history of complex migraine, youre more at risk of developing this type.
NORD defines the inheritance pattern as a 50 percent risk that a parent will pass the gene on to a child with each pregnancy.
However, many people with complex migraine dont have a family member with this migraine type.
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How To Prevent Hormonal Migraines
Many women have found success with starting a menstrual diary, recording when the migraine appeared during the last three cycles.
Once you have a better understanding of when the migraine appears during your menstrual cycle, the better prepared you will be to treat it. Youd be amazed on what you can figure out just by regular, diligent tracking.
It also helps to make note of any other symptoms you have along with the migraine, such as aura or visual disturbances.
Risk Factors And Complications
Like migraines without aura, migraines with aura dont appear to cause lasting damage, although they can be painful and disruptive.4 However, people who experience migraines with aura may have a slightly higher risk of stroke, and so should be aware of the signs.2,5
You should also consult a doctor when you first experience aura symptoms, as some of these can also be caused by a stroke, retinal tear or other serious conditions.2
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How Do We Understand A Migraine Aura
Migraine, just like many pains that we experience in our body are used by our body as a reflex.
This reflex is there to signal to us that we are creating tissue damage and to make us bring our awareness in onto our selves and stop what we are doing. Whether what we are doing right now is part of the cause or not.
Just like if we stub our toe on the corner of some furniture, the pain is there to make us stop doing it and teach us to not repeat the action.
Its a very primal reflex, but it has worked for us for millions of years.
Migraine Aura And Stroke
It has been shown that patients with migraine aura have a slightly increased risk of having a stroke. This is a small risk but can increase further if other risk factors are present such as smoking, high blood pressure, high cholesterol, and being over-weight. So, it is important that patients stop smoking, get their blood pressure, cholesterol and glucose levels checked regularly and maintain a healthy lifestyle and body weight. Another thing that can increase the chances of stroke in these patients is the use of the combined contraceptive pill: this should be avoided by female patients with migraine aura. There are other hormonal options available for contraception. It is important to note that use of oestrogen containing HRT is allowed in patients with migraine and aura.
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Preventive Medications Of Migraine
Medications can help prevent frequent migraines. Your doctor might recommend preventive medications if you have frequent, long-lasting or severe headaches that dont respond well to treatment.
Preventive medication is aimed at reducing how often you get a migraine, how severe the attacks are and how long they last. Options include:
- Blood pressure-lowering medications. These include beta blockers such as propranolol and metoprolol tartrate . Calcium channel blockers such as verapamil can be helpful in preventing migraines with aura.
- Antidepressants. A tricyclic antidepressant can prevent migraines. Because of the side effects of amitriptyline, such as sleepiness, other antidepressants might be prescribed instead.
- Anti-seizure drugs. Valproate and topiramate might help if you have less frequent migraines, but can cause side effects such as dizziness, weight changes, nausea and more. These medications are not recommended for pregnant women or women trying to get pregnant.
- Botox injections. Injections of onabotulinumtoxinA about every 12 weeks help prevent migraines in some adults.
- CGRP monoclonal antibodies. Erenumab-aooe , fremanezumab-vfrm , galcanezumab-gnlm , and eptinezumab-jjmr are newer drugs approved by the Food and Drug Administration to treat migraines. Theyre given monthly or quarterly by injection. The most common side effect is a reaction at the injection site.
Stress Management And Lifestyle
When symptoms of migraine with aura start, try heading to a quiet, darkened room. Close your eyes and rest or take a nap. Place a cool cloth or an ice pack wrapped in a towel or cloth on your forehead or at the back of your neck.
Other practices that might soothe migraine with aura pain include:
- Relaxation techniques. Biofeedback and other forms of relaxation training teach you ways to deal with stressful situations, which might help reduce the number of migraines you have.
- Develop a sleeping and eating routine. Don’t sleep too much or too little. Set and follow a consistent sleep and wake schedule daily. Try to eat meals at the same time every day.
- Drink plenty of fluids. Staying hydrated, particularly with water, might help.
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What Is An Aura
An aura is a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.
Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include:
- Seeing bright flashing dots, sparkles, or lights.
- Blind spots in your vision.
- Numb or tingling skin.
What Are The Symptoms Of A Migraine
Individual migraines are moderate to severe in intensity, often characterized by a throbbing or pounding feeling. Although they are frequently one-sided, they may occur anywhere on the head, neck and face or all over. At their worst, they are typically associated with sensitivity to light, noise and/or smells. Nausea is one of the most common symptoms and it worsens with activity, which often results in patient disability. In many respects, migraines are much like alcohol-related hangovers.
Migraine pain can be felt in the face, where it may be mistaken for sinus headache or in the neck, where it may be mistaken for arthritis or muscle spasm. Complicating the diagnosis of migraine is that the headaches may be accompanied by other “sinus like” symptoms, including watering eyes, nasal congestion and a sense of facial pressure. Most patients who think they have sinus headache in fact have migraines.
In up to 25 percent of patients, the migraine headache pain may be preceded by an aura, a temporary neurological syndrome that slowly progresses and then typically resolves just as the pain begins. While the most common type of migraine aura involves visual disturbances , many people experience numbness, confusion, trouble speaking, vertigo and other strokelike neurological symptoms. Some patients may experience auras without headaches.
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How Are Migraines Diagnosed
Your doctor can diagnose migraines by the symptoms you describe. If the diagnosis is not clear, your doctor will perform a physical exam. Your doctor might want to do blood tests or imaging tests, such as an MRI or CAT scan of the brain. These tests can help ensure there are no other causes for the headache. You may also be asked to keep a headache journal. This can help your doctor identify the things that might cause your migraines.
If headache pain is getting in the way of your daily activities, its time to see your family doctor. Read More
Are Migraine Auras Dangerous
Generally speaking, an aura associated with a migraine headache should recede within an hour. However, if an aura lasts longer than an hour, includes loss of vision in one eye, or causes severe weakness on one side of the body, it could be dangerous and potentially a warning sign for stroke. This is because both migraine and ischemic stroke are believed to be caused by hypoperfusion .
Still, migraine as a headache disorder is mostly benign. Since stress can act as a migraine trigger and even exacerbate symptoms , its best to remain calm and track symptoms. A significant majority of migraine auras arent a cause for worry beyond the temporary discomfort they can cause.
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Symptoms Of Migraine With Aura Vs Ocular Migraine
The most common symptoms of migraine with aura are visual changes that affect both eyes and include seeing things like:
- Light flashes
- Sparkly or shimmering dots
You could also get nausea or feel numbness and tingling down one side of the body. You might have changes in the way you talk, such as trouble coming up with the correct word or slurring your speech. Sometimes you have trouble with coordination.
Often these problems will come before the head pain. Sometimes you have the symptoms without any pain.
Also known as retinal migraines, ocular migraines are less common than migraines with aura. But they can be more serious. If you don’t get treatment, there’s a small chance that the vision loss in one eye could become permanent.
In an ocular migraine, a change in vision can happen in one eye before, during, or after a headache. The symptoms include:
- Seeing twinkling or sparkling lights
- Having blind spots
One way to tell if the vision changes are only happening in one eye is to close each of your eyes and check if you only see the changes in one of them.
What Causes Migraine With Aura
It is not known exactly what causes auras.
Scientists have looked into it and found that it may be caused by a slow wave of altered brain activity called cortical spreading depression. This leads to temporary changes in the chemicals, nerves and blood flow in the brain that affect how it works and could be related to pain.
Improving understanding of how these changes in the brain can lead to headache will help with the discovery of new drugs that could prevent migraine attacks.
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Can I Have A Visual Migraine Without A Headache
Definitely. It is actually very common to have a visual migraine without any headache. The medical term for this is acephalgic migraine, which literally means migraine symptoms without headache. Except for the absence of a headache, the visual symptoms in acephalgic migraine are identical to the episodes that accompany a classic migraine aura.