Keeping A Migraine Journal
Because migraine is diagnosed based on symptoms, it is a good practice to make a note of each attack. A migraine journal can be kept on paper, on a computer, or your phone.
Recording your symptoms and their intensity, and the date, time, and how long each attack lasts can help you and your doctor spot trends and triggers. A journal may also help you and your doctor find which treatments work best for you, or ones that are no longer working.
Common Types Of Migraine In Children And Youth
Children can also suffer from chronic or episodic headaches, and it is important to recognize the symptoms
According to the National Headache Foundation,;20% of school-aged children from 5 to 17 are prone to headaches. Of that population, 15% will suffer from tension-type headaches, while the other 5% will be prone to migraine .
Headaches and migraine can happen to anyone, at any age, including young children. Not only that, but the intricacies and symptoms of the disorder are different in children than in adults; common migraine symptoms such as nausea, vomiting, and sensitivity to light and sound are not always prevalent in child sufferers. Children, in addition, cannot always vocalize or describe in detail what they are feeling, which makes diagnosis even more difficult. These patients may go undiagnosed for years, leading into adulthood, which can take a toll on their emotional and mental well being.
The American Migraine Foundation;outlines a few key differences between childrens migraine and those of adults:
- migraines in children are typically shorter in duration and occur less frequently
- the pain children experience tends to be more bilateral, such as across the forehead, rather than unilateral
- while common symptoms may not be reported, a lot can be deferred from a childs behavior, such as wanting to sleep or lay down in a dark, quiet room.
Classic Migraine With Aura
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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What Tests Are Done For People With Migraine Headaches
A;doctor doesnt actually need any tests to make the diagnosis of common or classic migraine . Only with an exhaustive interrogatory of your symptoms and medical history can a doctor determine you have this condition.
Most migraine sufferers have normal findings on the physical examination. However, many conditions can cause headaches. Sinus headaches caused by sinus infections, strokes, tension headache, meningitis, and brain tumors are common causes.
Your doctor may want to run some tests to make sure your headache is just a migraine. Some blood tests, X-rays, and CT scans of the head to look for tumors or bleeding may be useful in the differential diagnosis of a headache.;
Do you always feel pulsing or throbbing on one side of the head? Is your headache accompanied by nausea, vomiting, sensitivity to sound, and light? Do you often see flashes of light across your field of vision? Then, you probably suffer from migraines.
How To Treat Migraine And Headaches
There are a variety of ways to help reduce or prevent headache symptoms. The first step is to find a doctor who can diagnose what type of headache you have just seeing your primary doctor is not likely to get you the diagnosis or treatment you need. Instead seek out a neurologist or headache specialist. The Migraine Research Foundation provides a list of headache doctors by state and city.
To diagnose your headache, you will probably be asked to fill out a detailed medical history and undergo a physical exam that will include testing your motor skills, senses, and reflexes. To rule out any possible serious conditions that may be causing your headaches, you also may be asked to undergo blood tests and imaging such as an MRI or CAT scan.
Once the diagnosis is made, your doctor will recommend a treatment approach based on the type of headache you have and the severity of your symptoms. The most common approaches include medications and making lifestyle changes, such as avoiding your known triggers and reducing stress.
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What Triggers A Migraine
Migraines can be triggered by a wide variety of factors that will vary from person to person. These triggers can generally be categorised into types, which can often overlap and interact with one another. Different types of migraines can generally have similar triggers.
Hormonal triggers include the menstrual cycle and the menopause.
Emotional triggers can centre around distressing or destabilising feelings and moods, such as:
- Alcohol and caffeine consumption
- Foods and drinks containing nitrates or tyramine
With such a range of possible triggers, you might find it useful to keep a migraine diary. Migraine diaries note the symptoms and duration of your attacks, but also any potential triggers and different types of migraines. For example, you might note down what you had to eat or drink that day, how many hours of sleep you had, whether or not you were exposed to bright lights, etc. Over time, youll be able to develop a personalised profile of your triggers, which can help you to avoid the offending stimuli and prepare appropriately.
Of course, its not just the causes that can vary. In addition to types of triggers, there are types of migraine, each with different symptoms, frequencies, and rarity.
What Can I Do Right Now
1.;;;; Start a migraine or headache diary. Keeping track of your headaches can help you recognize what triggers them. The American Migraine Foundation recommends that you include: the time and day of your migraine attack, any symptoms other than pain that started before the head pain; any possible triggers, how the headache progressed, whether treatment helped and what kind, how long the attack lasted, and any effects after it was over.19
2.;;;; Make changes to your work life. ;If you experience frequent attacks, talk to your employer about creating some flexibility in your schedule, either remote hours or weekend catchups if you miss time in the office because of a migraine attack.
3.;;;; Get help for related anxiety and/or depression. There are many resources available to help you manage mental health challenges, including from the National Alliance on Mental Illness ,;Anxiety and Depression Association of America, or Depression and Bipolar Support Alliance.
4.;;;; Reach out to a Support Group. Many people experience migraine and headaches and can offer both emotional support and practical help with finding resources. One example is;Move Against Migraine, an online Facebook support group maintained by the American Migraine Foundation.
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When To See Your Doctor
In most cases, episodic headaches will go away within 48 hours. If you have a headache that lasts more than two days or that increases in intensity, you should see your doctor for assistance.
If youre getting headaches more than 15 days out of the month over a period of three months, you might have a chronic headache condition. You should see your doctor to find out whats wrong, even if youre able to manage the pain with aspirin or ibuprofen.
Headaches can be a symptom of more serious health conditions, and some do require treatment beyond OTC medications and home remedies.
Xiii Theories Of Migraine
However, over the last two decades, an overwhelming volume of data has been generated which make this theory seem implausible, and in some respects impossible. First, only CGRP has been shown to be released during migraine, with no evidence of substance P or neurokinin A release . Furthermore, of all the inflammatory molecules shown to induce dural and retinal plasma protein extravasation, only CGRP, a marker of a migraine attack, failed to produce a response . It has proven very difficult to induce plasma protein extravasation in human skin, a process that is readily induced in guinea pigs, implying there may be a clear species difference that negates these preclinical studies . Also retinal plasma protein extravasation is not present during migraine , and there is little evidence of inflammatory pathology in migraineurs. Furthermore, a plethora of molecules developed to block extravasation without the vasoconstrictive effects of triptans, including neurokinin 1 receptor antagonists and extravasation inhibitors , failed as both acute and preventive treatments of migraine. These data indicate that it is unlikely that neurogenic dural inflammation plays a significant role in the pathophysiology of migraine, and the fact migraine can be so frequent and debilitating, and occur over many years, such an inflammatory insult would likely leave a pathology that is picked up on imaging, but nothing has been found .
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Can Migraines Be Treated With Medication
Nowadays there are plenty of effective medical treatments for migraine available for prescription.;Obviously, over-the-counter painkillers such as Paracetamol have their place for pain relief. However, these might not cut it for migraine pains. In addition, overusing these painkillers can actually worsen migraines in the long run ! If youre looking for a more specialised medication, Triptan medications might be just the solution, although they may not work for different types of migraines and you should always consult your GP or doctor before taking any new medication.
Triptans are a medicine group that work by reducing the widening of the blood vessels in the brain. The widening of these vessels is thought to be a contributing factor to migraines and associated symptoms. By preventing this, Triptans can help to relieve the pain of the headache, associated nausea and light and sound sensitivities that come with different types of migraines.
Triptans arent preventative. They are meant to be taken as the migraine attack begins, typically with a glass of water. You can usually take another Triptan tablet if the migraine hasnt subsided after 2 hours, but you shouldnt take more than two tablets within a 24 hour period. Dont take more than recommended or prescribed this could actually make migraines worse.
When To Call The Doctor
- A change in migraine features, how often a migraine happens, or how severe it is
- A headache that lasts days, getting worse as it goes
- A headache brought on by coughing, sneezing, bearing down, or straining while on the toilet
- The worst headache youâve ever had, especially if it started very quickly
NIH Medline Plus: “Migraine.â
WomensHealth.Gov: “Migraine Fact Sheet.â
UpToDate: “Pathophysiology, clinical manifestations, and diagnosis of migraine in adults,” “Acute Treatment of Migraine in Adults.â
The Migraine Trust: “Hemiplegic Migraine.â
Mayo Clinic: “Migraine Aura.â
American Migraine Foundation: “Chronic Migraine — The Basics.â
Bisdorff, A. Therapeutic Advances in Neurological Disorders, May 2011.
International Headache Society: “International Classification of Headache Disorders: ICHD-3 beta.”
National Headache Foundation.
American Headache Society.
American Migraine Foundation: “Silent Migraine: A Guide,” “What Type of Headache Do You Have?” “Abdominal Migraine.â
Cleveland Clinic: “A Migraine Without Pain? Yes, It Can Happen, and Itâs Called an Ocular Migraine.â
Yale Medicine: “Abdominal Migraine: Symptoms, Diagnosis & Treatment.â
Cephalalgia: “Abdominal migraine.”
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Two Main Types Of Migraine
The International Headache Society names 2 main types of migraine, and each has several subtypes. Migraine types are diagnosed based on the symptoms a person has. For example, a migraine that only causes stomach pain is called abdominal migraine. A migraine that causes head pain plus visual or auditory hallucinations is called a migraine with aura. The 2 main types are:1
People living with migraine can have both main migraine types and different subtypes over the years. Any type of migraine can be chronic, meaning the person has 15 or more of any type of headache per month for 3 months, with at least 8 of those being migraine attacks.1
When Should I Seek Medical Care For A Headache
Seek medical care if the headache is:
- The “worst headache of your life.” This is the wording often used in textbooks as a cue for medical practitioners to consider the diagnosis of a subarachnoid hemorrhage due to a ruptured cerebral aneurysm. The amount of pain will often be taken in context with the appearance of the patient and other associated signs and symptoms. Too often, patients are prompted to use this expression by a health care professional and do not routinely volunteer the phrase.
- Different than your usual headaches
- Starts suddenly or is aggravated by exertion, coughing, bending over, or sexual activity
- Associated with persistent nausea and vomiting
- Associated with fever or stiff neck. A stiff neck may be due to meningitis or blood from a ruptured aneurysm. However, most patients who complain of a stiff neck have muscle spasm and inflammation as the cause.
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What Are The Possible Complications Of Migraine Headaches
Although migraine headaches are a benign condition, it can result in further complications like prompting other diseases. The most common complication is status migrainosus.
This happens when a migraine headache lasts more than 72 hours, and the patient needs hospital care. Most of the time, status migrainosus results from a rebound headache after youve taken too many medications. Instead of making the migraine better, it gets worse.
Status migrainosus may cause sleeplessness and dehydration because of vomiting.;
Another complication is the migrainosus stroke or migrainosus infarction. One cause for migraines is the contraction or narrowing of the blood vessels in the brain.
Sometimes, these blood vessels can contract so much that blood flood to the brain is interrupted. When this happens, the brain doesnt receive enough oxygen, and the stroke occurs.
The patients who are most likely to suffer a migrainosus stroke are women on birth control pills, especially if they smoke. Migrainosus infarction is an emergency and needs medical assistance.
Persistent aura without infarction is another form of migraine complication. Sometimes, a migraines aura symptoms can stick way longer than usual, even if the headache is not there anymore.
You can have aura almost for as most as a week after the headache attack. The sufferer can also experience other symptoms like weakness or numbness in some parts of the body.;
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Can Migraines Be Prevented Or Avoided
Medicine to prevent migraines may be helpful if your headaches happen more than 2 times a month. You may want to consider this medicine if your headaches make it hard for you to work and function. These medicines are taken every day, whether you have a headache or not.
Preventive medications for migraines can include prescription drugs often used to treat other ailments. Anti-seizure medicines, antidepressants, medicines to lower blood pressure, and even Botox injections are some of the preventive medications your doctor may prescribe. Calcitonin gene-related peptide inhibitors can also help prevent migraines. They do so by blocking a gene-related peptide in your sensory nerves. This peptide is known to increase during a migraine attack, so blocking it can help prevent migraines.
There are also a number of non-medical treatments designed to help minimize migraine pain and frequency. One is an electrical stimulation device, which has been approved by the FDA. It is a headband that you wear once a day for 20 minutes to stimulate the nerve linked to migraines. Another non-medical treatment is counseling aimed at helping you feel in more control of your migraines. This counseling works best when paired with medical prevention of migraines, as well.
Migraine Aura What Is It
While migraines generally come with symptoms like severe pulsing or throbbing head pain, nausea, and sensitivity to sound, light, and smells, some individuals experience aura symptoms, too. These auras often develop before the migraine headache occurs.
Migraine auras often occur over a;period of 5-20 minutes;and typically last less than an hour. Auras come in six main forms:; visual disturbances, tactile disturbances, language difficulty, weakness, brainstem aura, and retinal migraine.; Some people will have multiple forms, often occurring back to back.
Visual migraine auras are some of the most common types of auras experienced before or during a migraine. Some of these visual changes may include:
- Seeing sparkles or light or stars
- Blind spots, known as scotomas
- Tunnel vision
- Zigzagging lines
- Colored spots
Often, these visual symptoms begin at the center of the individuals field of vision, then move outward. Some individuals even experience temporary blindness when they have a migraine.
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Migraine Without Aura And Its Subtypes
Migraine without aura means the person has throbbing head pain, usually on 1 side of the head, for 4 to 72 hours. Nausea and sensitivity to light and sound are the other most common symptoms. Roughly 3 out of 4 people with migraine have migraine without aura. The pain is often moderate to severe and gets worse with movement.1,2
Migraine without aura may also be called common migraine. Migraine without aura does not come with the warning stages called prodrome and aura.3
Common subtypes of migraine without aura include:1-3
- Chronic migraine, meaning the person has frequent migraine attacks
- Migraine triggered by menstruation, which is sometimes called menstrual migraine
- Medication-overuse migraine