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What Is A Migraine Headache



Can Using Birth Control Pills Make My Migraines Worse

In some women,  pills improve migraine. The pills may help reduce the number of attacks and their attacks may become less severe. But in other women, the pills may worsen their migraines. In still other women, taking birth control pills has no effect on their migraines.

The reason for these different responses is not well understood.  For women whose migraines get worse when they take birth control pills, their attacks seem to occur during the last week of the cycle. This is because the last seven pills in most monthly pill packs don’t have hormones; they are there to keep you in the habit of taking your birth control daily. Without the hormones, your body’s estrogen levels drop sharply. This may trigger migraine in some women.

Talk with your doctor if you think birth control pills are making your migraines worse. Switching to a pill pack in which all the pills for the entire month contain hormones and using that for three months in a row can improve headaches. Lifestyle changes, such as getting on a regular sleep pattern and eating healthy foods, can help too.

What Is The Difference Between Migraine And A Headache

Migraine is not just a headache, and attacks can include a variety of symptoms, such as:1-3

  • or pulsing pain on 1 side of the head
  • , vomiting
  • Sensitivity to light and sound

With a headache, the head pain is usually felt on both sides of the head and is more often a dull ache. Nausea and vomiting are not common. Most people with a headache can continue normal activities, though it might be unpleasant.

What Medications Are Used To Relieve Migraine Pain

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 provider’s advice.

What Can I Do To Help Myself

The main thing is to plan carefully. Try to take painkillers which are known to work in migraine and take them quickly. Many people cope well without seeing a health professional. The first step could be your local pharmacist or your GP. Only a minority of people with migraine have to see a headache specialist.

Barriers To Effective Care

How to Get Rid of Migraine Headache

Lack of knowledge among health-care providers is the principal clinical barrier. Worldwide, on average, only 4 hours of undergraduate medical education are dedicated to instruction on headache disorders. A large number of people with headache disorders are not diagnosed and treated: worldwide only 40% of those with migraine or TTH are professionally diagnosed, and only 10% of those with MOH.

Poor awareness extends to the general public. Headache disorders are not perceived by the public as serious since they are mostly episodic, do not cause death, and are not contagious. The low consultation rates in developed countries may indicate that many affected people are unaware that effective treatments exist. Half of people with headache disorders are estimated to be self-treating.

Many governments, seeking to constrain health-care costs, do not acknowledge the substantial burden of headache on society. They might not recognize that the direct costs of treating headache are small in comparison with the huge indirect-cost savings that might be made if resources were allocated to treat headache disorders appropriately.

What Treatment Can I Take

Drugs can be very effective at controlling migraine symptoms but not all pain-killers are equal.

Medications from the aspirin and Ibuprofen family work better than Paracetamol, and codeine is best avoided. A family of migraine specific painkillers known as Triptans also work well and probably work by reversing the changes in the brain that cause migraines.

The most important thing is to act quickly. There is a ‘window of opportunity’ during a migraine attack before the stomach stops working effectively when any drugs you take will not be absorbed properly. To help your stomach absorb the medicines better, take a large dose of the painkiller and try to choose a soluble form which you can dissolve. Adding an anti-sickness drug, such as domperidone 10mg not only stops you feeling sick, but helps the medication be absorbed by reversing this gastric stasis.

If the drugs do not work individually, taking them all together as soon as possible at the start of the attack can be effective: e.g. taking sumatriptan, ibuprofen and domperidone at the same time .

Even more important for prevention is dealing with the migraine “triggers”, the lifestyle choices, which can really improve migraine. These are listed above.

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 don’t 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

What Is The Treatment

Migraine is complex and there are different treatments available. The right treatment for you will depend on the type of migraine, your symptoms, how often you have attacks and how bad they are. It will also depend on your medical history.

Migraine treatment usually includes acute treatment such as painkillers and anti-sickness medication to stop or shorten an attack. If you are having more than four attacks a month you can ask your GP about preventive treatment. This is usually taken every day to reduce how often you have attacks and how bad they are.

Reviewing any lifestyle factors or triggers that may contribute to the attacks, such as stress, change in routine and sleep patterns, can help. There is currently no cure for migraine.

Migraines Without Aura Vi

Migraines without aura are the most common type of migraines, experienced by 70 to 90 percent of migraines sufferers. They begin with pain and no advance warning.

Episodes of migraine without aura can last between four and up to 72 hours. The headache is usually felt on one side of the head with a throbbing or pulsating pain which can affect daily life.

How Are Migraines Diagnosed

To diagnose a migraine, your healthcare provider will get a thorough medical history, not just your history of headaches but your family’s, too. Also, they’ll want to establish a history of your migraine-related symptoms, likely asking you to:

  • Describe your headache symptoms. How severe are they?
  • Remember when you get them. During your period, for example?
  • Describe the type and location of your pain. Is the pain pounding? Pulsing? Throbbing?
  • Remember if anything makes your headache better or worse.
  • Tell how often you get migraine headaches.
  • Talk about the activities, foods, stressors or the situations that may have brought on the migraine.
  • Discuss what medications you take to relieve the pain and how often you take them.
  • Tell how you felt before, during and after the headache.
  • Remember if anyone in your family gets migraine headaches.

Your healthcare provider may also order blood tests and imaging tests to make sure there are no other causes for your headache. An may be ordered to rule out seizures.

Common Causes Of Migraines

Doctors aren’t totally sure what causes migraine , but they think imbalances in certain  chemicals may play a role.

The trigeminal nerve in your head runs your  and . It also helps you feel sensations in your face and is a major pathway for pain. Your levels of a chemical called serotonin may fall at the start of a migraine, and this nerve can release chemicals called neurotransmitters that travel to your  and cause pain.

What Are Migraine Triggers

In many, but not all people it is possible to identify and avoid migraine triggers.

Migraine likes a regular routine.

Irregular or skipped meals should be avoided. People with migraine should take a fibre-containing breakfast within an hour of getting up, before leaving home for work or school. Eat little and often.Some people think dehydration can trigger migraine. This is easy to avoid.

Try to have a regular body clock, with the same or similar time for sleep and for getting up every day. Avoid shift work, or try to stay on the same shift all the time. On weekends or days off, stick to the same daily ritual as in the working week.

The let-down from stress is another reason for migraine at the weekend. Try to keep stress levels relatively constant, or change gradually.

Keeping physically fit makes you more resistant to migraine . Unaccustomed exercise can trigger migraine – try to exercise regularly at the same time every day; build up fitness gradually.In women, a falling oestrogen level can trigger migraine at menstruation or after childbirth. The oestrogen containing contraceptive pill can sometimes worsen migraine .

Change in the weather can trigger migraine: but this is unavoidable.

One of the commonest causes of worsening migraine, is too many painkillers! See the fact sheet on Medication Overuse.

Travel is a common migraine trigger. Many of the above triggers can contribute to migraine on holiday.

What Are Migraines

What Is Your Headache Telling You? 6 Most Important ...

A migraine is a type of that recurs , and also causes other symptoms. The pain is often throbbing and can happen on one or both sides of the head. People with migraines can feel dizzy or sick to their stomachs. They may be sensitive to light, noise, or smells.

Migraines can be disabling, and teens with migraines often need to skip school, sports, work, or other activities until they feel better.

What Is A Migraine Headache

Although the term “migraine” is often used to describe any severe , a migraine headache is the result of specific physiologic changes that occur within the brain, and lead to the characteristic pain and associated symptoms of a migraine.

Migraines usually are associated with sensitivity to sound, light, and smells. A migraine attack may be accompanied by or . This type of headache often involves only one side of the head, but in some cases, patients may have pain bilaterally or on both sides. The pain is often described as throbbing or pounding and it may be made worse with physical exertion.

Not all headaches represent migraines, and migraine is not the only condition that can cause severe and debilitating headaches. For example, cluster headaches are very severe headaches that affect one side of the head in a recurrent manner . The pain is sometimes described as “drilling,” and can be worse than migraine pain in some cases. Cluster headaches are less common than migraine.

Tension headaches are a more common cause of headache. These occur due to contraction of the muscles of the , face, and neck.

Changes In The Weather

Many people report that changes in the weather, particularly changes in barometric pressure, trigger migraine attacks. Other weather-related migraine triggers include heat, humidity, wind, and reduced light exposure.

Poor air quality, from wildfires or other sources of air pollution, can also be a trigger for some people.

What If Drugs Dont Work

Do not take drugs that do not work. If your migraine attack is going from bad to worse it is often important to stop taking acute treatments for a while. This is hard to do if you have a busy life. The single commonest reason for worsening migraine, , is the overuse of acute treatments. This is a big problem for people who take combinations of codeine and paracetamol, though any acute migraine treatment can do this.

Treatment Of Acute Migraine Headache

BENJAMIN GILMORE, MD, David Geffen School of Medicine, University of California, Los Angeles, California

MAGDALENA MICHAEL, MD, Mountain Area Health Education Center, Hendersonville, North Carolina

Am Fam Physician. 2011 Feb 1;83:271-280.

 Patient information: See related handout on this topic at .

    Migraine headache is one of the most common, yet potentially debilitating disorders encountered in primary care. Approximately 18 percent of women and 6 percent of men in the United States have migraine headaches, and 51 percent of these persons report reduced work or school productivity. Patients typically describe recurrent headaches with similar symptoms, and approximately one-third describe an aura preceding the headache. This article reviews treatment options for acute migraine headache.

    When To Worry About A Headache

    You can take care of many types of headaches by yourself, and your doctor can give you medication to control most of the tougher headaches. But some headaches call for prompt medical care. Here are some warning signs for when you should worry about headaches:

    • Headaches that first develop after age 50
    • A major change in the pattern of your headaches
    • An unusually severe headache
    • Head pain that increases with coughing or movement
    • Headaches that get steadily worse
    • Changes in personality or mental function
    • Headaches that are accompanied by fever, stiff neck, confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures
    • Headaches that are accompanied by a painful red eye
    • Headaches that are accompanied by pain and tenderness near the temples
    • Headaches after a blow to the head
    • Headaches that prevent normal daily activities
    • Headaches that come on abruptly, especially if they wake you up
    • Headaches in patients with cancer or impaired immune systems

    What Is A Headache

    Headaches are unpleasant pains in your head that can cause pressure and aching. The pain can range from mild to severe, and they usually occur on both sides of your head. Some specific areas where headaches can occur include the forehead, temples, and back of the neck. A headache can last anywhere from 30 minutes to a week. According to the Mayo Clinic, the most common headache type is a tension headache. Triggers for this headache type include , muscle strain, and .

    Tension headaches aren’t the only type of headache; other headache types include:

    How Are Migraines Treated

    Migraine headaches are chronic. They can’t be cured, but they can be managed and possibly improved. There are two main treatment approaches that use : 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.

    Visual Impairments Associated With Migraine Can Happen With Or Without A Headache

    What Causes Migraines?

    “Ocular Migraine” is a term that has been used to refer to a number of migraine subtypes that are characterized by a variety of visual disturbances including visual loss, blind spots, zig-zag lines, or seeing stars. Unlike other forms of migraine, they may occur without any accompanying head pain. It’s not uncommon for a single patient to experience a wide range of visual symptoms. Here’s what you need to know to better understand the migraine subtypes that affect vision.

    What Is A Migraine

    A migraine is a type of primary headache disorder that can cause severe pain and other symptoms. People with migraine may experience recurring symptoms that doctors call episodes or attacks.

    Headaches are only one symptom of migraines, and they can range in severity. Migraine can cause intense, throbbing headaches that last anywhere from a few hours to several days.

    A migraine headache usually affects one side of the head, but some people experience pain on both sides.

    A migraine episode can occur in four distinct phases, though not everyone experiences every phase.

    Premonitory phase

    Doctors also call the premonitory phase the preheadache or prodrome phase. It includes nonpainful symptoms that occur hours or days before the headache arrives.

    Premonitory phase symptoms can include:

    • unexplainable mood changes
    • sensitivity to light, sound, or smells

    Aura phase

    Auras refer to sensory disturbances that occur before or during a migraine attack. Auras can affect a person’s vision, touch, or speech.

    Visual auras can cause the following symptoms in one or both eyes:

    • flashing lights
    • blurred vision
    • blind spots that expand over time

    Sensory auras cause numbness or tingling that starts in the arm and radiates to the face.

    Motor auras affect a person’s ability to communicate and think clearly. Motor auras include:

    • slurred or jumbled speech
    • difficulty understanding what others say
    • difficulty writing words or sentences
    • having trouble thinking clearly

    Headache phase

    Postdrome phase

    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.

    What Is Migraine Symptoms Causes Diagnosis Treatment And Prevention

    Migraine is a neurological disease characterized by repeated episodes of symptoms, called attacks, that usually include headache, often accompanied by nausea; vomiting; sensitivity to light, touch, smell, or sound; dizziness; visual disturbances; and tingling or numbness in the face, hands, or feet.

    Migraine attacks may come on suddenly without warning, or they may be preceded by certain known triggers, such as skipping a meal, being exposed to smoke or air pollution, or experiencing a change in hormone levels as part of the menstrual cycle. Most migraine attacks last from 4 to 72 hours, although effective treatment can shorten them to a matter of hours. On the other hand, some migraine attacks can last even longer than 72 hours.

    Having migraine can be disabling and can lead to missing days of school or work, being less productive at school or work, being unable to perform household responsibilities, and missing out on family, social, and leisure activities.

    An estimated 1 billion people worldwide, and 39 million Americans, have migraine.

    While a variety of triggers can set off migraine attacks, they don’t directly cause the attacks or the underlying disease.

    Migraine And Vascular Disorders

    Migraine and ischemic strokes reportedly occur in 1.4-3.3 per 100,000 population and account for 0.8% of total strokes. Milhaud et al showed that in young patients with active migraine who had suffered ischemic stroke, risk factors such as patent foramen ovale, female gender, and oral contraceptive use were much more likely to be present; posterior circulation stroke was characteristic. Surprisingly, older patients characteristically lacked vascular risk factors .

    Even in patients older than 45 years, women with migraine are more likely to suffer from ischemic stroke.

    Migraineurs, male and female, have a 2.5-fold increased risk of subclinical cerebellar stroke and those with migraines with aura and increased headache frequency are at the highest risk.

    Migraineurs also have a higher incidence of adverse cardiovascular profiles , and they are more likely to be smokers, have a family history of early heart attacks, and have an unfavorable cholesterol profile. The odds of an elevated Framingham risk score of coronary artery disease are doubled with migraine with aura, and women who have migraine with aura are more likely to be using oral contraceptives.

    These findings have been confirmed in a population-based study by Bigal et al. Similarly, a study by Gudmundsson et al found that men and women who have migraine with aura are at a higher risk for cardiovascular and all-cause mortality than are those without headache.

    What Are The Symptoms Of Migraines

    The primary symptom of migraine is a headache. Pain is sometimes described as pounding or throbbing. It can begin as a dull ache that develops into pulsing pain that is mild, moderate or severe. If left untreated, your headache pain will become moderate to severe. Pain can shift from one side of your head to the other, or it can affect the front of your head, the back of your head or feel like it’s affecting your whole head. Some people feel pain around their eye or temple, and sometimes in their face, sinuses, jaw or neck.

    Other symptoms of migraine headaches include:

    • Sensitivity to light, noise and odors.
    • Nausea and vomiting, upset stomach and abdominal pain.
    • Loss of appetite.
    • Feeling very warm or cold .
    • Pale skin color .
    • Euphoric mood.

    Who Gets Migraines

    If you have migraines, you’re not alone. Up to 10% of U.S. teens and young adults get migraines. And after age 12, during and after puberty, migraines affect girls twice as often as guys.

    Experts believe that the likelihood of getting migraines runs in the family. If one of your parents gets migraines, you have a greater chance of having them than someone who doesn’t have that family history.

    What Causes Ocular Migraine

    Migraine aura is considered to be a result of abnormal electrical activity involving certain regions of the cortex of the brain. This abnormal activity spreads across the cortex at a slow rate of about 3mm per minute and this spread is responsible for the growth and movement of the visual disturbance over the 20-60 minutes that the visual aura lasts. Retinal migraine may be due to the same type of disturbance except occurring at the back of the eye in the retina, or it may be due to a reduction in blood flow to the retina.

    Like other types of migraine, harsh lights and electronic screens can be triggers. Straining your eyes by staring at a screen for long periods of time, spending time in fluorescent or other harsh lighting, driving long distances and other taxing visual activities can increase your risk for attacks. Talk to your eye doctor about how to avoid attacks.


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