Whats A Migraine What Does A Migraine Feel Like
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.
What Causes A Migraine
The cause of migraine headaches is complicated and not fully understood. When you have a headache its because specific nerves in your blood vessels send pain signals to your brain. This releases inflammatory substances into the nerves and blood vessels of your head. Its unclear why your nerves do that.
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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What Medicines Help Relieve Migraine Pain
For mild to moderate migraines, over-the-counter medicines that may help relieve migraine pain include:
- an acetaminophen, aspirin, and caffeine combination
People who have more severe migraines may need to try abortive prescription medicines. A medicine called ergotamine can be effective alone or combined with other medicines. Dihydroergotamine is related to ergotamine and can be helpful. Other prescription medicines for migraines include sumatriptan, zolmitriptan, naratriptan, rizatriptan, almotriptan, eletriptan, and frovatriptan.
If the pain wont go away, stronger pain medicine may be needed, such as a narcotic, or medicines that contain a barbiturate . These medicines can be habit-forming and should be used cautiously. Your doctor may prescribe these only if they are needed and only for a short period of time.
Is It Time To See A Neurologist For Your Headaches
Your family doctor is a great starting point for headache relief. But for chronic headaches that dont respond to treatment, you may need to enlist the help of a neurologist.
The average headache doesnt require a call to a neurologist or even your family doctor. But if you’re experiencing frequent headaches and using medication for them on the regular, thats a different story.
If you have a history of headaches that come once or twice a month and go away when you take an over-the-counter medication such as acetaminophen or ibuprofen, you may not need to seek further treatment, says Sandhya Kumar, MD, a neurologist and headache specialist at Wake Forest Baptist Health in Winston-Salem, North Carolina.
If youre having headaches more than four times a month, especially if they are debilitating and keeping you home from work, you should see a provider for diagnosis and medication, says Dr. Kumar.
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I’m Pregnant Can My Migraines Still Be Treated
Some migraine medicines should not be used when you are pregnant because they can cause birth defects and other problems. This includes over-the-counter medicines, such as aspirin and ibuprofen. Talk with your doctor if migraine is a problem while you are pregnant or if you are planning to become pregnant. Your doctor might suggest a medicine that will help you and that is safe during pregnancy. Home treatment methods, such as doing relaxation exercises and using cold packs, also might help ease your pain. The good news is that for most women migraines improve or stop from about the third month of the pregnancy.
Tension Headache Vs Migraine
Tension headaches, which are brought on by emotional, mental or physical stress, are more common than migraines.
People who have tension headaches often complain of a band of pain across their forehead, or pressure on either side of the head. The pain is tiring, but not as severe as migraine.
Migraine, on the other hand, usually hurts worse on one side of the head. And, you may experience light sensitivity, aura, or bright lines or dots in your field of vision.
Tension headaches may resolve on their own once the source of stress is gone. In these cases, over-the-counter pain medications and lifestyle adjustments may help.
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Diagnosing Migraine In Adults
Migraines are debilitating, recurrent headaches that cause moderate to severe throbbing pain. The pain may be on one or both sides of the head.
Most people experience headache pain every now and then. This pain can typically be relieved using over-the-counter medication. But if your headaches become severe, NYU Langone doctors can provide you with the best and most effective treatment plan.
Migraines can be chronic, meaning they occur 15 or more days per month over a 3-month time span. Or, they may be episodic, meaning they occur fewer than 15 days per month.
Migraine pain may intensify with movement or physical activity. Untreated, a migraine attack duration can range from four hours to days.
People who experience migraines tend to have recurring attacks that can be triggered by a variety of factors, such as anxiety, stress, hormonal changes, bright or flashing lights, and certain foods or drinks.
Visual or sensory symptoms often accompany migraines, causing sensitivity to light and sound as well as nausea or vomiting. People may also experience trouble speaking, dizziness, numbness, confusion, or other stroke-like symptoms during a migraine.
Should I Be Concerned About Ocular Migraines
Q: I recently found out by looking on the Web that my symptoms point to ocular migraines. I have also discovered that flashing lights sometimes bring these on. I am an intensive care unit nurse who believes in not running to doctors for every little thing, but should I be concerned?
Dr. Jerry W. Swanson responds:
Not necessarily, but here’s what you should know. Ocular is a term that usually refers to a condition known as migraine visual aura, which involves episodes of passing visual disturbances, such as bright spots, affecting both eyes. Visual aura usually precedes a migraine . However, it may also occur during a headache. In some cases, as with ocular migraine, people experience the symptoms of visual aura without getting a headache. The symptoms of an aura usually begin slowly and last 15 to 30 minutes, although they sometimes persist for up to an hour.
Often, the symptoms of ocular migraine begin near the center of vision as either a bright spot or area of visual loss that spreads to involve one-quarter or one-half of the visual field. Zigzag lines or other shapes may also appear. For some people, these shapes resemble the walls of a medieval fortress. In fact, the term “fortification spectrum” is used by neurologists to describe it.
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What Causes Migraines
Doctors dont know exactly what causes migraines. It appears that migraine headaches may be caused in part by changes in the level of a body chemical called serotonin. Serotonin plays many roles in the body, and it can have an effect on the blood vessels. When serotonin levels are high, blood vessels constrict . When serotonin levels fall, the blood vessels dilate . This swelling can cause pain or other problems. Another aspect that is being studied is that migraine headaches go along with a spreading pattern of electrical activity in the brain.
Some research suggests there could be a heredity factor for migraines, meaning they may run in families. Researchers have identified some genes associated with migraines. They are unsure, though, why these genes seem to impact some people more than others. The American Migraine Foundation reports that if one of your parents has migraines, there is a 50% chance that you will, too. If both of your parents have migraines, your chances jump up to 75%. Ultimately, migraines seem to be caused by a combination of factors: genetic, environmental, and lifestyle.
Women are more likely to have chronic migraines . This is likely linked to hormones. Hormones fluctuate each month around the time of your period. They can also fluctuate if you are pregnant or going through menopause.
When To See A Doctor
If you have any type of headaches consistently, its important to speak with your primary care physician so they can help create a treatment plan or refer you to a specialist.
“If your headaches are increasing in frequency or severity, or are interfering with your usual activities, see a doctor,” says Dr. Andiman.
Seek immediate medical attention if youre experiencing the worst headache youve ever had, lose vision or consciousness, have uncontrollable vomiting, or if your headache lasts more than 72 hours with less than 4 hours pain-free.
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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.
When Should I Seek Help For My Headaches
Sometimes, headache can signal a more serious problem. You should talk to your doctor about your headaches if:
- You have several headaches per month and each lasts for several hours or days
- Your headaches disrupt your home, work, or school life
- You have nausea, vomiting, vision, or other sensory problems
- You have pain around the eye or ear
- You have a severe headache with a stiff neck
- You have a headache with confusion or loss of alertness
- You have a headache with convulsions
- You have a headache after a blow to the head
- You used to be headache-free, but now have headaches a lot
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The Causes Of Ocular Migraines Are Unknown
Researchers dont know exactly what causes an ocular migraine. Its thought that they might occur as a result of a tightening or swelling in the blood vessels in the optic nerve at the back of your eye. This swelling or tightening is responsible for the unexpected light show you experience during an ocular migraine episode.
There is no specific diagnostic test available that can identify ocular migraines to diagnose your condition, the eye doctor may:
- Foods containing nitrates, caffeine, MSG, tyramine, or artificial sweeteners
Your Cold Becomes Unusually Bad
- A severe cough that lingers more than two weeks may indicate whooping cough, while sustained congestion can lead to a sinus infection if left untreated.
- If you have a fever, muscle aches or other flu-like symptoms, you may in fact have the flu. In these cases, its best to see the doctor for a Tamiflu prescription. Seniors, expecting mothers and persons with heart disease should exercise extra caution, as they are more likely to develop complications from the flu.
- Extremely difficult swallowing, chest pain and shortness of breath are not normal cold symptoms and may indicate a more serious condition.
- If you cant keep anything down, you may need an IV to get fluids to help your body function.
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What Tests Are Used To Find Out If I Have Migraine
If you think you get migraine headaches, talk with your doctor. Before your appointment, write down:
Your doctor may also do an exam and ask more questions about your health history. This could include past head injury and sinus or dental problems. Your doctor may be able to diagnose migraine just from the information you provide.
You may get a blood test or other tests, such as CT scan or MRI, if your doctor thinks that something else is causing your headaches. Work with your doctor to decide on the best tests for you.
When To See A Doctor For Your Migraine Or The Er
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With Migraines, there are times when one of our more difficult decisions can be whether we need to see a doctor.
Or maybe we need to go to the emergency room? When we’re in pain and / or having other awful symptoms, the last thing we want to do is to go somewhere. There are times, however, when we really do need to play it safe and be seen by a doctor, either or own doctor or an ER physician.
Statistically, the headache and/or other symptoms of a Migraine are usually painful and disruptive, but not truly dangerous. However, headache and some other Migraine symptoms can also be symptoms of other conditions, some of them pretty benign, some more serious. We need to be sure that any symptoms we have aren’t symptoms of another condition that could need immediate medical care.
I want to approach this methodically and logically, so I’m going to start with circumstances that indicate that we need to seek medical care. Then, I’ll go on to whether we should call our own doctors or head to the hospital.
We should consult our doctor if:
- our Migraines are severe or begin suddenly.
- we have more than the occasional Migraine or headache.
- we have Migraines or headaches accompanied by any of the following :
Should we see our doctor or go to the ER?
It pays to discuss these issues with our doctors in advance. Whenever I begin treatment with a new doctor, I ask these questions at my first appointment:
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Treatment Of Migraine In The Er
The primary role of an ER is to evaluate and treat conditions urgently. If you go to the ER for a migraine and have any unusual symptoms, the ER doctor will likely order brain imaging to rule out a stroke or aneurysm.
If you dont have any unusual symptoms, you may not need any diagnostic imaging tests. Your ER doctor will instead ask you questions about your headache and the medications you currently take.
If needed, your ER doctor can provide medications to help temporarily alleviate your migraine until you can see your regular doctor.
Headache medications can be given intravenously or intramuscularly. These include:
- antiemetics to help relieve nausea and pain
- dihydroergotamine, which is specifically used for prolonged migraine treatment
- nonsteroidal anti-inflammatory drugs and steroids to reduce inflammation and pain
- sumatriptan, which provides urgent migraine relief
- valproic acid, an anti-seizure medication used for headache relief
Sometimes, an ER doctor may prescribe you opioids, but this is rare. This is because of potential side effects and risk of dependence.
In addition to pain-relieving medications, your ER doctor may provide fluids via IV if youre experiencing dehydration.
What Is The Prognosis For People With Migraines
Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.
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Should I See An Eye Doctor About An Ocular Migraine
Despite the unsettling effects they have on our vision, ocular migraines are usually nothing to worry about. Typically, ocular migraine episodes resolve themselves after several minutes and do not require medical treatment. Symptoms can be relieved by closing your eyes, removing yourself from bright light, and taking a break from looking at a screen.
However, if you have frequent ocular migraines, or are experiencing an increase in their frequency, youll probably want to go in for a comprehensive eye exam. Ocular migraines may be a symptom of a more serious medical condition, such as a head injury, brain tumor, arterial problem, infection, or exposure to a toxic substance.
Retinal migraines arent the same as ocular migraines. Retinal migraines are much more serious. Rather than visual distortions, retinal migraines can temporarily cause severe vision loss or even blindness in the affected eye. Consult a doctor immediately if you begin to experience symptoms of retinal migraine.
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.
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