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Preventive Medicine

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What Are Migraine Headaches?

Migraine headaches are intense headaches that usually affect one side of the head and are often preceded by other symptoms. A migraine can last from 2 hours to 3 days.

What Causes Migraine Headaches?

The cause is unknown, but 60% to 80% of people inherit the tendency to have migraines. Migraines may be associated with alcohol (red wine), skipped meals, foods containing monosodium glutamate, nitrates (hot dogs, luncheon meats), tyramine (aged cheese, smoked fish), fatigue, and weather changes. Other triggers are stress, too little or too much sleep, medicines, menstrual periods, pregnancy, and birth control pills.

What Are the Symptoms of Migraine Headaches?

In classic migraine, hours to days before a headache, people have a symptom (prodrome) that tells them that a headache is starting. These include mood changes, sensitivity to light (photosensitivity), sensitivity to sound (phonosensitivity), hyperactivity, feeling sluggish, fatigue, appetite changes, and nausea. Auras (temporary disturbance of the senses or muscles) then come before the headache. They usually last 10 to 30 minutes, then the headache starts and aura symptoms go away. Aura symptoms include hearing and vision problems (flashes of light, flickering lights, blind spots). Dull pain on one side of the head may become intense and throbbing. Nausea and vomiting may occur.

With a common migraine, people don’t have an aura, and pain usually occurs on both sides of the head. People have nausea and sometimes numbness or weakness. Some people have vision or stomach problems without the headache.

How Are Migraine Headaches Diagnosed?

The health care provider makes a diagnosis from the medical history and physical examination. Computed tomography (CT) or magnetic resonance imaging (MRI) may be done to exclude other disorders that may cause similar symptoms.

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How Are Migraine Headaches Treated?

Many medicines are prescribed for migraine. Early treatment is best for faster relief. Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and naproxen, as well as ergotamine and sumatriptan and other triptans, may be given to stop migraines.

To prevent frequent migraines, people may use medicine daily. These drugs include beta-blockers, calcium channel blockers, antidepressants (amitriptyline, venlafaxine), anticonvulsants (topiramate, divalproex), NSAIDs, and hormones. Other medicine may be given for long and severe headaches.

Migraine triggers include chocolate, red wine, port wine, cheese, onions, fatty foods, and acidic foods (e.g., oranges and tomatoes) and should be avoided.

DOs and DON’Ts in Managing Migraine Headaches:
  • DO apply a cold cloth or ice pack to your head or splash your face with cold water when you feel a migraine starting.
  • DO lie down in a quiet, dark room, with pillows under your head. Relax and sleep.
  • DO minimize noise, light, and odors (especially cooking odors and tobacco smoke).
  • DO avoid migraine triggers, such as foods, stress, not sleeping, and medicines. Keep a food diary.
  • DO call your health care provider if your headache is worse than usual, your usual medicine doesn’t work, you have a fever and headache, or you have severe vomiting.
  • DO exercise as much as possible, to be healthy.
  • DON’T drive or use heavy machinery during an attack.
FOR MORE INFORMATION

Contact the following sources:

  • National Headache Foundation
    Tel: (888) 643-5552
    Website: http://www.headaches.org
  • American Headache Society Committee for Headache Education
    Tel: (800) 255-2243
    Website: http://www.achenet.org
  • MAGNUM: Migraine Awareness Group: A National
    Understanding for Migraine
    Tel: (703) 349-1929
    Website: http://www.migraines.org

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor