Migraine Headaches

The National Headache Foundation estimates that 29.5 million Americans suffer from migraines. 40% of sufferers experience one or more attack per month. Each migraine can last from four hours to three days, and rarely, even longer.

The exact causes of migraine headaches are unknown, but the headaches are linked to changes in the brain as well as to genetic causes. People with migraines may inherit the tendency to be affected by certain triggers, such as fatigue, bright lights, and weather changes. Additional possible triggers include:

  • Emotional stress
  • Sensitivity to specific chemicals and preservatives in food. (Aged cheeses; alcoholic beverages; processed meats; monosodium glutamate)
    • Possible food triggers:
      • Alcohol
      • Avocados
      • Bananas
      • Broad bean pods
      • Caffeine
      • Canned figs
      • Cheeses (aged)
      • Chicken livers
      • Chocolate
      • Citrus fruits
      • Cured meats
      • Fermented, pickled, or marinated foods
      • Fresh bread, coffee cake, doughnuts
      • Herring
      • MSG (monosodium glutamate)
      • Nuts, peanut butter
      • Onions
      • Pizza
      • Pork
      • Sour cream
      • Vinegar
      • Yogurt
      • Caffeine may precipitate, or in some cases relieve migraines.
  • Changing weather conditions, storm fronts, barometric pressure changes, strong winds, altitude changes.
  • Menstrual periods
  • Tension
  • Excessive fatigue
  • Skipping meals
  • Changes in normal sleep patterns

The symptoms of migraines can be variable, but often they begin as a dull ache and develop into a throbbing pain. The pain is usually aggravated by activity. Associated symptoms of migraine headaches include:

  • Sensitivity to light, noise and odors
  • Nausea and vomiting, stomach upset, abdominal pain
  • Loss of appetite
  • Sensations of being very warm or cold
  • Fatigue
  • Dizziness
  • Blurred vision

There are several types of migraine headaches, including:

  • Migraine with aura (Classic Migraine): This type is usually preceded by an aura. Most often, an aura is a visual disturbance (outlines of lights or jagged light images). Auras can also be changes in smell, taste, or other sensation.
  • Migraine without aura (Common Migraine): This type accounts for 80% of migraine headaches. There is no aura before a common migraine.
  • Status migrainosus: This is the term used to describe a long lasting migraine that does not go away on its own.

Mild to moderate migraines can often be handled by:

  • Applying a cold compress to the area of pain.
  • Resting with pillows comfortably supporting the head and neck.
  • Drinking a moderate amount of caffeine.
  • Trying certain over the counter medications. (Ibuprofen, acetaminophen, sometimes with caffeine)
  • Resting in a room with little or no sensory stimulation (light, sound, odors).
  • Withdrawing from stressful surroundings.
  • Sleeping.

When these measures do not help, migraine headaches may be eased with a prescription medication. Migraines can be treated in two ways: with abortive therapy (when the headache has already begun), or with preventive therapy (to keep them from occurring).

The goal of abortive therapy is to prevent a migraine attack or stop it once it starts. The sooner the medication is taken after the initial symptoms occur, the more effective it will be. Some abortive therapies include:

  • Imitrex (pills, nasal spray, or injection) or
  • Treximet (a combination of Imitrex and naproxen)
  • Zomig (pill or nasal spray)
  • Relpax
  • Amerge
  • Maxalt (pill or disintegrating tablet)
  • Frova
  • Axert

Preventive treatments are considered if migraine headaches occur more than once a week. These drugs are meant to lessen the frequency and severity of the migraine attacks. Preventive treatments include:

  • Medications used to treat high blood pressure, such as Inderal and Covera.
  • Antidepressants, such as Elavil and Pamelor.
  • Antiseizure medications such as neurontin, Depakote and Topamax.
  • Some antihistamines and anti-allergy drugs, including Benadryl and Periactin.

For more information on migraine headaches: www.migraines.org