Migraine headaches can be a debilitating neurological disorder that affects your daily life. Fortunately, there are many non-pharmacological and new pharmacological treatments that can help you stop the pain and get back to living. Learn about what you can do if you suffer from migraine headaches.
Headaches are one of the most common reasons patients visit a neurologist. Migraine headache is a type of primary headache disorder that commonly affects women more than men. There is also a strong genetic component that can predispose you to getting migraine headaches. Approximately 70% of patients have a first-degree relative with migraines.
What is a migraine headache?
A typical migraine headache is a gradual buildup of moderate to severe throbbing or pulsating pain on one side of your head. However, over 50% migraine sufferers report a non-throbbing pain. Most commonly, the pain is in the forehead or temple region but can extend to behind the eye, around the head, and down to the neck area. A migraine attack can last 4-72 hours and sometimes even longer.
Symptoms associated with migraines include nausea, vomiting, food intolerance, fatigue, light and noise sensitivity. Other neurological symptoms or auras can include dizziness, vertigo, weakness, speech difficulty, confusion, and numbness which can mimic a stroke. Visual auras can also occur which can consist of tunnel vision, vision loss, shimmering or zigzag or flashing lights.
Common Migraine Triggers
- Hormonal changes (i.e. menstruation, oral contraception, hormone replacement)
- Head trauma
- Sleep deprivation
- Stress
- Fasting or missing meals
- Dehydration
- Medications
- Strong Odors
10 Foods That Trigger Migraines
- Caffeine
- Artificial Sweeteners
- Alcohol (i.e. red wine)
- Chocolate
- Foods with MSG
- Meats with nitrites
- Aged Cheese
- Pickled and Fermented Foods
- Frozen foods (i.e. ice cream)
- Salty Foods
Complications of Migraines
- Chronic migraines (greater than 15 headache days per month)
- Migraine-triggered seizures
- Stroke with migraines
- Persistent aura (30-60 minutes)
Risks of strokes with migraines include migraine with aura, female sex, cigarette smoking, estrogen use.
How Is Migraine Diagnosed?
The cause of migraines is thought to be due to a cascade of chemical changes in the brain. This leads to activation of areas of the brain and ultimately resulting in pain. Genetics and environmental factors may play a role as well.
Migraines are diagnosed by clinical history. Your doctor will perform a detailed history and examination to see if you meet the criteria for migraine headaches. Certain patients will require blood tests and brain imaging to exclude other causes of their headaches.
When to Go to The Emergency Room?
- Thunderclap headache that occurs abruptly and severely
- Signs of meningitis like fever, stiff neck, confusion, seizures
- Signs of strokes like weakness, numbness, slurred speech, double vision
- Headaches worse with coughing, exertion, sudden movements, or straining
- New headaches after age 50
Treatments for Migraines
The type of treatments for migraines can include both non-pharmacological and pharmacological. The goal of migraine treatment is to stop the migraine from progressing and to reduce pain so you can go on with your day.
Non-pharmacological therapies
- Cognitive behavior therapy
- Mindful breathing
- Meditation
- Acupuncture
- Exercise
- Massage therapy
- Neck stretches
- Nerve stimulation devices
Pharmacological treatments target the chemicals that are released during a migraine attack. One of the chemicals implicated in causing migraines called calcitonin gene-related peptide (CGRP) has been the focused of a new migraine class of medication first approved in 2018.
Your doctor may prescribe medications for you to take as needed when you have a migraine. These rescue medications can include over the counter medicines like ibuprofen, Naprosyn, acetaminophen, Excedrin, aspirin or prescription triptans.
If you have more than 15 headache days per month, your doctor may also prescribe preventative medications for you. These medications can be anti-depressants, anti-convulsants, or anti-hypertensive type of medications as they help to block the chemical activation in migraines. Botox injections done by a trained neurologist can also be very effective in preventing migraines. New monthly self-injectable medications that block the CGRP chemical also work very well in preventing migraine. Side effects can include reaction site reaction, allergic reaction, and constipation. There is also a CGRP infusion that has recently been approved for migraines.
With so many different treatment options available, you do not have to continue suffering from migraine headaches anymore!