What is Migraine ?
A migraine can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.
For
some people, a warning symptom known as an aura occurs before or with the
headache. An aura can include visual disturbances, such as flashes of light or
blind spots, or other disturbances, such as tingling on one side of the face or
in an arm or leg and difficulty speaking.
Medications
can help prevent some migraines and make them less painful. The right medicines,
combined with self-help remedies and lifestyle changes, might help.
Symptoms
Migraines,
which often begin in childhood, adolescence or early adulthood, can progress
through four stages: prodrome, aura, attack and post-drome. Not everyone who
has migraines goes through all stages.
Causes
Though
migraine causes aren't fully understood, genetics and environmental factors
appear to play a role.
Changes
in the brainstem and its interactions with the trigeminal nerve, a major pain
pathway, might be involved. So might imbalances in brain chemicals — including
serotonin, which helps regulate pain in your nervous system.
Researchers
are studying the role of serotonin in migraines. Other neurotransmitters play a
role in the pain of migraine, including calcitonin gene-related peptide (CGRP).
Migraine
triggers
There
are a number of migraine triggers, including:
- Hormonal changes in women : Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women. Hormonal medications, such as oral contraceptives and hormone replacement therapy, also can worsen migraines. Some women, however, find their migraines occurring less often when taking these medications.
- Drinks : These include alcohol, especially wine, and too much caffeine, such as coffee.
- Stress : Stress at work or home can cause migraines.
- Sensory stimuli : Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells — including perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
- Sleep changes : Missing sleep, getting too much sleep or jet lag can trigger migraines in some people.
- Physical factors : Intense physical exertion, including sexual activity, might provoke migraines.
- Weather changes : A change of weather or barometric pressure can prompt a migraine.
- Medications : Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
- Foods : Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals or fasting.
- Food additives : These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.
When
to see a doctor
Migraines
are often undiagnosed and untreated. If you regularly have signs and symptoms
of migraine, keep a record of your attacks and how you treated them. Then make
an appointment with your doctor to discuss your headaches.
Even
if you have a history of headaches, see your doctor if the pattern changes or
your headaches suddenly feel different.
See
your doctor immediately or go to the emergency room if you have any of the
following signs and symptoms, which could indicate a more serious medical
problem:
- An abrupt, severe headache like a thunderclap
- Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
- Headache after a head injury, especially if the headache worsens
- A chronic headache that is worse after coughing, exertion, straining or a sudden movement
- New headache pain after age 50
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