Is it a migraine?

If you suffer from headaches, you are not alone. More than 45 million Americans are crippled by severe headaches. Approximately 29.5 million Americans suffer from migraines, and three out of four of them are women, most commonly between the ages of 20 and 45. Migraines are often misdiagnosed. There are about 150 types of headaches that fall into one of two categories – primary and secondary. Primary headaches, like migraines and tension headaches, are the most common. Secondary are headaches caused by a medical condition, like a sinus infection.

So how do you know if you are having a migraine? Migraine pain can occur on either side of the head or on both. It can last as little as a few hours and as much as three days. Besides pain, migraines can include nausea, vomiting, and sensitivity to light and sound. Some people experience so-called “aura” — sensory symptoms, such as flashing lights, zigzag lines, blind spots, numbness or tingling. These symptoms are created by transient changes in certain nerve cells and occur about 10 to 30 minutes before the onset of pain.

The exact cause of migraines is not fully understood. However, according to the National Headache Foundation, brain cells signal a sensory nerve in the brain (trigeminal nerve) to release a chemical that inflames surrounding tissue, causing the cranial blood vessels to swell, press on nerves and induce pain.

A genetic component has long been suspected in the case of migraines, since the condition usually runs in families. Research published in the Aug. 29, 2010 issue of Nature Genetics found an association between gene variations on chromosome 8 and the risk of getting migraines, particularly migraines with aura. The genes in question regulate the balance of a chemical (glutamate) in the body and brain that transmits signals between neurons. However, researchers do not know why an imbalance of this chemical contributes to migraines.

Triggers

What is known is that a variety of factors and events individually or in combination seem to trigger migraines, and these triggers can vary from migraine to migraine and from person to person. They can include:

  • Environmental factors, like weather, loud noises or smells
  • Stress
  • Too much or too little sleep
  • Hormonal changes brought on by menstruation or menopause. (Symptoms improve with menopause for about two-thirds of women with migraine, but for others menopause can actually trigger them to start.)
  • Food additives, like nitrates and monosodium glutamate (MSG)
  • Alcohol (particularly red wine)
  • Excessive amounts of caffeine (more than 2 cups/day)
  • Foods like cheese, chocolate and bananas, among others

Knowing your triggers and avoiding them when possible can help prevent some attacks. Experts recommend charting your headache history to help your doctor determine the type of headache you have and the best treatment for you.

The National Headache Foundation website includes a headache diary that you can download and print out to help you keep track of your headaches’ characteristics.  Also, BetterQOL.com™ offers free copies of the iHeadache® electronic headache diary app for iPhone, iPod touch and iPad. Click here to download your copy.

Treatments

When experiencing a migraine, it is best to rest in a dark room. Treatments can include over-the-counter migraine products that help relieve migraine pain and symptoms.

In some cases, birth control pills can lessen the number and severity of migraines. However, some women find the pills make the symptoms worse. Talk to your doctor about switching to a different pill if you think they are worsening your symptoms.

Severe migraines may require prescription medications such as triptans and ergot derivatives, which balance the chemicals in the brain. These are designed to be taken as soon as a migraine begins. Neither type of drug should be used if you have heart disease or high blood pressure, however. Severe migraines may require narcotic analgesics.

Your doctor may prescribe a medication to be taken daily to help prevent attacks. Such medications include beta blockers, antidepressants, calcium channel blockers and anticonvulsants.

Some women find relief from complementary and alternative therapies, like biofeedback and acupuncture.

For more information about migraines and other types of headaches, visit the National Headache Foundation at www.headaches.org.

 

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