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Migraine

Definition

A migraine headache can cause intense throbbing or a pulsing sensation in one area of the head and is commonly accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

Migraine attacks can cause significant pain for hours to days and be so severe that all you can think about is finding a dark, quiet place to lie down.

Some migraines are preceded or accompanied by sensory warning symptoms (aura), such as flashes of light, blind spots, or tingling in your arm or leg.

Symptoms

The symptoms of migraine headaches can occur in various combinations and include:

Moderate to severe pain (often described as pounding, throbbing pain) that can affect the whole head, or can shift from one side of the head to the other
Sensitivity to light, noise or odors
Blurred vision
Nausea or vomiting, stomach upset, abdominal pain
Loss of appetite
Sensations of being very warm or cold
Paleness
Fatigue
Dizziness
Fever (rare)
Bright flashing dots or lights, blind spots, wavy or jagged lines (aura)
When to see a doctor

Migraine headaches are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, 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.

Causes

Although much about the cause of migraines isn't understood, genetics and environmental factors appear to play a role.

Migraines may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway.

Imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system — also may be involved. Researchers continue to study the role of serotonin in migraines.

Serotonin levels drop during migraine attacks. This may cause your trigeminal system to release substances called neuropeptides, which travel to your brain's outer covering (meninges). The result is headache pain.

Treatment & Drugs

Migraines can't be cured, but doctors will work with you to help you manage your condition.

A variety of medications have been specifically designed to treat migraines. In addition, some drugs commonly used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

Pain-relieving medications

For the most effective results, take pain-relieving drugs as soon as you experience signs or symptoms of a migraine. It may help if you rest or sleep in a dark room after taking them. Medications include:

Pain relievers. Aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others), may help relieve mild migraines.

Triptans. Many people with migraine attacks use triptans to treat their migraines. Triptans work by promoting constriction of blood vessels and blocking pain pathways in the brain.

Ergots. Ergotamine and caffeine combination drugs (Migergot, Cafergot) are less effective than triptans. Ergots seem most effective in those whose pain lasts for more than 48 hours.

Anti-nausea medications. Because migraines are often accompanied by nausea, with or without vomiting, medication for nausea is appropriate and is usually combined with other medications.

Opioid medications. Opioid medications containing narcotics, particularly codeine, are sometimes used to treat migraine headache pain for people who can't take triptans or ergot.

Glucocorticoids. A glucocorticoid may be used in conjunction with other medications to improve pain relief.

Lifestyle & Home Remedies

Self-care measures can help ease the pain of a migraine headache.

Try muscle relaxation exercises. Relaxation may help ease the pain of a migraine headache.

Relaxation techniques may include progressive muscle relaxation, meditation or yoga.

Get enough sleep, but don't oversleep. Get an adequate amount of sleep each night. It's best to go to bed and wake up at regular times, as well.

Rest and relax. If possible, rest in a dark, quiet room when you feel a headache coming on. Place an ice pack wrapped in a cloth on the back of your neck and apply gentle pressure to painful areas on your scalp.


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