A: Migraine is an inherited neurological disorder more known for its attacks, which are characterized by intense, throbbing head pain that worsens with movement. Sensitivity to light is the next most common symptom, followed by sensitivity to sound, nausea and vomiting. For about 60% of people, the pain is confined to one side of the head and can switch from one side to the other from one migraine attack to the next. Attacks may be preceded by a visual aura (seeing flashing lights or squiggly lines or blind spots) or other neurological symptoms, like numbness, tingling or weakness on one side of your body, mood changes, nausea, excessive yawning, or a variety of other possible symptoms. Despite headache being the most prominently known feature of migraine attacks, it is possible to have a migraine with no headache at all. 90% of people report being disabled during a migraine attack.
Because migraine attacks involve over-excitability in the brain, symptoms can be felt throughout the body. In addition to the most well known symptoms, migraine can also cause fatigue, brain fog, increased urination, sweating, and a whole host of other symptoms.
A: Migraine is caused by a genetic neurological disorder. Individual migraine attacks can be triggered by many different things, such as weather changes, menstruation, fluorescent lights, bright lights, certain foods, disruptions in sleep patterns, skipping meals or drinking alcohol. What is a trigger for one person may not be a trigger for another. Someone who is sensitive to a particular trigger may not always have a migraine attack when exposed to that trigger. It is possible to have a migraine attack without exposure to any known triggers.
A: Non-migraine headaches typically have mild to moderate pain and feel like a dull pressure in the head. They are not accompanied by the other symptoms of migraine, like sensitivity to light, sensitivity to sound, nausea, vomiting and aura.
A: The two primary categories of migraine are migraine with aura and migraine without aura. In migraine with aura (also called classic migraine, an outdated term), the pain is preceded by some warning sign, most commonly visual changes. In migraine without aura (once known as common migraine, which is no longer used) attacks begin without that telltale warning sign.
Forms of migraine that occur less frequently include hemiplegic migraine, basilar migraine, abdominal migraine, acephalgic (headacheless) migraine and retinal migraine (also called ocular or ophthalmic migraine).
A: The biggest misconception about migraine is that there’s no effective treatment and a person just has to live with it. There is a widespread belief that any head pain is “just a headache” that can be taken care of with an over-the-counter painkiller. This makes some people believe their migraines aren’t a serious medical condition or that a doctor cannot help them. Also, because migraine is genetic, many people grew up seeing their parents suffer through migraines without treatment and assume this is how it has to be for them as well, even though today’s medications are far superior to those available 20 years ago.
A: Migraine is caused by a hereditary neurological disorder that causes over excitability in the brain. A person who does not have this underlying disorder cannot have a migraine. Individual migraine attacks have many potential triggers, including weather changes, fluorescent lights, bright light, inadequate sleep, too much sleep, foods, odors, excessive exercise and even sex.
A: There are many different treatment options for migraine. Medications and supplements are classified into three categories, acute (or abortive), rescue and preventive.
Migraine abortives are taken at the time of a migraine attack and are most effective at the earliest possible stage of the migraine. They include seven different triptans, of which Imitrex is the most well-known, as well as Midrin, Migranal and DHE-45.
Rescue meds are taken when a person has an unrelenting migraine that hasn’t responded to abortives. These are often non-steroidal anti-inflammatories, like naproxen or Toradol, and very occasionally narcotic painkillers.
Preventive treatments aren’t taken at the time of a migraine attack, but are taken daily to keep attacks from happening at all. There are more than 100 options for preventives, including prescription medications, supplements and herbal treatments. Preventives are recommended for a variety of reasons, including for people who have: more than two migraine attacks a month; feel like their migraine attacks cause significant disruptions to their lives; use acute (abortive) treatments more than twice a week; cannot use abortive therapies for other health reasons; have an uncommon type of migraine; or want to take a preventive medication.
There are numerous other migraine treatments in addition to medication, including TheraSpecs, acupuncture, massage, physical therapy, biofeedback, yoga and meditation. Lifestyle changes, like diet modification, regular aerobic exercise, sticking to a daily routine and stress management can also be of enormous benefit.
A: Yes, for most people medication can be tremendously effective in treating migraine attacks both as they occur and to keep them from happening in the first place. Some patients find success with the first medication they take, while others need to try a variety of medications before finding the right one.
A: If you have not received an official migraine diagnosis, you should see a health care professional. This is both to make sure there are no other underlying disorders and to help you find the most effective treatment.
If you have been diagnosed and would like to discuss options for migraine prevention, you should also see a health care professional. The best treatment for migraine is to keep it from happening in the first place.
You should also see a health care professional whenever you notice a change in the frequency, severity or duration of your migraine attacks. This is to check for an underlying disorder unrelated to migraine and also to adjust your medication appropriately.
A: Prevention is by far the most effective approach to treating migraine and there are a variety of ways to prevent migraine attacks. Lifestyle modification is the first recommended approach to migraine prevention. This can include diet modification, regular aerobic exercise, sticking to a daily routine, yoga, meditation and stress management.
There are also more than 100 different possible migraine preventive medications and a wide range of non-pharmaceutical treatments (like magnesium, butterbur and riboflavin). In addition, TheraSpecs precision-tinted eyewear can prevent light-triggered migraines, especially for those sensitive to fluorescent lighting, bright lights, sunshine or glare.
A: As soon as you know a migraine is coming on, you should take your abortive medication immediately. Early in the migraine attack is when it is most effective. You should get to a safe place – don’t drive if you have a visual aura – and then do whatever you need to do to take care of yourself. Most people prefer to be in a dark, quiet room during a migraine and usually try to sleep. If a dark room isn’t an option, TheraSpecs can help with the light sensitivity while a pair of earplugs help with noise. Some find relief from putting an ice pack on their foreheads and others benefit from taking a hot shower.
A: There are numerous alternative treatments for migraine. In clinical trials, acupuncture and biofeedback have both shown to be effective for some patients, and the benefits of yoga and meditation are also supported by research. Massage, craniosacral therapy (a specific type of massage), aromatherapy and dietary changes can also be effective. Studies show that precision-tinted TheraSpecs are effective for preventing light-triggered and soothing light-aggravated migraines. Supplements, such as magnesium, riboflavin and butterbur, are also beneficial for some people with migraine.
A: Some people do outgrow migraine, others do not. After menopause, about a third of women experience a drastic reduction of their migraines and some women’s migraines stop altogether. Men in their 50s and 60s also often have a decrease in or cessation of their migraines. Researchers hypothesize that for both sexes, the reduction in hormone fluctuation associated with aging are responsible for the decrease in migraines.
A: There are many different possible migraine triggers and they vary from person to person. Someone who is sensitive to a particular trigger may not always have a migraine attack when exposed to that trigger. It is also possible to have a migraine attack without exposure to any known triggers.
Food triggers get the most attention in the media, but many people can identify no food triggers at all. More common food-related triggers include skipping meals or drinking alcohol. Fluorescent lights, bright lights, sunlight and glare can also be triggers. Getting too much or too little sleep, or going to sleep too early or too late can trigger migraine attacks. Scents, like perfume, fabric softener, or even cooking odors, are potential triggers. Weather changes, being in temperatures that are too hot or too cold, hormonal fluctuations, loud sounds, and stress can all be triggers.
Rather than look at a list of possible triggers and try to avoid all of them, many people with migraine find more success in keeping a migraine diary in which they record things that could have preceded each migraine attack. Over time, a pattern often emerges, helping the person identify which triggers are problematic for them.
A: A migraine aura occurs before the onset of pain and is very helpful in alerting a person to the need to take a migraine abortive medication. The most commonly known aura is a visual disturbance in which a person sees flashing lights or squiggly lines or has a blind spot. Other types of auras, sometimes called prodrome, can include numbness, tingling or weakness on one side of your body, nausea, excessive yawning, or a variety of other possible symptoms. It is helpful to reflect on how you feel before migraine attacks hit and discuss this with your health care professional. You could have a warning sign that would help you treat your migraine attacks early.
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—Heather Northwest OH
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