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Common migraine Causes and Risks:
Migraine headaches affect about 6 out of 100 people. They are a common type of chronic headache . They most commonly occur in women and usually begin between the ages of 10 and 46. They appear to run in the families in some cases. Common migraine accounts for almost all migraine headaches. Migraine may also appear as classical migraine (migraine preceded by other symptoms) and other (rare) forms.
Migraines occur when blood vessels of the head and neck spasm or constrict, which decreases blood flow to the brain. Minutes to hours later, the blood vessels dilate (enlarge), resulting in a severe headache. Common migraine may be accompanied by symptoms other than headache but only rarely includes any preliminary symptoms (aura). Multiple mechanisms trigger the spasm and subsequent blood vessel dilation. There is an increase in many of the substances produced by the body that can cause blood vessels to constrict or dilate. Inflammation around the blood vessels also occurs in some cases.
Attacks of migraine headache may be associated with allergic reactions , bright lights, loud noises, relaxation after a period of physical or mental stress , prolonged muscle tension (or tension headache ), lack of sleep, smoking or exposure to tobacco smoke, missed meals, specific foods, alcohol use , caffeine , menstrual periods, use of oral contraceptives (birth control pills), and other conditions. Foods associated with migraine include foods containing the amino acid tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, some beans), chocolates, nuts, peanut butter, fruits (avocado, banana, citrus fruit), onions, dairy products, baked goods, meats containing nitrates (bacon, hot dogs, salami, cured meats), foods containing monosodium glutamate (an additive in many foods), and any processed, fermented, pickled, or marinated foods.
Prevention:
The occurrence of common migraine may be reduced in high-risk people who avoid factors that have been associated with previous migraine . Preventive (prophylactic) medications may be advised for some people (see Treatment).
Symptoms:
Symptoms after an attack:
Signs and Tests:
If a headache disturbs sleep, occurs whenever the person is active, is severe (especially in a previously well person), persistent, or other symptoms accompany the headache (such as drowsiness , vision changes, changes in movement or sensation, seizures , changes in alertness, nausea & vomiting , or other symptoms), a health care provider should be consulted to rule out other disorders that may be causing the head pain . Migraine headache may be diagnosed by the health care provider based on the pattern of symptoms, history of migraines in the family, and response to treatment. A physical examination will reveal no detectable abnormalities.
Treatment:
There is no cure for common migraine. The goals of treatment include controlling symptoms and preventing further attacks.
Rest in a quiet, darkened room often will reduce the severity of symptoms.
Several medications may be advised for relief of symptoms, because the response of migraine to medications is highly variable. If a medication has been effective in relieving a previous migraine, it may be tried before others. Over-the-counter analgesics may reduce pain if they are taken early in the development of the headache . If mild analgesics are ineffective, vasoconstricting or other medications may be beneficial. Ergotamine tartrate preparations constrict the arteries of the head and may be used alone or in combination with other drugs such as caffeine (Cafergot), phenobarbital, or belladonna. Ergonovine maleate may provide relief of symptoms. Propoxyphene or other medications that relieve pain or inflammation may provide relief for some people. Nausea should be treated early with Reglan, Compazine, or other antiemetics.
Any factors that have triggered a migraine in the past should be avoided.
Preventive (prophylactic) medications include propranolol, amitriptyline, ergonovine, cyproheptadine, clonidine, methysergide, calcium channel antagonists, and others. Several medications may need to be tried before a medication that is effective in preventing migraine is found. Imitrex is a newly released medication that has been found very effective in the treatment of migraine. It is self-administered as an injection under the skin (cost: about $35.00 per dose).
Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See migraine - support group .
Prognosis:
Common migraine does not indicate a life-threatening disorder. It usually is painful and annoying at the time. It may be chronic and recurrent, which can interfere with a persons lifestyle.
Rarely, permanent neurologic symptoms occur, probably because of prolonged constriction of the blood vessels. The side effects of medications may be severe.
Complications:
- frequent, recurrent attacks may interfere with lifestyle
- permanent neurologic impairments (rare)
- side effects of medications
Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms of migraine are severe, persistent, recurrent, or accompanied by other symptoms.
Call your health care provider if previously effective treatments no longer are helpful, or if symptoms indicating side effects of medications occur, including irregular heartbeat , changes in skin color ( pale or blue), extreme sleepiness or sedation, persistent cough , depression , fatigue , nausea , vomiting , diarrhea , constipation , stomach pain or cramps, dry mouth, extreme thirst , or others (see specific medication).
Call for an appointment with your health care provider if taking an ergotamine-containing medication, and you are likely to become pregnant (these medications should not be taken when pregnant).
Call for an appointment with your health care provider if any other new symptoms develop, or there is a change in the severity or pattern of symptoms.
This is an illustration of the major areas of the brain. Each area has one or more specific functions.
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