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Migraine

 

Migraine is a painful headache which can be excruciating and may incapacitate you for hours or even days.

Symptoms

  • Moderate to severe pain — many migraine headache sufferers feel pain on only one side of their head, while some experience pain on both sides
  • Head ache with a pulsating or throbbing quality
  • Pain that worsens with physical activity
  • Pain that hinders your regular daily activities
  • Nausea with or without vomiting
  • Sensitivity to light and sound
  • Sparkling flashes of light
  • Dazzling zigzag lines in your field of vision
  • Slowly spreading blind spots in your vision
  • Tingling, pins-and-needles sensations in one arm or leg
  • Rarely, weakness or language and speech problems
  • Feelings of elation or intense energy
  • Cravings for sweets
  • Thirst
  • Drowsiness
  • Irritability or depression

Causes

Although much about headaches still isn't understood, some researchers think migraines may be caused by functional changes in the trigeminal nerve system, a major pain pathway in the nervous system, and by imbalances in brain chemicals, including serotonin, which regulates pain messages going through this pathway.
Common migraine headache triggers include:

  • Hormonal changes
  • Certain foods
  • Stress
  • Bright lights and sun glare
  • Unusual smells
  • Intense physical exertion
  • Changes in sleep patterns
  • Certain medications
  • Change of weather, season, altitude level, barometric pressure or time zone

Treatment

You may be a candidate for preventive therapy if you have two or more debilitating attacks a month, if you use pain-relieving medications more than twice a week, if pain-relieving medications aren't helping or if you have uncommon migraines.
Pain relieving medicines: For best results, take pain-relieving drugs as soon as you experience signs or symptoms of a migraine headache. It may help if you rest or sleep in a dark room after taking them:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs):These medications, such as ibuprofen (Advil, Motrin, others) or aspirin, may help relieve mild migraines. Drugs marketed specifically for migraine, such as the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine), also may ease moderate migraines, but aren't effective alone for severe migraines. If taken too often or for long periods of time, NSAIDs can lead to ulcers, gastrointestinal bleeding and rebound headaches.
  • Triptans: Sumatriptan (Imitrex) was the first drug specifically developed to treat migraines. It mimics the action of serotonin by binding to serotonin receptors and causing blood vessels to constrict. Sumatriptan works faster than any other migraine-specific medication — in as little as 15 minutes — and is effective in most cases. Side effects of triptans include nausea, dizziness, and muscle weakness and, rarely, stroke and heart attack.
  • Ergots: These drugs may have more side effects than do triptans.
  • Medications for nausea: Metoclopramide is useful for relieving the nausea and vomiting associated with migraines, not the migraine pain itself. It also improves gastric emptying, which leads to better absorption and more rapid action of many oral drugs.

Preventive medications: Preventive medications can reduce the frequency, severity and length of migraines and may increase the effectiveness of pain-relieving medicines used during migraine attacks. In most cases, preventive medications don't eliminate headaches completely:

  • Cardiovascular drugs: Beta blockers — which are commonly used to treat high blood pressure and coronary artery disease — can reduce the frequency and severity of migraines. These drugs are considered among first-line treatment agents. Side effects can include dizziness, drowsiness or lightheadedness.
  • Antidepressants: Certain antidepressants are good at helping prevent all types of headaches, including migraines. These medications are considered among first-line treatment agents and may reduce migraines by affecting the level of serotonin and other brain chemicals. Newer antidepressants, however, generally aren't as effective for migraine prevention.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Regularly taking over-the-counter NSAIDs such as ibuprofen may reduce the frequency of migraines. If these medications don't help, your doctor may suggest a stronger, prescription-only version of the same drug. However, NSAIDs may increase your risk of cardiovascular events, such as heart attack and stroke. In addition, long-term use of these medications can lead to ulcers and other gastrointestinal problems, such as stomach bleeding. Talk to your doctor before taking these medications regularly — even the nonprescription varieties.

Prevention

Whether or not you take preventive medications, you may benefit from lifestyle changes that can help reduce the number and severity of migraines. One or more of these may be helpful for you:

  • Avoid triggers
  • Exercise regularly
  • Reduce the effects of estrogen.
  • Quit smoking