Migraine headaches are intense headaches that usually affect one side of the head and are often preceded by other symptoms. A migraine can last from 2 hours to 3 days.
The cause is unknown, but 60% to 80% of people inherit the tendency to have migraines. Migraines may be associated with alcohol (red wine), skipped meals, foods containing monosodium glutamate, nitrates (hot dogs, luncheon meats), tyramine (aged cheese, smoked fish), fatigue, and weather changes. Other triggers are stress, too little or too much sleep, medicines, menstrual periods, pregnancy, and birth control pills.
In classic migraine, hours to days before a headache, people have a symptom (prodrome) that tells them that a headache is starting. These include mood changes, sensitivity to light (photosensitivity), sensitivity to sound (phonosensitivity), hyperactivity, feeling sluggish, fatigue, appetite changes, and nausea. Auras (temporary disturbance of the senses or muscles) then come before the headache. They usually last 10 to 30 minutes, then the headache starts and aura symptoms go away. Aura symptoms include hearing and vision problems (flashes of light, flickering lights, blind spots). Dull pain on one side of the head may become intense and throbbing. Nausea and vomiting may occur.
With a common migraine, people don’t have an aura, and pain usually occurs on both sides of the head. People have nausea and sometimes numbness or weakness. Some people have vision or stomach problems without the headache.
The health care provider makes a diagnosis from the medical history and physical examination. Computed tomography (CT) or magnetic resonance imaging (MRI) may be done to exclude other disorders that may cause similar symptoms.
Many medicines are prescribed for migraine. Early treatment is best for faster relief. Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and naproxen, as well as ergotamine and sumatriptan and other triptans, may be given to stop migraines.
To prevent frequent migraines, people may use medicine daily. These drugs include beta-blockers, calcium channel blockers, antidepressants (amitriptyline, venlafaxine), anticonvulsants (topiramate, divalproex), NSAIDs, and hormones. Other medicine may be given for long and severe headaches.
Migraine triggers include chocolate, red wine, port wine, cheese, onions, fatty foods, and acidic foods (e.g., oranges and tomatoes) and should be avoided.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
Ferri’s Netter Patient Advisor