Migraine
What is it?
A migraine is a severe, sudden headache that usually
begins on one side of the head, but can involve the entire
head. Migraines are often accompanied by nausea, and may
be preceded by some type of visual or neurologic
disturbance.
Who gets it?
Migraines may begin in childhood, and the tendency to
get migraines often runs in families. Migraines affect
women more often than men.
What causes it?
Migraines occur when the arteries in the brain narrow,
then widen. Research has found that this can be caused by
an imbalance in certain neurotransmitters.
Neurotransmitters are brain chemicals that transmit
signals between nerve cells. Migraine headaches often have
a trigger, such as changes in the hormonal cycle (in women
and girls), foods, odors, noises, lights, fatigue, stress,
or physical exertion.
What are the symptoms?
Migraine headaches begin as pain in a localized area,
such as around one eye or temple. The pain gradually
spreads down one side, or to both sides. As the migraine
develops, any movement or sound can cause more severe,
throbbing pain. A person may have some indication that the
migraine is coming, called an aura. Common auras include
unique smells, visual disturbances, or odd feelings, such
as a tingling sensation. Other characteristics of a
migraine include sensitivity to light and sound and nausea
and/or vomiting. A migraine headache can last for anywhere
from a few hours to a few days. Migraines can be
complicated by other symptoms, such numbness or paralysis
on one side of the body, severe pain at the back of the
head accompanied by weakness and loss of coordination,
noticeable confusion and lethargy, and severe eye pain
with eye muscle paralysis. Cluster headaches are a severe
type of migraine headache that occur several times in one
day and can last for several hours.
How is it diagnosed?
Migraine headaches are usually easy to diagnose because
they have such unique symptoms. Your doctor will perform a
physical examination and take a complete medical history.
People with migraines are frequently treated by a
neurologist, a specialist in the area of the nervous
system. A headache diary is especially useful in
diagnosing migraines. Your doctor will ask you to keep a
record of when and how often the headaches occur, what
type of pain you have, how long the headache lasts, any
other symptoms before or during the headache, your
activities when each headache occurs, and patterns of rest
and diet. Women may also be asked to keep track of where
the headaches occur in their menstrual cycle. The doctor
may try treating the headaches with migraine medications.
If these medications help, then migraine is the probable
cause. However, your doctor may also order a magnetic
resonance imaging (MRI) or computed tomography (CT) scan.
Both are painless procedures that provide the doctor with
an image of your brain and can help rule out other causes
of your symptoms.
What is the treatment?
People with migraines feel better if they lie down in a
darkened room and sleep. You will also be taught to avoid
your migraine triggers. These might be certain foods that
include nitrates, monosodium glutamate (MSG), and
caffeine; strong perfumes; lack of sleep; or hunger.
Patients with a pattern of recurring migraines are treated
with preventive medications, taken on a daily basis, or
medications taken at the onset of the migraine. A dental
device may also be recommended to prevent jaw clenching
while sleeping.
Self-care tips
Recognizing the triggers of your migraines can help you
to do as much as possible to prevent these types of
headaches. If you experience signs of an impending
migraine, follow your doctor’s recommendations for
treatment. Contact your doctor immediately if a migraine
is accompanied by fever, stiff neck, trouble with speech
or balance, or weakness or numbness in the face, arm, or
leg. These can be signs of a serious condition, such as
meningitis, encephalitis, or stroke.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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