How often do migraines occur. What are the primary symptoms of a migraine attack. What causes migraines and how are they diagnosed. What are the most effective treatments for migraines. How can migraines be prevented.

Understanding Migraine Frequency and Patterns

Migraines are a complex neurological condition that can significantly impact an individual’s quality of life. The frequency of migraine attacks varies greatly from person to person, ranging from rare occurrences to several episodes per month. Understanding the patterns and triggers of migraines is crucial for effective management and treatment.

How Often Do Migraines Typically Occur?

The frequency of migraine attacks can be categorized as follows:

• Episodic migraines: Occurring less than 15 days per month
• Chronic migraines: Occurring 15 or more days per month for at least three months

Factors influencing migraine frequency include genetics, hormonal changes, environmental triggers, and lifestyle habits. Some individuals may experience migraines only a few times a year, while others may suffer from weekly or even daily attacks.

Recognizing the Four Stages of a Migraine Attack

A migraine attack typically progresses through four distinct stages, although not everyone experiences all of them. Understanding these stages can help individuals better manage their condition and seek appropriate treatment.

What Are the Four Stages of a Migraine?

1. Prodrome: The early warning phase
2. Aura: Neurological symptoms preceding or accompanying the headache
3. Attack: The acute headache phase
4. Postdrome: The recovery phase

Each stage has its unique characteristics and duration, contributing to the overall migraine experience. Recognizing these stages can help individuals take proactive measures to minimize the impact of an attack.

Identifying Migraine Symptoms and Warning Signs

Migraine symptoms can vary widely among individuals, but certain key indicators are common across most cases. Being aware of these symptoms can aid in early detection and prompt treatment.

What Are the Primary Symptoms of a Migraine Attack?

The most common migraine symptoms include:

• Intense, throbbing pain, often on one side of the head
• Nausea and vomiting
• Sensitivity to light, sound, and sometimes smell
• Visual disturbances (in cases of migraine with aura)
• Dizziness and vertigo

During the prodrome phase, individuals may experience subtle changes such as mood swings, food cravings, and increased yawning. These warning signs can help people prepare for an impending migraine attack and take preventive measures.

Unraveling the Causes and Triggers of Migraines

While the exact causes of migraines are not fully understood, researchers have identified several factors that contribute to their occurrence. Understanding these causes and triggers is essential for developing effective prevention strategies.

What Are the Main Causes and Triggers of Migraines?

Migraine causes and triggers can be broadly categorized into:

• Genetic factors: Family history plays a significant role in migraine susceptibility
• Hormonal changes: Especially in women, fluctuations in estrogen levels can trigger migraines
• Environmental factors: Certain foods, weather changes, and strong odors can act as triggers
• Lifestyle habits: Stress, sleep disturbances, and dietary choices can influence migraine frequency
• Neurochemical imbalances: Changes in brain chemicals like serotonin and calcitonin gene-related peptide (CGRP) are implicated in migraine pathophysiology

Identifying personal triggers through careful observation and journaling can help individuals avoid or minimize exposure to factors that precipitate their migraine attacks.

Diagnosing Migraines: Tools and Techniques

Accurate diagnosis of migraines is crucial for developing an effective treatment plan. Healthcare providers use a combination of clinical assessment, patient history, and diagnostic tools to confirm a migraine diagnosis and rule out other potential causes of headaches.

How Are Migraines Diagnosed?

The diagnostic process for migraines typically involves:

• Detailed medical history and symptom review
• Physical and neurological examination
• Headache diary analysis
• Imaging studies (in some cases) to rule out other conditions
• Application of diagnostic criteria, such as those outlined by the International Classification of Headache Disorders (ICHD)

In some cases, additional tests may be necessary to exclude other neurological conditions or to investigate atypical symptoms. These may include MRI scans, CT scans, or blood tests.

Exploring Treatment Options for Migraines

Migraine treatment aims to relieve symptoms, prevent future attacks, and improve overall quality of life. A comprehensive treatment plan often involves a combination of medication, lifestyle changes, and complementary therapies.

What Are the Most Effective Treatments for Migraines?

Migraine treatments can be categorized into two main types:

1. Acute treatments: Medications taken during a migraine attack to relieve symptoms
2. Preventive treatments: Medications and therapies used to reduce the frequency and severity of migraine attacks

Acute treatments may include over-the-counter pain relievers, prescription migraine-specific medications (such as triptans), and anti-nausea drugs. Preventive treatments can range from oral medications and CGRP inhibitors to Botox injections and neuromodulation devices.

Are There Non-Pharmacological Approaches to Migraine Treatment?

Yes, several non-pharmacological approaches can be effective in managing migraines:

• Lifestyle modifications: Regular sleep patterns, stress management, and dietary changes
• Complementary therapies: Acupuncture, biofeedback, and cognitive-behavioral therapy
• Physical therapies: Massage, chiropractic care, and physical therapy
• Mindfulness and relaxation techniques: Meditation, yoga, and progressive muscle relaxation

Many individuals find that a combination of pharmacological and non-pharmacological approaches provides the most comprehensive relief from migraine symptoms.

Developing Strategies for Migraine Prevention

Preventing migraines is a key aspect of managing the condition and improving quality of life. While it may not be possible to prevent all migraine attacks, various strategies can help reduce their frequency and severity.

How Can Migraines Be Prevented?

Effective migraine prevention strategies include:

• Identifying and avoiding personal triggers
• Maintaining a consistent sleep schedule
• Regular exercise and stress-reduction techniques
• Dietary modifications, such as avoiding known trigger foods
• Preventive medications, when recommended by a healthcare provider
• Hormonal management for women with menstrual-related migraines
• Addressing comorbid conditions that may exacerbate migraines

Developing a personalized prevention plan in consultation with a healthcare provider can significantly reduce the impact of migraines on daily life.

Living with Migraines: Coping Strategies and Support

Living with migraines can be challenging, but adopting effective coping strategies and seeking support can help individuals manage their condition and maintain a good quality of life.

What Are Some Effective Coping Strategies for Migraine Sufferers?

Coping strategies for migraine sufferers may include:

• Developing a migraine action plan for acute attacks
• Creating a supportive home and work environment
• Joining support groups or online communities
• Educating family, friends, and colleagues about the condition
• Exploring alternative therapies such as mindfulness and relaxation techniques
• Maintaining open communication with healthcare providers
• Advocating for accommodations at work or school when necessary

By implementing these strategies and seeking appropriate support, individuals with migraines can better manage their condition and improve their overall well-being.

Is There Hope for New Migraine Treatments in the Future?

Yes, the field of migraine research is constantly evolving, with promising developments on the horizon. Ongoing studies are exploring new treatment modalities, including:

• Advanced CGRP inhibitors and receptor antagonists
• Novel neuromodulation devices
• Personalized medicine approaches based on genetic profiling
• Innovative delivery methods for existing medications
• Combination therapies targeting multiple aspects of migraine pathophysiology

These advancements offer hope for more effective and tailored treatments in the future, potentially revolutionizing migraine management and improving outcomes for those living with this challenging condition.

Migraine – Symptoms and causes

Overview

A migraine can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.

Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

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Symptoms

Migraines, which often begin in childhood, adolescence or early adulthood, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.

Prodrome

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

• Constipation
• Mood changes, from depression to euphoria
• Food cravings
• Neck stiffness
• Increased thirst and urination
• Frequent yawning

Aura

For some people, aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They’re usually visual, but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes.

Examples of migraine aura include:

• Visual phenomena, such as seeing various shapes, bright spots or flashes of light
• Vision loss
• Pins and needles sensations in an arm or leg
• Weakness or numbness in the face or one side of the body
• Difficulty speaking
• Hearing noises or music
• Uncontrollable jerking or other movements

Attack

A migraine usually lasts from four to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

• Pain usually on one side of your head, but often on both sides
• Pain that throbs or pulses
• Sensitivity to light, sound, and sometimes smell and touch
• Nausea and vomiting

Post-drome

After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.

When to see a doctor

Migraines are often undiagnosed and untreated. If you regularly have signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which could indicate a more serious medical problem:

• An abrupt, severe headache like a thunderclap
• Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
• Headache after a head injury, especially if the headache worsens
• A chronic headache that is worse after coughing, exertion, straining or a sudden movement
• New headache pain after age 50

Causes

Though migraine causes aren’t fully understood, genetics and environmental factors appear to play a role.

Changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway, might be involved. So might imbalances in brain chemicals — including serotonin, which helps regulate pain in your nervous system.

Researchers are studying the role of serotonin in migraines. Other neurotransmitters play a role in the pain of migraine, including calcitonin gene-related peptide (CGRP).

Migraine triggers

There are a number of migraine triggers, including:

• Hormonal changes in women. Fluctuations in estrogen, such as before or during menstrual periods, pregnancy and menopause, seem to trigger headaches in many women.

  Hormonal medications, such as oral contraceptives and hormone replacement therapy, also can worsen migraines. Some women, however, find their migraines occurring less often when taking these medications.

• Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.
• Stress. Stress at work or home can cause migraines.
• Sensory stimuli. Bright lights and sun glare can induce migraines, as can loud sounds. Strong smells — including perfume, paint thinner, secondhand smoke and others — trigger migraines in some people.
• Sleep changes. Missing sleep, getting too much sleep or jet lag can trigger migraines in some people.
• Physical factors. Intense physical exertion, including sexual activity, might provoke migraines.
• Weather changes. A change of weather or barometric pressure can prompt a migraine.
• Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.
• Foods. Aged cheeses and salty and processed foods might trigger migraines. So might skipping meals or fasting.
• Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.

Risk factors

Several factors make you more prone to having migraines, including:

• Family history. If you have a family member with migraines, then you have a good chance of developing them too.
• Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.
• Sex. Women are three times more likely to have migraines.
• Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

Complications

Taking combination painkillers, such as Excedrin Migraine for more than 10 days a month for three months or in higher doses can trigger serious medication-overuse headaches. The same is true if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 15 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt), for more than nine days a month.

Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

Jan. 16, 2020

Migraines and gastrointestinal problems: Is there a link?

There may be a link between headaches and the gut. Nausea and vomiting are often associated with migraine attacks. And research suggests that people with frequent headaches may be more likely to develop gastrointestinal disorders.

In young children, several syndromes that cause gastrointestinal symptoms are also associated with migraines. These syndromes can cause episodes of vomiting (cyclical vomiting), abdominal pain (abdominal migraine) and dizziness (benign paroxysmal vertigo). They’re often called childhood periodic syndromes or episodic syndromes that may be associated with migraine.

Although these syndromes usually aren’t accompanied by head pain, they’re considered a form of migraine. In many cases, childhood periodic syndromes evolve into migraines later in life.

Research has shown that people who regularly experience gastrointestinal symptoms — such as reflux, diarrhea, constipation and nausea — have a higher prevalence of headaches than do those who don’t have gastrointestinal symptoms.

These studies suggest that people who get frequent headaches may be predisposed to gastrointestinal problems. Digestive conditions, such as irritable bowel syndrome and celiac disease, also may be linked to migraines. Treating these digestive conditions may help reduce the frequency and severity of migraines. However, more research is needed to understand these connections.

If you experience nausea, vomiting or diarrhea with your headaches, talk to your doctor about treatment options. Treating the headache usually relieves gastrointestinal symptoms.

However, in some cases, your doctor may recommend an anti-nausea or anti-diarrheal medication or a nonoral pain medication. Keep in mind that some pain medications, such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), may increase nausea.

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Show references

1. Lee SH, et al. Clinical implications of associations between headache and gastrointestinal disorders: A study using the Hallym smart clinical data warehouse. Frontiers in Neurology. 2017:8;526.
2. Gelfand AA. Episodic syndromes that may be associated with migraine: A.K.A. “the childhood periodic syndromes.” Headache. 2015;55:1358.
3. O’Brien H. Classification of migraine in children. https://www.uptodate.com/contents/search. Accessed Oct. 16, 2018.
4. Garza I, et al. Chronic migraine. https://www.uptodate.com/contents/search. Accessed Oct. 16, 2018.
5. Camara-Lemarroy CR, et al. Gastrointestinal disorders associated with migraine: A comprehensive review. World Journal of Gastroenterology. 2016:22;8149.
6. Bajwa ZH, et al. Acute treatment of migraine in adults. https://www.uptodate.com/contents/search. Accessed Oct. 16, 2018.
7. Hindiyeh N, et al. What the gut can teach us about migraine. Current Pain and Headache Reports. 2015:19;33.

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Migraine – Care at Mayo Clinic

Migraine care at Mayo Clinic

Your Mayo Clinic care team

The doctors trained in nervous system disorders (neurologists) include internationally recognized researchers in the treatment and prevention of migraines. Teams of doctors work together to bring you the best possible treatment for your migraines.

Your care team of experts collaborates to provide you with the benefit of each specialist’s knowledge and experience.

Advanced diagnosis and treatment

Innovative treatment for migraine headaches.

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The Migraine Research Program at Mayo Clinic works to better understand migraine triggers, prevention and treatment to offer you a prompt, accurate diagnosis and the latest in treatment options.

Expertise and rankings

Mayo Clinic doctors have extensive experience in diagnosing and treating migraines and other types of headaches. Each year, Mayo experts treat nearly 19,000 people for migraine.

Mayo Clinic in Rochester, Minn., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for neurology and neurosurgery in the U. S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Ariz., is ranked highly performing for neurology and neurosurgery by U.S. News & World Report.

Learn more about Mayo Clinic’s neurosurgery and neurology departments’ expertise and rankings.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn’t require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer’s customer service number is printed on the back of your insurance card.

More information about billing and insurance:

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Jan. 16, 2020

Migraine Headaches: Causes, Treatment & Symptoms

Overview

What’s a migraine? What does a migraine feel like?

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that it’s the sixth most disabling disease in the world.

What are the types of headaches? What type of headache is a migraine?

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.

What is an aura?

An aura is a group of sensory, motor and speech symptoms that usually act like warning signals that a migraine headache is about to begin. Commonly misinterpreted as a seizure or stroke, it typically happens before the headache pain, but can sometimes appear during or even after. An aura can last from 10 to 60 minutes. About 15% to 20% of people who experience migraines have auras.

Aura symptoms are reversible, meaning that they can be stopped/healed. An aura produces symptoms that may include:

• Seeing bright flashing dots, sparkles, or lights.
• Blind spots in your vision.
• Numb or tingling skin.
• Speech changes.
• Ringing in your ears (tinnitus).
• Temporary vision loss.
• Seeing wavy or jagged lines.
• Changes in smell or taste.
• A “funny” feeling.

What are the types of migraines?

There are several types of migraines, and the same type may go by different names:

• Migraine with aura (complicated migraine): Around 15% to 20% of people with migraine headaches experience an aura.
• Migraine without aura (common migraine): This type of migraine headache strikes without the warning an aura may give you. The symptoms are the same, but that phase doesn’t happen.
• Migraine without head pain: “Silent migraine” or “acephalgic migraine,” as this type is also known as, includes the aura symptom but not the headache that typically follows.
• Hemiplegic migraine: You’ll have temporary paralysis (hemiplegia) or neurological or sensory changes on one side of your body. The onset of the headache may be associated with temporary numbness, extreme weakness on one side of your body, a tingling sensation, a loss of sensation and dizziness or vision changes. Sometimes it includes head pain and sometimes it doesn’t.
• Retinal migraine (ocular migraine): You may notice temporary, partial or complete loss of vision in one of your eyes, along with a dull ache behind the eye that may spread to the rest of your head. That vision loss may last a minute, or as long as months. You should always report a retinal migraine to a healthcare provider because it could be a sign of a more serious issue.
• Chronic migraine: A chronic migraine is when a migraine occurs at least 15 days per month. The symptoms may change frequently, and so may the severity of the pain. Those who get chronic migraines might be using headache pain medications more than 10 to 15 days a month and that, unfortunately, can lead to headaches that happen even more frequently.
• Migraine with brainstem aura. With this migraine, you’ll have vertigo, slurred speech, double vision or loss of balance, which occur before the headache. The headache pain may affect the back of your head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears and vomiting.
• Status migrainosus. This is a rare and severe type of migraine that can last longer than 72 hours. The headache pain and nausea can be extremely bad. Certain medications, or medication withdrawal, can cause you to have this type of migraine.

What are the four stages or phases of a migraine? What’s the timeline?

The four stages in chronological order are the prodrome (pre-monitory), aura, headache and postdrome. About 30% of people experience symptoms before their headache starts.

The phases are:

1. Prodrome: The first stage lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. Some know it as the “preheadache” or “premonitory” phase.
2. Aura: The aura phase can last as long as 60 minutes or as little as five. Most people don’t experience an aura, and some have both the aura and the headache at the same time.
3. Headache: About four hours to 72 hours is how long the headache lasts. The word “ache” doesn’t do the pain justice because sometimes it’s mild, but usually, it’s described as drilling, throbbing or you may feel the sensation of an icepick in your head. Typically it starts on one side of your head and then spreads to the other side.
4. Postdrome: The postdrome stage goes on for a day or two. It’s often called a migraine “hangover” and 80% of those who have migraines experience it.

It can take about eight to 72 hours to go through the four stages.

How common are migraine headaches?

Experts estimate that nearly half of the adult population experiences headaches and 12% of Americans get migraine headaches. Women are about three times more likely than men to experience migraines.

Who gets migraines? What are the risk factors?

It’s difficult to predict who may get a migraine and who may not, but there are risk factors that may make you more vulnerable. These risk factors include:

• Genetics: Up to 80% of people who get migraine headaches have a first-degree relative with the disease.
• Gender. Migraine headaches happen to women more than men, especially women between the ages of 15 and 55. It’s likely more common in women because of the influence of hormones.
• Stress level. You may get migraines more often if you’re high-stress. Stress can trigger a migraine.
• Smoking.

How often do migraines happen?

The frequency of a migraine could be once a year, once a week or any amount of time in between. Having two to four migraine headaches per month is the most common.

Are migraines hereditary?

Migraines tend to run in families. As many as four out of five people with migraines have a family history. If one parent has a history of migraines, their child has a 50% chance of having them. If both parents have a history of migraines, the risk jumps to 75%. Again, up to 80% of people with migraines have a first-degree relative with the disease.

Can children get migraines?

Yes, but pediatric migraines are often shorter and there are more stomach symptoms.

Who should I see about my migraine pain?

Discuss your symptoms with your primary care provider first. They can diagnose migraine headaches and start treatment. You may require a referral to a headache specialist.

Do migraines cause permanent brain damage? If I have migraines, does that mean I’ll get another disease?

No. Migraines don’t cause brain damage.

There is a tiny risk of stroke in people who get migraines with aura – 1 or 2 people out of 100,000.

Symptoms and Causes

What are the symptoms of migraines?

The primary symptom of migraine is a headache. Pain is sometimes described as pounding or throbbing. It can begin as a dull ache that develops into pulsing pain that is mild, moderate or severe. If left untreated, your headache pain will become moderate to severe. Pain can shift from one side of your head to the other, or it can affect the front of your head, the back of your head or feel like it’s affecting your whole head. Some people feel pain around their eye or temple, and sometimes in their face, sinuses, jaw or neck.

Other symptoms of migraine headaches include:

• Sensitivity to light, noise and odors.
• Nausea and vomiting, upset stomach and abdominal pain.
• Loss of appetite.
• Feeling very warm (sweating) or cold (chills).
• Pale skin color (pallor).
• Feeling tired.
• Dizziness and blurred vision.
• Tender scalp.
• Diarrhea (rare).
• Fever (rare).

Most migraines last about four hours, although severe ones can last much longer.

Each phase of the migraine attack can come with different symptoms:

Prodrome symptoms:

• Problems concentrating.
• Irritability and/or depression.
• Difficulty speaking and reading.
• Difficulty sleeping. Yawning.
• Nausea.
• Fatigue.
• Sensitivity to light and sound.
• Food cravings.
• Increased urination.
• Muscle stiffness.

Aura symptoms:

• Numbness and tingling.
• Visual disturbances. You might be seeing the world as if through a kaleidoscope, have blurry spots or see sparkles or lines.
• Temporary loss of sight.
• Weakness on one side of the body.
• Speech changes.

Headache symptoms:

• Neck pain, stiffness.
• Depression, giddiness and/or anxiety.
• Sensitivity to light, smell and sound.
• Nasal congestion.
• Insomnia.
• Nausea and vomiting.

Postdrome symptoms:

• Inability to concentrate.
• Depressed mood.
• Fatigue.
• Lack of comprehension.
• Euphoric mood.

What causes a migraine?

The cause of migraine headaches is complicated and not fully understood. When you have a headache it’s because specific nerves in your blood vessels send pain signals to your brain. This releases inflammatory substances into the nerves and blood vessels of your head. It’s unclear why your nerves do that.

What triggers a migraine?

Migraine attacks can be triggered by a variety of factors. Common triggers include:

• Emotional stress. Emotional stress is one of the most common triggers of migraine headaches. During stressful events, certain chemicals in the brain are released to combat the situation (known as the “flight or fight” response). The release of these chemicals can bring on a migraine. Other emotions like anxiety, worry and excitement can increase muscle tension and dilate blood vessels. That can make your migraine more severe.
• Missing a meal. Delaying a meal might also trigger your migraine headache.
• Sensitivity to specific chemicals and preservatives in foods. Certain foods and beverages such as aged cheese, alcoholic beverages, chocolate and food additives such as nitrates (found in pepperoni, hot dogs and luncheon meats) and fermented or pickled foods may be responsible for triggering up to 30% of migraines.
• Caffeine. Having too much caffeine or withdrawal from caffeine can cause headaches when the caffeine level abruptly drops. Your blood vessels seem to become sensitized to caffeine and when you don’t get it, a headache may occur. Caffeine is sometimes recommended by healthcare providers to help with treating acute migraine attacks but should not be used frequently.
• Daily use of pain-relieving medications. If you use medicine meant to relieve headache pain too often, that can cause a rebound headache.
• Hormonal changes in women. Migraines in women are more common around the time of their menstrual periods. The abrupt drop in estrogen that triggers menses can also trigger migraines. Hormonal changes can also be brought on by birth control pills and hormone replacement therapy. Migraines are generally worse between puberty and menopause since these estrogen fluctuations generally don’t occur in young girls and post-menopausal women. If your hormones are a strong factor in your migraines, you may have fewer headaches after menopause. Hormonal changes do not appear to trigger migraines in men.
• Light. Flashing lights, fluorescent lights, light from the TV or computer and sunlight can trigger you.

Other possible triggers include:

• Changing weather conditions such as storm fronts, barometric pressure changes, strong winds or changes in altitude.
• Being overly tired. Overexertion.
• Dieting, or not drinking enough water.
• Changes in your normal sleep pattern.
• Loud noises.
• Exposure to smoke, perfumes or other odors.
• Certain medications cause blood vessels to swell.

Diagnosis and Tests

What’s a migraine journal?

• Keeping a migraine journal is not only beneficial to you, but it helps your healthcare provider with the diagnosis process. Your journal should be detailed and updated as much as possible before, during and after a migraine attack. Consider keeping track of the following:
• The date and time of when the migraine began – specifically when the prodrome started, if you’re able to tell it’s happening. Track time passing. When did the aura phase begin? The headache? The postdrome? Do your best to tell what stage you’re in and how long it lasts. If there’s a pattern, that may help you anticipate what will happen in the future.
• What are your symptoms? Be specific.
• Note how many hours of sleep you got the night before it happened and your stress level. What’s causing your stress?
• Note the weather.
• Log your food and water intake. Did you eat something that triggered the migraine? Did you miss a meal?
• Describe the type of pain and rate it on a one to 10 scale with 10 being the worst pain you’ve ever experienced.
• Where is the pain located? One side of your head? Your jaw? Your eye?
• List all of the medications you took. This includes any daily prescriptions, any supplements and any pain medication you took.
• How did you try to treat your migraine, and did it work? What medicine did you take, at what dosage, at what time?
• Consider other triggers. Maybe you played basketball in the sunlight? Maybe you watched a movie that had flashing lights? If you’re a woman, are you on your period?

There are some smartphone apps you can use to keep a migraine journal if you don’t want to use pen and paper.

How are migraines diagnosed?

To diagnose a migraine, your healthcare provider will get a thorough medical history, not just your history of headaches but your family’s, too. Also, they’ll want to establish a history of your migraine-related symptoms, likely asking you to:

• Describe your headache symptoms. How severe are they?
• Remember when you get them. During your period, for example?
• Describe the type and location of your pain. Is the pain pounding? Pulsing? Throbbing?
• Remember if anything makes your headache better or worse.
• Tell how often you get migraine headaches.
• Talk about the activities, foods, stressors or the situations that may have brought on the migraine.
• Discuss what medications you take to relieve the pain and how often you take them.
• Tell how you felt before, during and after the headache.
• Remember if anyone in your family gets migraine headaches.

Your healthcare provider may also order blood tests and imaging tests (such as a CT scan or a MRI) to make sure there are no other causes for your headache. An electroencephalogram (EEG) may be ordered to rule out seizures.

What symptoms must you have to be diagnosed with a migraine?

Migraine with aura (complicated migraine). This is a headache, plus:

• Visual symptoms (seeing spots, sparkles, or lines) or vision loss.
• Sensory symptoms (feeling pins and needles, for example).

Migraine without aura (common migraine). A common migraine is a headache and:

• The attacks included pain on one side of your head.
• You’ve had at least five attacks, each lasting between four and 72 hours.

Plus, you’ve experienced at least one of the following:

• Nausea and/or vomiting.
• Lights bother you and/or you avoid light.
• Sounds bother you and/or you avoid sounds.

Are migraines misdiagnosed?

Sometimes you or your healthcare provider may assume that the pain you’re feeling is a sinus headache or a tension-type headache. Show your healthcare provider your migraine journal so that they can learn about your unique situation.

Management and Treatment

How are migraines treated?

Migraine headaches are chronic. They can’t be cured, but they can be managed and possibly improved. There are two main treatment approaches that use medications: abortive and preventive.

• Abortive medications are most effective when you use them at the first sign of a migraine. Take them while the pain is mild. By possibly stopping the headache process, abortive medications help stop or decrease your migraine symptoms, including pain, nausea, light sensitivity, etc. Some abortive medications work by constricting your blood vessels, bringing them back to normal and relieving the throbbing pain.
• Preventive (prophylactic) medications may be prescribed when your headaches are severe, occur more than four times a month and are significantly interfering with your normal activities. Preventive medications reduce the frequency and severity of the headaches. Medications are generally taken on a regular, daily basis to help prevent migraines.

What medications are used to relieve migraine pain?

Over-the-counter medications are effective for some people with mild to moderate migraines. The main ingredients in pain relieving medications are ibuprofen, aspirin, acetaminophen, naproxen and caffeine.

Three over-the-counter products approved by the Food and Drug Administration for migraine headaches are:

• Excedrin® Migraine.
• Advil® Migraine.
• Motrin® Migraine Pain.

Be cautious when taking over-the-counter pain relieving medications. Sometimes overusing them can cause analgesic-rebound headaches or a dependency problem. If you’re taking any over-the-counter pain medications more than two to three times a week, report that to your healthcare provider. They may suggest prescription medications that may be more effective.

Prescription drugs for migraine headaches include:

Triptan class of drugs (these are abortives):

• Sumatriptan.
• Zolmitriptan.
• Naratriptan.

Calcium channel blockers:

Calcitonin gene-related (CGRP) monoclonal antibodies:

• Erenumab.
• Fremanezumab.
• Galcanezumab.
• Eptinezumab.

Beta blockers:

• Atenolol.
• Propranolol.
• Nadolol.

Antidepressants:

• Amitriptyline.
• Nortriptyline.
• Doxepin.
• Venlafaxine.
• Duloxetine.

Antiseizure drugs:

• Valproic acid.
• Topiramate.

Other:

• Steroids.
• Phenothiazines.
• Corticosteroids.

Your healthcare provider might recommend vitamins, minerals, or herbs, including:

• Riboflavin (vitamin B2).
• Magnesium.
• Feverfew.
• Butterbur.
• Co-enzyme Q10.

Drugs to relieve migraine pain come in a variety of formulations including pills, tablets, injections, suppositories and nasal sprays. You and your healthcare provider will discuss the specific medication, combination of medications and formulations to best meet your unique headache pain.

Drugs to relieve nausea are also prescribed, if needed.

All medications should be used under the direction of a headache specialist or healthcare provider familiar with migraine therapy. As with any medication, it’s important to carefully follow the label instructions and your healthcare provider’s advice.

Alternative migraine management methods, also known as home remedies, include:

• Resting in a dark, quiet, cool room.
• Applying a cold compress or washcloth to your forehead or behind your neck. (Some people prefer heat.)
• Massaging your scalp.
• Yoga.
• Applying pressure to your temples in a circular motion.
• Keeping yourself in a calm state. Meditating.
• Biofeedback.

What’s biofeedback?

Biofeedback is the use of special equipment strapped to your head. The equipment measures the physical tension in your body and alerts you when you need to control your stress, which changes the physical processes related to stress. You won’t have to use the equipment forever because you’ll learn how to detect the tension on your own. The device works on children as well as adults.

Are there surgical procedures that relieve migraines?

Surgical treatments are not generally recommended for migraine headaches.

What are the treatment options for migraine headaches during pregnancy?

Avoid medications for migraines when you’re pregnant, or if you think you may be pregnant. They can negatively affect your baby. With your healthcare provider’s permission, you may be able to take a mild pain reliever like acetaminophen.

Prevention

Can migraine headaches be prevented?

There is no cure for migraine headaches, but you can take an active role in managing them, maybe reducing how often you get them and possibly controlling how severe they are by following these tips:

• Keep a migraine diary. Take notes about any foods and other triggers that you think may have caused you to develop a migraine. Make changes in your diet and avoid those triggers as much as possible.
• Get a prescription for CGRP monoclonal antibodies. This injection was created specifically to help with migraines.
• Get seven to nine hours of sleep a night.
• Eat at regular intervals. Don’t skip meals. Drink plenty of water.
• Exercise regularly and maintain a healthy weight.
• Learn techniques to control stress such as meditation, yoga, relaxation training, or mindful breathing.
• Take medications as directed by your healthcare provider. Preventative medications include antidepressants, anti-seizure medications, calcitonin gene-related peptides, medicines that lower blood pressure and Botox injections. You might be prescribed timolol, amitriptyline, topiramate and divalproex sodium. Notice that some of the same medications that can help you manage a migraine may also help prevent one.
• Talk to your healthcare provider about hormone therapy if your migraines are thought to be linked to your menstrual cycle.
• Consider trying a transcutaneous supraorbital nerve stimulation device. This battery-powered electrical stimulator device is approved by the Food and Drug Administration to prevent migraines. The device, worn like a headband or on your arm, emits electrical charges. The charge stimulates the nerve that transmits some of the pain experienced in migraine headaches. (The device may not be covered by your health insurance.)
• Get counseling from a therapist for help controlling your stress. Ask your healthcare provider for a referral.

Outlook / Prognosis

What is the prognosis (outlook) for people with migraines?

Migraines are unique to each individual. Likewise, how migraines are managed is also unique. The best outcomes are usually achieved by learning and avoiding personal migraine triggers, managing symptoms, practicing preventive methods, following the advice of your healthcare provider and reporting any significant changes as soon as they occur.

Is there a cure for migraines?

Although there isn’t a cure, there are treatments that may help you manage the symptoms.

How long will I have migraine headaches?

You may experience migraine headaches for the rest of your life. If your migraines are caused by your period, you may stop having them when menopause starts.

Living With

When should I seek immediate help, or contact my healthcare provider?

Call 911 or go to an emergency department right away if:

• You are experiencing the “worst headache of my life. ”
• You are having neurologic symptoms that you’ve never had before, including speaking difficulty, balance problems, vision problems, mental confusion, seizures or numbing/tingling sensations.
• Your headache comes on suddenly.
• You have a headache after experiencing a head injury.

Schedule a visit with your healthcare provider if:

• The number or severity of your headaches increase or your headache pattern changes.
• Your medications no longer seem to be working or you’re experiencing new or different side effects.

What questions should I ask my healthcare provider?

• Will my child grow out of their migraines?
• What medications do you recommend for me?
• What should I change about my lifestyle to prevent my migraine headaches?
• Should I get tested?
• What type of migraine do I have?
• What can my friends and family do to help?
• Are my migraines considered chronic?

A note from Cleveland Clinic

Migraine headaches can be devastating and make it impossible to go to work, school or experience other daily activities. Fortunately, there are some ways to possibly prevent a migraine and other ways to help you manage and endure the symptoms. Work with your healthcare provider to keep migraines from ruling your life.

Causes, treatment, types, and symptoms

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission. Here’s our process.

Migraine is a medical condition that involves severe, recurring headaches and other symptoms. Before the headache, there may be sensory changes that are known as an aura.

A migraine episode is different from a headache unrelated to migraine. An episode usually occurs in stages and can last for several days. It can affect a person’s daily life, including their ability to work or study.

How migraine affects people can also vary. There is a range of triggers, severity, symptoms, and frequency. Some people have more than one episode each week, while others have them only occasionally.

In 2018, researchers found that more than 15% of adults in the United States had experienced a migraine episode or a severe headache within the last 3 months.

Figures from 2015 found that migraine affects just over 19% of females and 9% of males. Episodes often occur from the ages of 18 to 44 years, but they can happen at any time, including during childhood.

Share on PinterestA person may experience physical and sensory symptoms before a migraine episode starts.

Symptoms of migraine tend to occur in stages:

Before the headache: According to older research, around 20–60% of people experience symptoms that start hours, or possibly days, before the headache. These include physical and sensory symptoms, such as aura.

During the headache: Alongside a mild to severe throbbing or pulsing headache, symptoms may include nausea, vomiting, and nasal congestion.

Resolution: Tiredness and irritability may last another 2 days, and this period is sometimes called the “migraine hangover.”

Other common features are:

• head pain that worsens during physical activity or straining
• an inability to perform regular activities due to pain
• increased sensitivity to light and sound that lying quietly in a darkened room relieves

Other symptoms may include sweating, temperature changes, a stomachache, and diarrhea.

Find out what else can cause a headache, nausea, and fatigue here.

A migraine episode is different from a typical headache. The experience is different, and they can have different causes.

Keeping a diary of symptoms can help a person and their doctor identify a migraine episode. Keep the journal for at least 8 weeks, and record the following.

• the time that symptoms start
• possible triggers, such as stress or menstruation
• the nature of the headache
• any other symptoms
• how long symptoms last
• any noticeable indicators of migraine, such as aura
• any medications used and the effect that they had

Learn more about the differences between migraine and a headache here.

Experts do not know what causes migraine episodes. They may stem from changes in the brain that affect the:

• way nerves communicate
• balance of chemicals
• blood vessels

Genetic features may also play a role, as having a family history of migraine is a common risk factor.

Migraine triggers vary but include:

• Hormonal changes, for example, around the time of menstruation.
• Emotional triggers, such as stress, depression, anxiety, and excitement.
• Dietary factors, including alcohol, caffeine, chocolate, cheese, citrus fruits, and foods containing the additive tyramine.
• Medications, such as sleeping pills, hormone replacement therapy (HRT), and some birth control pills.
• Environmental factors, including flickering screens, strong smells, secondhand smoke, loud noises, stuffy rooms, temperature changes, and bright lights.

Some other possible triggers include:

• tiredness
• a lack of sleep
• shoulder and neck tension
• poor posture
• physical overexertion
• low blood sugar
• jet lag
• irregular mealtimes
• dehydration

What causes headaches? Find out here.

Risk factors

Anyone can develop migraine, but it is more common in people with any of the following:

• depression
• bipolar disorder
• fibromyalgia
• irritable bowel syndrome
• an overactive bladder
• sleep disorders
• obsessive-compulsive disorder
• anxiety

Is there a link between migraine and COVID-19?

There is no cure for migraine. However, medications can treat the symptoms when they arise, and people can take steps to reduce the frequency and severity of episodes.

Medications

Pain relief and other types of medication can often help. Taking medication as soon as symptoms start may keep them from becoming severe.

Some over-the-counter pain relief medications that may benefit people with migraine include:

Other options include:

• triptans, such as sumatriptan, to help reverse the brain changes that cause migraine
• antiemetics to manage any nausea and vomiting
• gepants, which block a protein involved in inflammation and pain called calcitonin gene-related peptide (CGRP)
• ditans, which interact with 5-HT1F receptors on the sensory nerves and blood vessels

It is important not to overuse medication, as doing so can cause a rebound headache. A healthcare provider can help a person determine how much of each medication is safe and effective.

Get some tips for instant migraine relief here.

While it is not always possible to prevent migraine episodes, there are ways to reduce their frequency and severity.

Medication to prevent episodes

The following prescription drugs may help reduce the number of episodes that a person with severe migraine experiences:

It may take several weeks to see an improvement.

The best treatment in children or adolescents may be different from that in adults. A doctor can advise on the best option.

Identifying and avoiding triggers

A migraine episode is often a response to a trigger. To figure out the culprit, a person might try keeping a diary and recording what they did, ate, and drank before an episode.

It may be particularly helpful to avoid:

• low blood sugar
• physical overexertion
• stress
• certain foods, such as chocolate and any that contain tyramine
• certain medications, including HRT and some birth control pills
• bright lights and flickering screens

The following strategies can also help reduce the frequency of migraines:

If making these changes does not ease the severity and frequency of migraine episodes, a doctor may suggest medication or other options.

There are various types of migraine. A major distinguishing factor is whether they involve aura, or sensory changes.

Migraine with aura

Aura is a disturbance of the senses in the early stages of an episode. It can act as a warning that a migraine headache is approaching.

Aura can involve:

• having confusing thoughts or experiences
• seeing strange, sparkling, or flashing lights that are not there
• seeing zig-zagging lines of light
• having blind spots or blank patches in the vision
• feeling pins and needles in an arm or leg
• having difficulty speaking
• having weakness in the shoulders, neck, or limbs
• seeing things that are not there out of one eye, such as transparent strings of objects
• not being able to see part of something clearly
• having part of the field of vision disappear, then reappear

Aura may feel similar to the sensation that follows exposure to a very bright camera flash, but the visual changes can last for several minutes or up to an hour.

Find out more about migraine aura here.

Migraine without aura

More commonly, a person experiences no sensory disturbances before an episode.

According to the Migraine Trust, 70–90% of episodes occur without aura.

Other types

Other types of migraine include:

• Chronic migraine: This involves having an episode on more than 15 days per month.
• Menstrual migraine: This occurs in a pattern that follows the menstrual cycle.
• Hemiplegic migraine: This type causes temporary weakness on one side of the body.
• Abdominal migraine: This involves migraine episodes linking with irregular function in the gut and abdomen, often with nausea or vomiting. It mainly affects children under 14 years of age.
• Vestibular migraine: Severe vertigo is a symptom of this form of migraine.
• Basilar migraine: This rare type is also known as migraine with brainstem aura, and it can affect neurological functions, such as speech.

Anyone who may be experiencing migraine should consult a doctor.

Diagnosis

The International Headache Society recommend the “5, 4, 3, 2, 1” criteria to diagnose migraine without aura. This number series stands for:

• having five or more attacks, each with a duration of 4 hours to 3 days
• the headache having at least two of the following qualities:
  – occurring on one side
  – pulsating
  – causing moderate-to-severe pain aggravated by activity
• having at least one additional symptom, such as:
  – nausea
  – vomiting
  – sensitivity to light
  – sensitivity to sound

The doctor may recommend imaging or other tests to exclude other causes of symptoms, such as a tumor.

A person should see a doctor if they experience:

• what seems to be a first migraine episode
• worsening or unusual migraine symptoms
• severe symptoms

If any of the following occur, seek immediate medical help:

• an unusually severe headache
• visual disturbances
• a loss of sensation
• difficulty speaking

These could indicate another condition that may need urgent attention, such as a stroke.

When is it sensible to worry about a headache?

Migraine is a medical condition that involves a headache, but it is not only a headache. It can have a significant impact on daily life, making it difficult to work or perform regular activities.

Identifying triggers can often help reduce the frequency or severity of episodes, though it is not always possible to prevent them.

Medication and other treatments can help manage migraine and its symptoms. Anyone who has concerns about migraine should see a doctor.

Read the article in Spanish.

Headache: When to worry, what to do

Understanding what causes headaches and finding treatments to relieve the pain

Nearly everyone has had headache pain, and most of us have had it many times. A minor headache is little more than a nuisance that’s relieved by an over-the-counter pain reliever, some food or coffee, or a short rest. But if your headache is severe or unusual, you might worry about stroke, a tumor, or a blood clot. Fortunately, such problems are rare. Still, you should know when a headache needs urgent care and how to control the vast majority of headaches that are not threatening to your health.

What causes headaches?

Doctors don’t fully understand what causes most headaches. They do know that the brain tissue and the skull are never responsible since they don’t have nerves that register pain. But the blood vessels in the head and neck can signal pain, as can the tissues that surround the brain and some major nerves that originate in the brain. The scalp, sinuses, teeth, and muscles and joints of the neck can also cause head pain.

When to worry about a headache

You can take care of many types of headaches by yourself, and your doctor can give you medication to control most of the tougher headaches. But some headaches call for prompt medical care. Here are some warning signs for when you should worry about headaches:

• Headaches that first develop after age 50
• A major change in the pattern of your headaches
• An unusually severe headache
• Head pain that increases with coughing or movement
• Headaches that get steadily worse
• Changes in personality or mental function
• Headaches that are accompanied by fever, stiff neck, confusion, decreased alertness or memory, or neurological symptoms such as visual disturbances, slurred speech, weakness, numbness, or seizures
• Headaches that are accompanied by a painful red eye
• Headaches that are accompanied by pain and tenderness near the temples
• Headaches after a blow to the head
• Headaches that prevent normal daily activities
• Headaches that come on abruptly, especially if they wake you up
• Headaches in patients with cancer or impaired immune systems

Types of headaches

There are more than 300 types of headaches, but only about 10% of headaches have a known cause. The others are called primary headaches. Here is a rundown on some major primary headaches.

Tension headaches

Occurring in about three of every four adults, tension headaches are the most common of all headaches. In most cases, they are mild to moderate in severity and occur infrequently. But a few people get severe tension headaches, and some are troubled by them for three or four times a week.

The typical tension headache produces a dull, squeezing pain on both sides of the head. People with strong tension headaches may feel like their head is in a vise. The shoulders and neck can also ache. Some tension headaches are triggered by fatigue, emotional stress, or problems involving the muscles or joints of the neck or jaw. Most last for 20 minutes to two hours.

If you get occasional tension-type headaches, you can take care of them yourself. Over-the-counter pain relievers such as acetaminophen (Tylenol, other brands) and nonsteroidal anti-inflammatories (NSAIDs) such as aspirin, naproxen (Aleve, other brands), or ibuprofen (Motrin, Advil, other brands) often do the trick, but follow the directions on the label, and never take more than you should. A heating pad or warm shower may help; some people feel better with a short nap or light snack.

If you get frequent tension-type headaches, try to identify triggers so you can avoid them. Don’t get overtired or skip meals. Learn relaxation techniques; yoga is particularly helpful because it can relax both your mind and your neck muscles. If you clench your jaw or grind your teeth at night, a bite plate may help.

If you need more help, your doctor may prescribe a stronger pain medication or a muscle relaxant to control headache pain. Many people with recurrent tension-type headaches can prevent attacks by taking a tricyclic antidepressant such as amitriptyline (Elavil, generic). Fortunately, most people with tension-type headaches will do very well with simpler programs.

Migraine

Migraines occur less often than tension headaches, but they are usually much more severe. They are two to three times more common in women than men, but that’s small consolation if you are among the 6% to 8% of all men who have migraines. And since a Harvard study of 20,084 men age 40 to 84 reported that having migraines boosts the risk of heart attacks by 42%, men with migraines should take their headaches to heart.

Neurologists believe that migraines are caused by changes in the brain’s blood flow and nerve cell activity. Genetics play a role since 70% of migraine victims have at least one close relative with the problem.

Migraine triggers. Although a migraine can come on without warning, it is often set off by a trigger. The things that set off a migraine vary from person to person, but a migraine sufferer usually remains sensitive to the same triggers. The table lists some of the most common ones.

Migraine symptoms. Migraines often begin in the evening or during sleep. In some people, the attacks are preceded by several hours of fatigue, depression, and sluggishness or by irritability and restlessness. Because migraine symptoms vary widely, at least half of all migraine sufferers think they have sinus or tension headaches, not migraines.

About 20% of migraines begin with one or more neurological symptoms called an aura. Visual complaints are most common. They may include halos, sparkles or flashing lights, wavy lines, and even temporary loss of vision. The aura may also produce numbness or tingling on one side of the body, especially the face or hand. Some patients develop aura symptoms without getting headaches; they often think they are having a stroke, not a migraine.

The majority of migraines develop without an aura. In typical cases, the pain is on one side of the head, often beginning around the eye and temple before spreading to the back of the head. The pain is frequently severe and is described as throbbing or pulsating. Nausea is common, and many migraine patients have a watering eye, a running nose, or congestion. If these symptoms are prominent, they may lead to a misdiagnosis of sinus headaches. One way to remember the features of migraine is to use the word POUND

P is for pulsating pain
O for one-day duration of severe untreated attacks
U for unilateral (one-sided) pain
N for nausea and vomiting
D for disabling intensity.

Without effective treatment, migraine attacks usually last for four to 24 hours. When you’re suffering a migraine, even four hours is far too long — and that’s why early treatment for a migraine is so important.

Migraine treatment. If you spot a migraine in its very earliest stages, you may be able to control it with nonprescription pain relievers. Acetaminophen, aspirin, ibuprofen, naproxen, and a combination of pain medications and caffeine are all effective — if you take a full dose very early in the attack. The anti-nausea drug metoclopramide (Reglan) may enhance the activity of NSAIDs.

When prescription drugs are needed, most doctors turn to the triptans, which are available as tablets, nasal sprays, or as injections that patients can learn to give to themselves. Examples include sumatriptan (Imitrex), zolmitriptan (Zomig), and rizatriptan (Maxalt). Triptans provide complete relief within two hours for up to 70% of patients; the response is best if treatment is started early. Some patients require a second dose within 12 to 24 hours. Because the triptans can affect blood flow to the heart as well as the head, patients with cardiovascular disease should not use them. Patients who take antidepressants in the SSRI family should also avoid triptans.

Work with your doctor to find the migraine treatment that works best for you. Remember, though, that overuse can lead to rebound headaches and a vicious cycle of drugs and headaches. So, if you need treatment more than two or three times a week, consider preventive medications.

Migraine prevention. Some people can prevent migraines simply by avoiding triggers. Others do well with prompt therapy for occasional attacks. But patients who suffer frequent migraine attacks often benefit from preventive medications. Effective prescription drugs include beta blockers (such as propranolol, nadolol and atenolol), certain antidepressants (such as amitriptyline), and certain antiseizure medications (such topiramate and valproate). Difficult cases may benefit from referral to a headache specialist.

Cluster headaches

Cluster headaches are uncommon but very severe headaches, and they occur five times more often in men than women. Although anyone can get cluster headaches, the typical patient is a middle-aged man with a history of smoking.

The problem gets its name because the headaches tend to come in clusters, with one to eight headaches a day during a one- to three-month period every year or two, often at the same time of year. The pain always strikes one side of the head and is very severe. The eye on the painful side is red and watery, the eyelid may droop, and the nose runs or is blocked. The attack starts abruptly and lasts for 30 to 60 minutes. Most sufferers become restless and agitated during the attack; unable to sit still, they pace, jog in place, or beat their head against a wall. Nausea and sensitivity to light and sound may accompany the pain.

Inhaling high flow oxygen soon after the onset of the headache can often stop the attack. Sumatriptan is often effective for cluster headaches, particularly when given by injection. Other triptans may also help. Some patients favor lidocaine nose drops, dihydroergotamine injections, or other treatments. The most effective medication for preventing cluster headache attacks is verapamil, a calcium-channel blocker. Other drugs that may help include divalproex, topiramate, and lithium.

Other types of headaches

Doctors have diagnosed hundreds of conditions associated with headaches. Here are just a few:

Medication headaches. Many drugs number headaches among their side effects. And although it seems paradoxical, many medications used to treat headaches can also cause medication overuse headaches or rebound headaches. Migraine sufferers are particularly vulnerable to a vicious cycle of pain leading to more medication, which triggers more pain. If you have frequent headaches and use medication, OTC or prescription, or both, for more than 10 to 15 days a month, you may have medication overuse headaches. The way to find out is to discontinue or taper your medication — but always consult your doctor first. A corticosteroid such as prednisone may help control pain during the withdrawal period.

Sinus headaches. Acute sinusitis causes pain over the forehead, around the nose and eyes, over the cheeks, or in the upper teeth. Stooping forward increases the pain. Thick nasal discharge, congestion, and fever pinpoint the problem to the sinuses. When the acute infection resolves, the pain disappears. Sinusitis is not a common cause of chronic or recurrent headaches.

Ice cream headaches. Some people develop sharp, sudden headache pain when they eat anything cold. The pain is over in less than a minute, even if you keep eating. If you are bothered by ice cream headaches, try eating slowly and warming the cold food at the front of your mouth before you swallow it.

Headache from high blood pressure. Except in cases of very high blood pressure, hypertension does not cause headaches. In fact, most people with high blood pressure don’t[h2] have any symptoms at all, and a study of 51,234 people reported that hypertension was associated with a reduced incidence of headaches. But that’s no reason to neglect your blood pressure. Hypertension leads to strokes, heart attacks, heart failure, and kidney disease, so all men should have their pressure checked, and then take steps to correct abnormalities.

Headache from exercise and sex. Sudden, strenuous exercise can bring on a headache. Gradual warm-ups or treatment with an anti-inflammatory medication before exercise can help. Sexual intercourse may also trigger headaches; some men note only dull pain, but others suffer from severe attacks called orgasmic headaches. Some people can prevent orgasmic headaches by taking an NSAID 30 to 60 minutes before intercourse.

Headache testing

Modern medicine depends on tests to diagnose many problems. For most headaches, though, a good old-fashioned history and physical will do the job. In fact, CT scans, MRIs, and EEGs (brain wave tests) look normal in tension-type headaches, migraines, and cluster headaches. Still, these tests can be vital in patients with warning signs or other worrisome headaches.

Living with constant headaches

For most of us, an occasional headache is nothing more than a temporary speed bump in the course of a busy day. Even so, most men can ease the problem with simple lifestyle measures and nonprescription medications. Relaxation techniques, biofeedback, yoga, and acupuncture may also help. But for some of us, headaches are a big problem. Learn to recognize warning signs that call for prompt medical care. Work with your doctor to develop a program to prevent and treat migraines and other serious headaches. And don’t fall into the trap of overusing medications; for some gents, rebound headaches are the biggest pain of all.

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As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Chronic Migraine:What is it? | American Migraine Foundation

The Basics of Chronic Migraine

Migraine is a common and disabling condition reported in approximately 12% of the population. In the Global Burden of Disease Study by the World Health Organization, updated in 2013, migraine was found to be the sixth highest cause worldwide of years lost due to disability. Migraine attacks sometimes increase in frequency over time. Headache experts divide this process of transition into four distinct states:

• No migraine
• Low-frequency episodic migraine (less than 10 headache days per month)
• High-frequency episodic migraine (10-14 headache days per month)
• Chronic migraine (15 or more headache days per month; meaning that people with chronic migraine have a migraine or headache more often than not)

As per the International Headache Society, chronic migraine is defined as headache occurring on 15 or more days per month for more than three months, which, on at least 8 days per month, has the features of migraine headache. Chronic migraine occurs in approximately 1% of the population. Studies estimate that about 2.5% of people with episodic migraine will transition to chronic migraine each year.

To make a diagnosis of chronic migraine, it is very important to know the exact number of days per month that a person experiences a headache of any kind. This is best done my maintaining a daily headache diary. Often when people are asked how many headaches they have, they may report only their most severe headaches (like the ones that keep them from work/school or the ones that they take medications for). By reporting only their most severe headaches, they may give the doctor a false impression of their true headache burden and consequently a diagnosis of chronic migraine may be missed.

People suspected of having chronic migraine should be carefully assessed by their doctor to exclude other potential causes of frequent headaches such as secondary headaches (meaning headaches caused by an underlying condition or disease) or other forms of chronic daily headache including chronic tension-type headache, hemicrania continua, or new daily persistent headache.

Please refer to the International Classification of Headache Disorders 3^rd edition (beta version) website for more information on the criteria used to diagnosis chronic migraine: https://www.ichd-3.org/1-migraine/1-3-chronic-migraine/

Risk Factors for Chronic Migraine

Transition to chronic migraine is associated with well-recognized, potentially treatable risk factors. Some examples of risk factors include:

• Depression
• Anxiety
• Other pain disorders
• Obesity
• Asthma
• Snoring
• Stressful life events
• Head/Neck injury
• Caffeine
• Acute medication overuse
• Persistent, frequent nausea

Treatment

Treatment of chronic migraine is similar to that of episodic migraine with a few notable exceptions. Treatment should consist of:

• Acute medications for use at onset of a headache attack to try to break it. Limitation on number of uses of acute medications is important to try to avoid medication overuse and risk of medication overuse headache
• Preventive medications to help reduce the frequency and severity of headache attacks. Currently, Onabotulinumtoxin A (Botox) is the only FDA approved preventive treatment for chronic migraine. Preventive treatments used for episodic migraine such as anti-seizure medications (Example: depakote, topiramate), anti-depressants (Example: amitriptyline, venlafaxine) and blood pressure medications (Example: propranolol) may also be used for chronic migraine prevention.
• Non-medication preventive treatments including biofeedback, cognitive behavioral therapy
• Addressing risk factors such as depression, anxiety, snoring, obesity, etc.

Summary of Chronic Migraine

Migraine is considered chronic when people have 15 or more headache days per month, with at least 8 of those days meeting criteria for migraine. Chronic migraine can be a very disabling condition. Development of chronic migraine has been associated with a number of potentially treatable risk factors. Chronic migraine treatment should primarily focus on prevention through use of medication and non-medication preventive strategies as well as addressing identified risk factors.

Resources:

The International Headache Society. https://www.ichd-3.org/1-migraine/1-3-chronic-migraine/

Lipton RB. Tracing transformation: Chronic migraine classification, progression, and epidemiology. Neurology 2009;72:S3-7.

Schwedt TJ. Chronic migraine. BMJ 2014; 348:g1416

Bigal ME, Lipton RB. Modifiable risk factors for migraine progression. Headache 2006; 46:1334.

90,000 Diagnosis and treatment of migraines in the MEDSI clinic

Contents

There are four types of headache most commonly encountered:

• Tension headache. The most common form of headache that can occur from time to time to every person. Despite the fact that tension headache does not pose a threat to human life and health, it can significantly impede daily activities. People with frequent tension headaches should be seen by a doctor
• Bundle (cluster) headache.
  A rare disease (occurs in about 3 people out of 1000). Bundle (cluster) headache occurs 5 times more often in men, in contrast to most other forms of headache, where women predominate. As a rule, the first attack occurs between the ages of 20 and 40, however, the onset of cluster headache can occur at any age 90 010

• Chronic daily headache. This term combines headaches that occur 15 or more days a month for more than 3 months
• Migraine

What is migraine?

Migraine is a neurological disease.It manifests itself in seizures, which can occur with varying frequency – from 1-2 times a year to several times a month.

The main manifestation of a migraine attack is headache, which can be very severe. Other common symptoms include nausea and vomiting, and intolerance to light and sound.

If during a headache you feel nauseous, irritated by light or sound, and the headache interferes with your usual activity, then most likely it is a migraine.

Why does migraine occur?

The cause of migraine is in the brain. Migraine pain is associated with abnormalities in structures that are responsible for carrying pain and other sensations. There is a hereditary predisposition to the development of migraine, that is, you can inherit it from one of the parents.

Who gets a migraine?

One in seven adults suffers from migraine, so the disease is quite common.Women have three times more migraines than men. It usually begins in childhood or adolescence. In girls, migraines usually start around puberty. Since there is a hereditary predisposition to the development of migraine, this disease is transmitted from generation to generation.

How does a migraine manifest itself?

All migraine symptoms occur during an attack, which has four stages of development, although not all of them can be fully represented.Most people with migraines feel good between attacks.

The precursor phase of migraine (prodrome) occurs earlier than all other symptoms of an attack and in no more than half of the patients. If you have a prodrome, you may feel irritable, depressed or tired for a few hours or even a couple of days before the headache develops. On the contrary, some may notice an unusual increase in activity. Some people may have an increased appetite, some “just know” they are going to have a seizure.

Aura , if present, is the next phase. Only a third of migraine patients have ever experienced an aura, and it may not develop in every attack.

Aura is a reflection of a certain process (transitory and harmless to health) that takes place in the brain and is associated with the mechanism of a migraine attack. It lasts 10-30 minutes, but it can be longer. Most often, there is a visual aura. You may “see” blind spots, flashes of light, or a multi-colored zigzag line extending from the center of the field of view to the periphery.Less commonly, sensitive symptoms occur – a tingling sensation or numbness that occurs in the fingertips on one side, spreads up to the shoulder, sometimes spreads to the cheek or tongue on the same side. Sensitive symptoms are almost always accompanied by visual disturbances. In addition, during the aura there are speech difficulties or difficulty in finding words.

The headache phase is the most severe for most people, it lasts from several hours to 2-3 days.A migraine headache is usually very severe, often occurs in one side of the head, but can also affect the entire head. Most often, pain occurs in the frontal or temporal region, although it can be localized in any part of the head. This is usually a throbbing or bursting pain that worsens with movement and physical exertion. Often there is nausea and even vomiting, which subjectively relieves the headache. Light and sounds can be unpleasant during an attack, and most patients prefer to be alone in a quiet and dark room.

The headache phase is followed by a resolution phase. During this period, you may again feel tired, irritable or depressed, it is difficult for you to concentrate. These symptoms can persist for up to 24 hours before you feel completely healthy.

What causes migraines?

There are many reasons for migraines and they are very diverse:

• Diet: some foods (and alcohol), but only in some patients; much more often an attack can be caused by skipping meals, inadequate nutrition, caffeine withdrawal and insufficient water intake
• Sleep: Change in sleep patterns, both lack of sleep and excessive sleep
• Other factors of life: intense physical activity, long journeys, especially with a change of time zones
• External: bright or flickering light, strong odors, changing weather
• Psychological: emotional stress or, oddly enough, relaxation after stress
• Hormonal factors in women: menstruation, hormonal contraceptives and hormone replacement therapy

One of the common causes of migraine is hunger or insufficient food intake.This is especially true for young patients – children with migraines should not skip breakfast! In women, fluctuations in hormones associated with the menstrual cycle are a significant potential cause.

What treatment can I use?

Medicines that are used to relieve an existing migraine attack are called migraine relief agents. The right medicines can be very effective when taken correctly and in small amounts.These include over-the-counter analgesics, most of which contain aspirin, ibuprofen, or paracetamol; paracetamol is the least effective among them. Soluble forms of these drugs, such as effervescent tablets, work faster and better.

If you are very concerned about nausea or vomiting, antiemetics can be used. Some of them actually enhance the action of analgesics, as they increase their absorption in the gastrointestinal tract.If you experience severe nausea or vomiting, then you can use these drugs in the form of rectal suppositories.

When buying a drug, the pharmacist can advise you on the best OTC analgesic to take. If none of the drugs of this class helps you, or you need a dose of the drug that exceeds the recommended dose, then you should consult a neurologist.

A neurologist may prescribe one of the specific anti-migraine drugs for you.These drugs should be used if analgesics and antiemetics do not relieve your symptoms and do not quickly return you to daily activity. According to the principle of action, anti-migraine drugs differ from conventional pain relievers. They act not on pain, but on pathological processes occurring in the brain during a migraine attack. These drugs include ergotamine, which is widely used in some countries and not available in others, and a group of newer drugs called triptans.If the doctor has prescribed these drugs for you, then, if necessary, you can combine them with analgesics and antiemetics.

What if this treatment does not work?

If migraine attacks are very frequent or severe, and are difficult to treat with relief drugs, then there is preventive treatment. Unlike remedies for arresting an attack, preventive treatment requires taking drugs every day, since this treatment is aimed at preventing the development of migraine attacks.In other words, preventive treatment can raise the threshold for a migraine attack.

When prescribing one or more drugs to you, carefully follow the directions for their use. Studies have shown that the most common reason for the lack of effectiveness of preventive treatment is non-adherence to therapy.

What else can you do to help yourself?

Exercising regularly and staying in shape will significantly improve your well-being.It is advisable to avoid predisposing factors and causes, so it makes sense to know all possible provocateurs. Try to rule out at least some of them, even if other causes are difficult to identify or cannot be avoided.

Do you need additional examinations?

In most cases, the diagnosis of migraine is straightforward. There are no examination methods to confirm the diagnosis of migraine. The diagnosis is based on your description of the characteristics of the headache and accompanying symptoms, and it is imperative that there are no abnormalities in the medical examination.Try to describe your headache to the neurologist in as much detail as possible. It is very important to tell your doctor how often and how much you are taking pain relievers or other medications for your headache.

Can migraines be cured?

There is no complete cure for migraines. However, for most people with migraines, attacks become less frequent with age.

Migraine aura

These are certain neurological disorders that occur before the onset of a migraine headache attack.

• Visual disturbances – various visual “special effects” – these are the most typical manifestations of the aura.
• Less commonly, there are changes in sensations: numbness or tingling in the lips, tongue, half of the face. Sensations move: spread to the neck and arm, or rise from the fingertips to the neck.

Symptoms of the aura are divided into positive – when something appears: flashes of light, a flickering zigzag line in front of the eyes, tingling. And negative – when something, on the contrary, disappears.For example, the field of vision falls out or the hand becomes numb.

Another property of the aura is dynamism. Symptoms increase in 5-20 minutes and then subside. The aura lasts no more than an hour. As a rule, a headache comes to replace.

But in some cases, the aura can appear on its own, without being associated with pain [1]. This is especially true for older people who have suffered from migraines all their lives. With age, the pain becomes easier or disappears altogether, and attacks may consist only of an aura.Then the disease is called headless migraine [3].

What causes the migraine aura

The aura is based on changes in the electrical and biochemical activity of neurons (nerve cells) in certain areas of the brain. For example, a visual aura occurs when neurons in the occipital cortex are fired – because this part of the brain processes visual information.

Other symptoms of an approaching attack – prodrome
Most people with migraines (with or without aura) have symptoms that indicate that they are about to have an attack.They can occur even two days before a migraine attack. Each person with migraine can identify their own symptoms that “predict” an attack. For some, this is euphoria or, conversely, a decrease in mood. For others, hyperactivity or drowsiness. Desire to eat sweet or salty foods, increased yawning. [4] These are just some of the forerunners of migraine, and over time you can learn to recognize them in order to prevent attacks in time.

Misconceptions about aura and migraine

Even many doctors believe that migraines necessarily involve an aura.And the aura should be replaced by an intense one-sided throbbing headache with nausea, vomiting, intolerance to light and sound – then the disease can be considered a migraine.

However, although about 10% of people worldwide suffer from migraines, only a few have all these symptoms . A migraine attack can consist only of an aura without any headache. Or manifest as a severe headache without an aura. [2.5].

Aura of migraine is experienced by 20-25% of people with migraine, but only a few have an aura with every attack.

Literature:

1. Tabeeva G.R., Yakhno N.N. Migraine. // GEOTAR-media. – 2011 .– 624s.
2. Eriksen M.K., Thomsen L.L., Olesen J. Implications of clinical subtypes of migraine with aura. // Headache. – 2006. – v.46. – p.286-297.
3. Kelman L. Migraine changes with age: IMPACT on migraine classification. // Headache. – 2006. – v.46. – p. 1161-1171.
4. Kelman L. The premonitory symptoms (prodrome): a tertiary care study of 893 migraineurs. // Headache. – 2004. – v.44. – p.865-872.
5. Rothrock J.F. Migraine aura // Headache. – 2009. – v.49. – p. 1123-1124.
6. Zhang X., Levy D. Noseda R., et al. Activation of meningeal nociceptors by cortical spreading depression: implications for migraine with aura. // J Neurosci. – 2010. – v.30. – p. 8807-8814.

Menstrual migraine

What is a menstrual migraine?

This is a migraine in which attacks occur in women two days before the onset of menstruation and within three days after the onset.At least two out of three cycles. So menstrual migraine is defined by the III International Classification of Headaches.

Menstrual migraines have several types. With “pure” menstrual migraine attacks occur exclusively at the beginning of menstruation, and no more in any other phase of the cycle.
At menstrual-associated migraine attacks occur during other phases.

According to the classification, a “pure” menstrual migraine is a migraine without an aura, although this is not an exceptional rule, a menstrual migraine can be a migraine with an aura [1, 7].

What is migraine in general?

Migraine is a disease of the brain (often hereditary) that causes a very severe headache. The pain lasts 4 to 72 hours. It is accompanied by nausea or increased sensitivity to light and sound. The pain is such that it interferes with daily activities.

Are menstrual migraines common?

Yes. Menstrual migraines are very common. This is a significant medical problem.Two-thirds of women with migraines report that their attacks are more severe during their period. At the beginning of the cycle, the likelihood of an attack is 2-3 times higher than usual. The attacks that occurred during this period are more severe and prolonged [2].

Why does menstruation make migraines worse?

Migraine is very sensitive to fluctuations in the level of female sex hormones. Before the onset of menstruation, estrogen levels drop sharply. This triggers the development of the seizure.
Proof of this is the fact that most women do not experience migraine attacks until adolescence.In childhood, the ratio of boys and girls with migraine is the same. And in adulthood, the prevalence of migraine among women is already three times higher than among men [3].

How are menstrual migraines treated

Two ways [6]:

1. relieve an attack that has already arisen;
2. prevent new attacks.

How to relieve an attack menstrual migraine

It is most effective to relieve (stop) seizures with specific anti-migraine drugs – triptans (read the article about them: Triptans).Non-steroidal anti-inflammatory drugs (NSAIDs) can also be effective, you can read about them here: Non-steroidal anti-inflammatory drugs) and ergotamine preparations.

How to Prevent a Menstrual Migraine Attack

Drugs for prophylaxis are prescribed 1-2 days before the most probable day of the attack. This type of prophylactic treatment is called mini prophylaxis. For her, triptans, NSAIDs and magnesium preparations are used. All of them are effective if they are prescribed just before the onset of the attack, and treatment continues for 5-7 days.

Hormone therapy gives conflicting results. Some women note that when menstruation is stopped with the help of oral contraceptives or modern intrauterine systems, migraines also go away [4]. Preventing a drop in estrogen levels with estrogen-containing gels and patches has been shown to be beneficial in preventing menstrual migraines in several small studies [5].

Menstrual migraine may reflect hormonal dysregulation.This disease is very common and greatly reduces the quality of life, but there are always solutions. Do not tolerate pain, see a doctor!

Literature:

1. International classification of headaches, 2nd edition (full Russian version) “. , 2006, 380 p.
2. Tabeeva G. R. “Menstrual migraine”. // Ros. honey. zhurn. 2008, vol. 16, no. 4, p. 195-199.
3. Tabeeva G. R. Gromova S. A. “Estrogens and migraine.” // Neurological journal.2009. No. 5, p. 45-53
4. Allais G., Castagnoli Gabellari I., et al. Oral contraceptives in migraine therapy. // Neurol Sci. – 2011. – v.32. – Suppl 1. – S135-139.
5. Almén-Christensson A., Hammar M., Lindh-Åstrand L., et al. “Prevention of menstrual migraine with perimenstrual transdermal 17-β-estradiol: a randomized, placebo-controlled, double-blind crossover study.” // Fertil Steril. – 2011. – v.96. – p. 498-500
6. MacGregor E.A. “Prevention and treatment of menstrual migraine”. // Drugs. – 2010. – v.70. – p. 1799-818.

Rothrock J.F. Oral triptan therapy. // Headache. – 2009. – v.49. – p. 1399-1400

Photo by Polina Zimmerman from Pexels

90,000 Migraine diagnostics and treatment – Neuron Clinic

Migraine is a neurological disorder. It manifests itself in seizures, which can occur with varying frequency – from 1-2 times a year to several times a month.

What is a migraine?

Migraine is a neurological disorder.It manifests itself in seizures, which can occur with varying frequency – from 1-2 times a year to several times a month.

The main manifestation of a migraine attack is headache, which can be very severe. Other common symptoms include nausea and vomiting, and intolerance to light and sound.

If during a headache you feel nauseous, irritated by light or sound, and the headache interferes with your usual activity, then most likely it is a migraine.

Why do migraines occur?

The cause of migraine is in the brain.Migraine pain is associated with abnormalities in structures that are responsible for carrying pain and other sensations. There is a hereditary predisposition to the development of migraine, that is, you can inherit it from one of the parents.

Who gets migraines?

Migraine affects one in seven adults, so the disease is quite common. Women have three times more migraines than men. It usually begins in childhood or adolescence.In girls, migraines usually start around puberty. Since there is a hereditary predisposition to the development of migraine, this disease is transmitted from generation to generation.

How does a migraine manifest itself?

All migraine symptoms occur during an attack that has four stages of development, although not all of them may be fully represented. Most people with migraines feel good between attacks.

In most cases, the diagnosis of migraine is straightforward.There are no examination methods to confirm the diagnosis of migraine. The diagnosis is based on your description of the characteristics of the headache and accompanying symptoms, and it is imperative that there are no abnormalities in the medical examination. Try to describe your headache to the neurologist in as much detail as possible. It is very important to tell your doctor how often and how much you are taking pain relievers or other medications for your headache.

Can migraines be cured?

There is no complete cure for migraines.However, for most people with migraines, attacks become less frequent with age. 90,029 90,000 Migraines in children and adolescents

What is Migraine?

Migraine is a disease, the main symptom of which is severe paroxysmal headaches . They are localized in one half of the head. Migraine differs from the usual headache in the nature of the pain and the absence of any organic causes that cause it.

Causes

The reasons are still being studied, but scientists have found that the predisposition to the disease is inherited, through the female line.That is why migraine in women is recorded much more often than in men. The peculiarities of the functioning of the nervous system are inherited, which cause the appearance of headaches under certain circumstances.

In children and adolescents, migraines are usually associated with overwork, which occurs during heavy workload at school. Another common cause of migraines is hormonal changes that occur during puberty, which is why adolescent migraines are so often recorded.But the predisposition itself may not manifest itself in any way without the influence of certain factors, the so-called triggers. They can be divided into 4 groups:

• Psychological causes of migraine: mental, emotional overload, stress.
• Physiological : sleep disorders, fatigue, changes in hormonal levels.
• Nutritional : It has been proven that tyramine, which is found in many foods (coffee, chocolate, nuts, cheese, cocoa, smoked meats, citrus fruits), can provoke the development of migraine pain.Migraine and alcohol are also closely related. Wine, champagne and other low alcohol drinks are often the cause of migraines.
• External factors : harsh odors, bright light, loud sounds, changes in atmospheric pressure, being in stuffy rooms.

Causes of migraine in men and women can be associated with the peculiarities of hormonal levels. Women are much more likely to experience situations that provoke the development of pain, many scientists explain the higher frequency of migraines in women by this fact.

Signs of migraine.

The main symptom of a migraine is a severe throbbing headache. Usually it is unilateral and localized in the frontotemporal region, but there may be another location of the focus of pain. In addition to pain, there are other symptoms:

• Nausea or vomiting, decreased appetite;
• Hypersensitivity to light, sounds, tastes, odors;
• Dizziness;
• Drowsiness;
• Irritability up to aggression.

The duration of an attack is individual: it can last from 2 to 72 hours. The symptoms of migraine in men and women do not differ significantly. The difference is only in the frequency of attacks – in women, they are usually more frequent. Distinguish between migraines with and without aura. . A migraine attack can begin suddenly and with precursors. Aura is a complex of neuropsychological symptoms that anticipate the onset of pain, becoming the first signs of migraine, or develop simultaneously with pain syndrome.They are caused by vasospasm of the cerebral vessels, which occurs at the initial stage of the development of an attack.

Types of migraine aura:

• Visual – flashes, “fog”, glare, distortion, loss of visual fields;
• Auditory – tinnitus, auditory hallucinations;
• Sensory – change in taste, smell;
• Aphatic – speech disorder;
• Motor – difficulty in limb movements, including walking;
• Vestibular – dizziness, may fall due to loss of balance.

How is migraine treated?

Migraine treatment includes two approaches:

• help during an attack;
• preventive measures to reduce the intensity and frequency of attacks.

How to relieve pain during a migraine attack?

When the first signs of migraine appear, it is necessary to exclude, if possible, all external influences that provoke pain. A universal recommendation is to place the patient in a quiet, dark room with open windows.You can reduce pain with the help of non-drug means: acupressure of active points, cold compresses on the forehead, massage of the cervical-collar zone. Sometimes a cool or, conversely, a warm shower or bath helps patients.

Migraine tablets can be taken at the first sign of aura or pain. There are several groups of drugs that are prescribed for migraines. The choice of drugs depends on the form of the disease, the characteristics of its course. Self-medication is unacceptable! Only a doctor can competently prescribe a drug that will help you!

What else can you do to help yourself?

Regular exercise and staying in shape will significantly improve your well-being.

It is advisable to avoid predisposing factors and causes, so it makes sense to know all possible provocateurs. Try to rule out at least some of them, even if other causes are difficult to identify or cannot be avoided.

Can migraines be cured?

There is no complete cure for migraines. However, for most people with migraines, attacks become less frequent with age.

Grivitskaya Tatyana Viktorovna neurologist of the 10th City Children’s Clinical Polyclinic Healthcare Institution

Treatment of migraine in Smolensk – Cost of service, appointment

Migraine is one of the most common types of headache.About 15% of people suffer from this ailment. Moreover, in women it is diagnosed three times more often than in men.

How does migraine manifest

Migraine is an aggravated type of headache with specific manifestations. It is characterized by unbearable, throbbing pain, which usually covers one half of the head. Among the accompanying symptoms: nausea, vomiting, phobia and sound phobia. The attack can last from 4 to 72 hours.

Another distinguishing feature of migraine is the special symptoms before and after the onset of the pain itself. A classic attack takes place in 4 phases:

• 1. Prodromal phase (a few days before) – change in emotional state, muscle stiffness, edema, increased appetite and thirst, intolerance to light and sounds, nausea, constipation, drowsiness, or vice versa, a surge of activity.
• 2. Aura (one hour before or simultaneously with pain) – loss of visual fields, luminous zigzags, sparks in front of the eyes.
• 3. Headache – often localized in the orbital, temporal or frontal regions. The pain increases within two hours, then its intensity stabilizes and slowly begins to decrease.
• 4. Postdromal phase (days after) – fatigue, or, on the contrary, rise, diarrhea, nausea, lack of coordination.

It is important to remember that migraines do not always flow clearly through these stages. For example, a quarter of patients do not develop an aura.

Why does migraine occur

Previously, it was believed that migraine develops due to the expansion of blood vessels in the brain, but now scientists have come to the conclusion that the disease provokes a number of biochemical processes that trigger neurons in the cerebral cortex.Among the reasons that can cause migraines are the following:

• increased intracranial pressure,
• overstrain of the muscles of the shoulder girdle and head,
• osteochondrosis,
• frequent stress,
• overwork,
• strict diet,
• dehydration,
• heredity (80% of cases).

How to treat migraine

Many are accustomed to dealing with headaches with analgesics and pay little attention to its frequency.However, if attacks occur frequently, the body may stop responding to the action of painkillers; completely different drugs are needed here. Without proper treatment, the disease can become chronic and even lead to stroke. To reduce the number and severity of seizures, be sure to see a neurologist.

Experienced doctors of the 2K Clinic accurately diagnose migraines by collecting a detailed history and excluding other diseases. To check, electroneuromyography and ultrasound of the vessels of the brain and neck are prescribed.As a therapy, the neurologist will prescribe medications that match the type and nature of the migraine. Healing blocks and injections are given to relieve pain. Physiotherapy, massage, reflexology, exercise therapy, plasma therapy will be a good prevention of attacks.
90 029 90 000 Childhood migraine

Migraine in children: guidance for teachers and school health personnel.

Children get headaches too! Headache occurs at any age, even in children between the ages of two and three.The number of severe headaches peaks during adolescence. Headache symptoms in children are not at all the same as in adults. As a result, children are often left without a correct diagnosis for many years, until the headache “symptoms” into a more adult picture. Migraine headache in adults with loss of performance that lasts up to 3 days, as well as nausea, vomiting, and / or sensitivity to light and sound. Since children with severe headaches may not always be able to describe how they are feeling, this description of the symptoms will be important for parents to take action in time.With close observation and in-depth interviewing, you can get an idea of ​​your child’s headache, which will help in making a correct diagnosis. Differences in headaches in children. The episodic headaches that children experience can actually be migraines with or without an aura.

There are some notable differences when comparing the clinical symptoms of migraine between children and adults: 1. Headaches can be shorter, lasting as little as an hour or two. 2. Attacks do not happen as often.They can only happen once a month, or every few months. 3. The pain is most often localized in the forehead on both sides, which is one-sided. As children and adolescents get older, the pain tends to become one-sided. 4. Young children may develop other migraine syndromes even before they complain of headaches. The two most common are cyclic vomiting syndrome and abdominal migraine.

* Cyclic vomiting syndrome is defined as regular, predictable bouts of vomiting over several weeks.These bouts of vomiting can be severe and can lead to dehydration.

* Abdominal migraine is similar to a normal migraine, only instead of headache, children complain of abdominal pain. Vague or cramping pain around the navel.

Since occasional abdominal pain or vomiting can occur due to gastrointestinal problems, parents should take this into account and consult a gastroenterologist to assess their child’s condition before starting migraine therapy.

5. Children may simply not be aware of many of the common symptoms commonly associated with migraines, such as sensitivity to light or sound. They may also complain about trouble concentrating. (These symptoms can be suspected by the child’s behavior during a headache attack.)

Helping Your Child If your child is experiencing episodic headaches, it is important that a doctor gets the correct diagnosis as soon as possible. After clarifying the diagnosis, your child will be prescribed effective therapy to relieve a headache attack and, if necessary, preventive treatment.Ideally, therapy should stop the headache, or at least reduce it within 2 hours, and prophylactic treatment will reduce the incidence of headache by 50% or more. If the therapy is not effective, then you need to show the child to a pediatric neurologist or a headache specialist (cephalgologist).

ADDITIONAL THERAPY FOR CHILDREN SUFFERING WITH MIGRAINE.

Currently, there are only two approved drugs for the relief of migraine attacks in children.Most parents need to use additional ways to help their children with migraines.

There are many methods available to alleviate your baby’s suffering:

Cold use – cold compresses placed on the head and relieve headaches. For very young children, you can use bags in the shape of animals or other interesting shapes. For older children, cold compresses should be applied to the hands.

Acupuncture is a minimally invasive procedure that does not have any serious adverse reactions, however, it is important to select a well trained professional to administer the sessions.

Managing Nausea:

• Recent research has shown that a sea salt bandage on your wrist can help regulate nausea.

• Lemon, lime, or ginger with soda and salty crackers can help calm the stomach.

• You can also use mints.

• Many adults find ginger or peppermint tea to be a sedative. If your kids don’t like a hot drink, make tea and add ice to it.

Sun and light protection.If you are at home, close the blinds and curtains in the nursery to keep the light out. When you are away from home and cannot change the environment, you need to wear sunglasses or a sleep mask on your child to protect him from irritating sunlight.

Minimize noise. It is desirable that during a migraine attack, it is calm and quiet around. Tuck him in your bedroom and leave him alone if possible. Minimize the spread of noise in the child’s room or use earplugs.

Temperature control. Most children with migraines prefer to wait out the attack in a cold room, so try to ventilate and cool the room as much as possible.

Aromatherapy. Using high quality oils that contain soothing aromas such as lavender, mint, or tangerine can be incredibly beneficial and safe. If you choose to use pure essential oils for aromatherapy, remember that, with the exception of lavender, oils should never be applied undiluted to the skin as they can cause skin irritation or burns.Dilute them before use. Coconut oil is a good choice because it doesn’t smell of its own and can be easily disposed of if it gets on your clothes or bedding.

Balanced nutrition and adherence to drinking regime. It is important that your child gets enough fluids to prevent dehydration. In addition to plain water, you can dilute the fruit juice with water for a change. Using electrolyte drinks may seem like a good idea, but they often contain substances that trigger migraine attacks, so it is very important to be thoughtful and understand whether this is right for your child or not.