• Severe headaches that often begin as a dull ache and then develop into a constant, throbbing pain which is typically accompanied by other physical symptoms such as nausea, sensitivity to light and noise, etc.
  • Approximately 29.5 million people in the United States suffer from migraines
  • 1 in 5 American women suffer from migraines
  • Women experience migraines three times more often than men
  • 1 in 4 households has at least one migraine sufferer
  • 4 out of 5 have a family history of migraine

Migraine Headache Classifications

  • Migraine with aura: “Aura” is a sensory warning sign that happens before the migraine occurs. When the headache takes hold the majority of the Aura symptoms typically stop.
  • Migraine without aura: The headache is caused by the change in the size of the arteries in your head. As the blood vessels change, pain is caused by the pressure on and inflammation of the blood vessels.
  • Chronic migraine: Migraine headache that occurs at least 15 days a month.

Symptoms

Individuals each suffer in unique ways, but typically have premonitory (warning) symptoms

  • Premonitory symptoms can occur up to 24 hours before onset of headache and can include:
    • Vague awareness that headache is coming
    • Changes in mental states: elation, depression, hyperactivity, talkativeness, irritability, restlessness, drowsiness
    • Neurological changes
      • Photophobia - sensitivity to light
      • Phonophobia - sensitivity to loud sounds
      • Hyperosmia - increased ability to smell
      • Dysphasia - partial or complete impairment of the ability to communicate
      • Yawning
      • Difficulty concentrating
    • General symptoms: stiff neck, food cravings, cold feeling, sluggish, diarrhea or constipation, thirst, frequent urination, fluid retention
  • Constant, throbbing pain
  • Nausea
  • Sensitivity to light and sound

Diagnosis

The physician will begin by helping the patient identify his/her personal migraine triggers. The physician will often ask the patient to track daily activities, foods, drinks, medications, environmental changes, stressful situations, sleep patterns, and characteristics of the headache itself on a calendar. The calendar will then be analyzed in further detail to help determine the unique triggers.

Known Migraine Triggers

  • Stress
  • Fatigue
  • Change in sleep pattern
  • Missing a meal
  • Medication
  • Foods including: caffeine and chocolate
  • Alcohol
  • Menstruation
  • Hormonal changes
  • Changes in weather
  • Changes in altitude

Treatment

  • Goals: relieve the pain and prevent future migraines
  • Preventive Treatment: Medications
    • Choose medication based on medical condition(s) and potential side-effects
    • Start low and increase dose slowly
    • Types:
      • Beta-blockers
      • Calcium channel blockers
      • NSAIDs
      • Tricyclic antidepressants
      • Anticonvulsants
      • Minerals and vitamins
  • Self-Help Treatments
    • Counseling
    • Relaxation Training
    • Progressive Muscle Relaxation
    • Visualization
    • Breathing Exercises
    • Acupuncture
    • Physical Therapy
    • Massage Therapy
    • Yoga and Tai Chi
    • Nerve Blocks
    • Aerobic Exercise

Benefits of Early Intervention

  • Increase pain-free effectiveness
  • Return to normal function
  • Improve patient satisfaction
  • Use fewer rescue medications, decreasing chance of rebound
  • Reduce recurrence
  • Reduce cost
  • Reduce adverse events