If you suffer from migraine headaches, you know the feeling: sensitivity to light, fatigue, slight pressure building at the side of your head — the list goes on. The National Headache Foundation estimates that 37 million Americans suffer from migraines, which are more common than asthma, diabetes or congestive heart failure.
Dr. Eva Leonard, a Sharp Grossmont Hospital-affiliated doctor specializing in internal medicine, regularly treats migraine sufferers. She answers these five frequently asked questions to provide a better understanding about this common, yet debilitating condition.
1. What are the signs of a migraine?
The classic signs of a migraine include a visual aura, nausea, vomiting and sensitivity to light and/or sound. However, 80 percent of cases occur without aura. Auras are symptoms that come on less than an hour before the headache pain begins. They include visual, sensory, and speech and language auras, as well as motor, brainstem and retinal. Auras can last from five minutes to an hour, and may occur in succession. Symptoms are not permanent.
Other non-aura symptoms that may precede a migraine attack by several days include fatigue, nausea, neck stiffness, blurred vision, yawning, pale appearance, sensitivity to light or sound, and trouble concentrating. Sinus symptoms are common in patients with migraine headaches, making differentiation between these two types of headache more difficult.
Migraines can occur periodically and last from four to 72 hours, with symptoms, occurrences and severity varying with each individual. They affect one side of the head and often have a pulsating feeling.
2. What triggers a migraine?
Migraine triggers vary with each individual, but most are associated with external factors, which may include:
- Chemicals and preservatives found in food (such as aspartame) and beverages (including alcohol)
- Changes in sleep patterns, especially sleep deprivation
- Excessive caffeine consumption or withdrawal from caffeine
- Hormonal factors, including menstruation and hormonal excesses, deficiency or fluctuations
- Skipping meals, prolonged fasts or inconsistent nutritional states
- Some medications (such as nitrates)
- Physical or emotional stress
- Weather conditions or changes
- Unproven triggers include monosodium glutamate, smoking, odors, chocolate and tyramine (found in aged foods such as cheeses, smoked fish or cured meats)
3. Who is at risk for migraines?
Migraines can be hereditary. According to the National Headache Foundation, four out of five migraine sufferers have a family history of migraines. If one parent has a history of migraines, the child may have a 50 percent chance of developing migraines, and if both parents have a history, the risk may increase to 75 percent.
The most common age group in which migraines occur is adults ages 30 to 39. Women are also three times more likely than men to suffer from migraines.
4. How are migraines treated?
Migraines cannot be cured, but there are a number of treatments available, including those that can prevent onset or severity, including:
- Anti-nausea medication
- Biofeedback and other relaxation techniques
- Lifestyle modifications
- Over-the-counter supplements (such as vitamin B-2, magnesium, feverfew, coQ10, ginger or melatonin) or prescription medications (anti-inflammatories, vasoconstrictive drugs and analgesics)
- Preventive medications (such as beta blockers, calcium channel blockers, anticonvulsants, angiotensin receptor blockers and antidepressants)
- Sleeping in a darkened, quiet room
5. Can migraines be prevented?
Yes, migraines can be prevented. Here are some tips to keep them at bay:
- Engage in a healthy lifestyle. Eat well and consistently, exercise regularly, avoid smoking and secondary smoke, taper off caffeine use, sleep seven to eight hours a day, and limit or eliminate alcohol use.
- Identify and avoid your triggers. Keep track of patterns and note triggers by keeping a journal of any headache or migraine episodes.
- Take appropriately prescribed medications at the beginning of a migraine headache. This can prevent prolonged severe symptoms.
- Manage stress. Stress reduction and relaxation training can help prevent or lessen the severity of a migraine.
- Know your cycle. Women who often get migraines around their menstrual period can take preventive therapy when they know their period is coming.
- Be careful not to overuse headache medications. Repetitive use for three months or more can bring on continuous headaches that cannot otherwise be prevented. The treatment for this type of headache is to stop taking the headache medication.
Play a key role in preventing and treating migraines by knowing your personal triggers, following your doctor's treatment guidelines and maintaining a healthy lifestyle.