Migraine

As anyone who's ever had one can tell you, a migraine is far more than just a bad headache. It's a debilitating cluster of neurological symptoms that usually involves a throbbing headache on one side of the head.  More than three million Canadian women have migraines and over 60 percent of sufferers have more than one attack a month. The most common two types are migraines with auras, or “classic” migraines, where the headache pain is preceded by an aura that may involve visual disturbances, light sensitivity and nausea, and migraines without auras. A migraine can cause pain that lasts for hours or days.

Migraine causes Migraines may be caused by abnormal function in the trigeminal nerve, a major pain pathway in the brain that triggers the release of neuropeptides, which result in headache pain. Changes in levels of the brain chemical serotonin, which helps regulate pain, may also be involved. Migraines tend to have a genetic basis. They can be triggered by hormonal changes, particularly the drop in estrogen before menstruation; weather changes, especially changes in barometric pressure; certain foods, commonly aged cheeses, chocolate, nuts and wine; strong smells, bright lights or loud noises; skipped meals; stress, or the let-down after stress; and sleeping too much or too little.

Migraine symptoms Migraine symptoms vary from person to person and can change from one attack to the next. They may include intense throbbing pain, usually on one side of the head; nausea and vomiting; vision changes, including blurred vision or blind spots; sensitivity to noise, light and odours; fatigue; and confusion.

Migraine diagnosis/tests Do not try to diagnose yourself with migraines; if you suspect you have them or have bothersome headaches, see your doctor for a proper diagnosis. There is no blood test or X-ray that can confirm you have them but your doctor will be able to deduce if you do by conducting a physical examination and asking you describe your symptoms. If she suspects that something other than migraines may be causing your problems, such as a neurological disease, she may order a cranial CT scan, an examination of the head with a special three-dimensional X-ray or a cranial MRI (magnetic resonance imaging), which is a special three-dimensional image made using a magnetic field.

Migraine treatment Migraines are a chronic condition but they can be managed with lifestyle changes and medications. Keeping a headache diary to identify trigger foods and then eliminating those foods may reduce the frequency of migraines. Non-prescription medications, such as acetaminophen or ibuprofen, can help with the pain of migraine. Triptans, such as Imitrex, are widely considered the best treatment for aborting a migraine, but they cannot be used if a sufferer has certain health conditions, such as heart disease.

Migraine prevention Some migraine triggers, such as genetics, your hormones and weather changes, are out of your control. But making certain lifestyle changes may lead to fewer attacks:

• Reduce stress and get enough sleep — but not too much.

• Avoid the triggers, the smells or lights and foods that contribute to your migraines.

• Find a better birth control. The estrogen in the birth control pill may worse migraines, so using a different form of contraceptive or a low-dose monophasic Pill is recommended.

• Preventative medications, including antidepressants, are sometimes prescribed to women who get frequent migraines. Acupuncture, biofeedback and Botox may also help reduce the frequency of migraines.

Outside resources
Headache Network Canada