The occasional headache is not uncommon, but severe migraine headaches can be debilitating. According to the Migraine Research Foundation, nearly one in four U.S. households includes someone who experiences migraines.
Migraines can affect men, women and children, but women tend to be most susceptible. While migraines have been seen at all ages, they are most often seen in adults in their mid- to late-30s.
How do you know if your headache is indeed a migraine? Most migraines tend to be unilateral, meaning that they impact one area or side of the head more than others. Migraine headaches tend to throb or pound, meaning you may be able to feel your pulse or heartbeat in the area impacted.
Another sign is changes in vision, such as seeing spots or sparkles. Migraines are often accompanied by sensitivity to light, sound and smells, and may include nausea and vomiting.
Migraines last a variable amount of time, anywhere from 30-45 minutes to 12-24 hours or longer. Some patients have migraines that last days and even weeks.
The cause of migraines is relatively unknown. We do, however, know that serotonin is probably involved. In the body, serotonin helps relay signals from one area of the brain to another, and plays an important role in the regulation of learning, mood, sleep and constriction of blood vessels.
There also seems to be a genetic component to migraines.
When a patient comes to me with migraines, I first rule out any lifestyle habits that may cause concern, such as drinking excessive amounts of caffeine or taking over-the-counter pain medications more than three to four times a week. Sometimes just eliminating caffeine can help cut down on migraine occurrences.
I also prefer to do an MRI or CT scan of the brain to rule out any serious causes. Most of the time, those tests come back normal, but I feel it is an important first step to give the patients peace of mind and rule out other causes.
The goal of treatment for migraines is to reduce frequency and intensity and to keep people working and involved in daily life.
Most people treat their headaches with acute, or over-the-counter medications. If a patient experiences four or more migraines a month, we recommend preventive treatments. Patients experiencing migraines that frequently are losing as many as 36 days each year from their daily activities due to their condition.
Common preventive medications used to treat migraines are borrowed from several classes of drugs, including anti-seizure or convulsants, antidepressants and anti-hypertensive medications. However, migraines are not related to seizures, depression or high blood pressure. How these diverse classifications of medications work on migraines is unclear.
If you experience severe headaches, try to avoid excessive caffeine and too many over-the-counter pain medications. Other migraine triggers include certain types of red wine, alcohol, aged cheeses and chocolate. Be sure to stay well hydrated, avoid fasting or skipping meals, get plenty of sleep and avoid stress.
If those simple lifestyle changes are not effective, seek treatment.
Dr. Warren Chumley is with Saint Joseph Neurology Associates, part of KentuckyOne Health