Migraine Headaches

He scored more points then anyone else in the history of the National Basketball Association, but when he got a migraine headache, all Kareem Abdul-Jabbar wanted to do was hide in a dark room. The basketball super star is one of some 28 million Americans who suffer from migraine headaches. According to the National Institutes of Health, however, he is not the typical sufferer, since 75 percent of sufferers are women. One in four households in the United States has someone who gets migraines, with migraines costing the U.S. economy some $13 billion a year.

Symptoms

Most of us have experienced the ache of a tension headache. (Read about "Tension Headaches") But migraines can be far more debilitating. According to the National Headache Foundation, symptoms can include:

• throbbing pain that starts on one side of the head and can spread
• nausea and vomiting
• extreme sensitivity to light and sound

The two most prevalent types of migraine-caused headache are classic and common.

• Classic migraine - The major difference between the classic and common migraines is the appearance of neurological symptoms 10 to 30 minutes before a classic migraine attack. These symptoms are called an aura. The most common auras are visual disturbances or hallucinations, such as blinking or brightly colored lights called scintillating scotomas. Classic migraines can involve other senses too, including noxious smells (olfactory auras) or weakness of an extremity. Classic migraine starts on one side of the head but may eventually spread to the other side. An attack lasts 1 to 2 pain-wracked days.
• Common migraines - Common migraine - a term that reflects the disorder's greater occurrence in the general population - is not preceded by an aura. But some people experience a variety of vague symptoms beforehand, including mental fuzziness, mood changes, fatigue and unusual retention of fluids. During the headache phase of a common migraine, a person may have diarrhea (Read about "Diarrhea") and increased urination, as well as nausea and vomiting. Common migraine pain can last 3 or 4 days.

In addition to classic and common, migraine headache can take several other forms:

• Patients with hemiplegic migraine have temporary paralysis on one side of the body, a condition known as hemiplegia. Some people may experience vision problems and vertigo - a feeling that the world is spinning. (Read about "Balance Disorders") These symptoms begin 10 to 90 minutes before the onset of headache pain.
• In ophthalmoplegic migraine, the pain is around the eye and is associated with a droopy eyelid, double vision, and other problems with vision. (Read about "The Eye")
• Basilar artery migraine involves a disturbance of a major brain artery at the base of the brain. (Read about "The Brain") Preheadache symptoms include vertigo, double vision and poor muscular coordination. This type of migraine occurs primarily in adolescent and young adult women and is often associated with the menstrual cycle.
• Benign exertional headache is brought on by running, lifting, coughing, sneezing or bending. The headache begins at the onset of activity, and pain rarely lasts more than several minutes.
• Status migrainosus is a rare and severe type of migraine that can last 72 hours or longer. The pain and nausea are so intense that people who have this type of headache must be hospitalized. The use of certain drugs can trigger status migrainosus. Neurologists report that many of their status migrainosus patients were depressed and anxious before they experienced headache attacks. (Read about "Depressive Illnesses" "Anxiety")
• Headache-free migraine is characterized by such migraine symptoms as visual problems, nausea, vomiting, constipation or diarrhea. (Read about "Constipation") Patients, however, do not experience head pain. Headache specialists have suggested that unexplained pain in a particular part of the body, fever and dizziness could also be possible types of headache-free migraine.
• Ocular migraine or ophthalmic migraine is a term that can vary in meaning. According to the National Headache Foundation, people who get ocular migraine have just the visual warning signs or aura of a migraine attack without the headache. This is also referred to as acephalgic migraine, retinal migraine or migraine aura without headache. It is important to rule out eye disease or a disorder of the blood vessels leading to the eye as possible causes. (Read about "Eye Exams")

Although both males and females seem to be equally affected by migraine, the condition is more common in adult women. Migraines in women may also be associated with the menstrual cycle. (Read about "Premenstrual Syndrome" "Menstrual Disorders") Many women suffer their first migraine during pregnancy or after menopause. (Read about "Healthy Pregnancy" "Menopause").

Causes

According to the American Academy of Neurology, many researchers believe that people with migraines have a more sensitive nervous system response, and that during a migraine attack, changes in brain activity may affect blood vessels and nerves around the brain. (Read about "The Brain" "Nervous System") Other theories suggest that migraines are genetic (Read about "Genetics") and that people inherit abnormalities in certain cell populations in the brain. When a migraine hits, it's the result of those cells causing the blood vessels nearby to dilate and inflame, resulting in the headache. If this is the case, because of the genetic connection, certain people will always have a predisposition to migraine attacks.

Triggers

Many migraines are the result of triggers that set off the headache, according to the National Institute of Neurological Diseases and Stroke (NINDS) and the Food and Drug Administration (FDA). Those triggers can include:

• lack of food or sleep (Read about "Sleep")
• changes in weather or altitude
• exposure to bright lights or sunshine
• hormonal changes
• anxiety and stress (Read about "Anxiety" "Stress")
• relaxation after periods of stress
• certain foods and beverages including chocolate, dairy products, red wine and aged cheese
• food with additives such as nitrites, MSG or aspartame

Treatments

Various treatments are being tried to control migraines. Some people who experience the aura before a migraine report being able to stop the attack by finding a quiet dark place to use biofeedback. (Read about biofeedback in "CAM Therapies") Stress management techniques such as exercise also work for some people.

Some women have had success with hormonal therapy. According to the American Medical Association, many women who get migraines link the attacks to their menstrual cycles; so fluctuating and/or declining estrogen levels may play a role.

Medications can also be used. Over-the-counter anti-inflammatory drugs such as aspirin and ibuprofen can also be effective but have gastrointestinal side effects, such as stomach upset, heartburn and gastritis. (Read about "Digestive System" "Heartburn" "Gastritis")

There are several types of prescription medications. Ergotamine used to be one of the most frequently used drugs to stop migraines. According to the National Headache Foundation though, ergotamine should not be used too much because it can produce what's called a rebound headache if it's stopped following prolonged use. Sometimes hospitalization is needed to break the dependency.

Triptans are a more commonly used prescription medication for migraines. According to NINDS, the class of migraine drugs called triptans seems to act on the natural brain chemical serotonin. Triptans can be helpful with pain, as well as nausea and light sensitivity. Studies have also shown that this class of drugs makes the blood vessels in the brain contract (Read about "Clinical Studies"), according to the National Headache Foundation. There are concerns that triptans, as well as ergot-type drugs, also affect blood vessels in the rest of the body, so they may not be advisable for people with blood and heart problems.

There are also preventive medications. Some of these are medications that are primarily used to treat other conditions. Examples include beta-blockers, antidepressants and certain anti-seizure medications. (Read about "Depressive Illnesses" "Seizures" "Epilepsy") There is also a new class of medication that works by blocking the activity of calcitonin gene-related peptide, a molecule that is involved in migraine attacks. It is always important to remember that medications can cause serious side effects, so discuss all possibilities with your doctor. (Read about "Medicine Safety")

As an alternative to medications, there is also a device approved as a preventative treatment for migraine headaches. FDA has approved the transcutaneous electrical nerve stimulation (TENS) device for use prior to the onset of pain. The device resembles a plastic headband worn across the forehead and atop the ears. The device applies an electric current to the skin and underlying body tissues to stimulate branches of the trigeminal nerve. A study showed that those who used the device experienced significantly fewer days with migraines per month and used less migraine attack medication than those who used a placebo device.

If you are experiencing migraines, talk with your doctor about prevention and treatment. Also remember that head pain can be a sign of a more serious problem (Read about "Headaches"), so if you get frequent headaches, or a sudden severe headache, see a doctor at once.

Related Information:

    Headaches

    Cluster Headaches

    Sinusitis & Rhinitis

    Tension Headaches