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Health > Times Health Guide > m > Migraine
Migraine
Overview
Alternative Names
Causes
Symptoms
Exams and Tests
Treatment
Support Groups
Outlook (Prognosis)
Possible Complications
When to Contact a Medical Professional
Prevention
References
In-Depth Report
News & Features
Reporter's File
Expert Q & A
Questions for Your Doctor
Clinical Trials
Web Links
National Headache Foundation
American Headache Society
American Academy of Neurology
National Institute of Neurological Disorders and Stroke
Find clinical trials
National Migraine Association
Related Topics
Migraine Without Aura
Migraine With Aura
Mixed Tension Migraine
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Migraine Headache
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Migraine Cause
CT Scan of the Brain

Central Nervous System and Peripheral Nervous System
A migraine is a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light. In many people, a throbbing pain is felt only on one side of the head.
Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. An aura is a group of symptoms, usually vision disturbances, that serve as a warning sign that a bad headache is coming. Most people, however, do not have such warning signs.
See also:
Migraine without aura (no warning symptoms)
Migraine with aura (visual disturbances before the headache starts)
Mixed tension migraine (features of both migraines and tension headache)
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Reference from A.D.A.M.
Back to TopAlternative Names
Headache - migraine
Back to TopCauses »
A lot of people get migraines -- about 11 out of 100. The headaches tend to start between the ages of 10 and 46 and may run in families. Migraines occur more often in women than men. Pregnancy may reduce the number of migraines attacks. At least 60 percent of women with a history of migraines have fewer such headaches during the last two trimesters of pregnancy.
Until the 1980s, scientists believed that migraines were due to changes in blood vessels within the brain. Today, most believe the attack actually begins in the brain itself, and involves various nerve pathways and chemicals in the brain.
A migraine attack can be triggered by stress, food, environmental changes, or some other factor. However, the exact chain of events remains unclear.
Migraine attacks may be triggered by:
Allergic reactions
Bright lights, loud noises, and certain odors or perfumes
Physical or emotional stress
Changes in sleep patterns
Smoking or exposure to smoke
Skipping meals
Alcohol
Menstrual cycle fluctuations, birth control pills
Tension headaches
Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami)
Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods In-Depth Causes »
Back to TopSymptoms
Migraine headaches, which can be dull or severe, usually:
Feel throbbing, pounding, or pulsating
Are worse on one side of the head
Last 6 to 48 hours
Symptoms accompanying migraines include:
Nausea and vomiting
Sensitivity to light or sound
Loss of appetite
Fatigue
Numbness, tingling, or weakness
Warning signs (auras) that can precede a migraine include seeing stars or zigzag lines, tunnel vision, or a temporary blind spot.
Symptoms that may linger even after the migraine has gone away include:
Feeling mentally dull, like your thinking is not clear or sharp
Increased need for sleep
Neck pain
Back to TopExams and Tests »
Migraine headache may be diagnosed by your doctor based on your symptoms, history of migraines in the family, and your response to treatment. Your doctor will take a detailed history to make sure that your headaches are not due to tension, sinus inflammation, or a more serious underlying brain disorder. During the physical exam, your doctor will probably not find anything wrong with you.
Sometimes an MRI or CT scan is obtained to rule out other causes of headache like sinus inflammation or a brain mass. In the case of a complicated migraine, an EEG may be needed to exclude seizures. Rarely, a lumbar puncture (spinal tap) might be performed.In-Depth Diagnosis »
Back to TopTreatment
There is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or altering triggers. When you do get migraine symptoms, try to treat them right away. The headache may be less severe.
A good way to identify triggers is to keep a headache diary. See headache.
When migraine symptoms begin:
Rest in a quiet, darkened room
Drink fluids to avoid dehydration (especially if you have vomited)
Try placing a cool cloth on your head
Over-the-counter pain medications like acetaminophen, ibuprofen, or aspirin are often helpful, especially when your migraine is mild. (Be aware, however, that chronic usage of such pain medications may result in rebound headaches.) If these don't help, ask your doctor about prescription medications.
Your doctor will select from several different types of medications, including:
Ergots like dihydroergotamine or ergotamine with caffeine (Cafergot)
Triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), frovatriptan (Frova), and zolmitriptan (Zomig); these are available as a tablet, nasal spray, or self-administered injection
Isometheptene (Midrin)
Stronger pain relievers (narcotics)
Many of the prescription medications for migraines narrow your blood vessels. Therefore, these drugs should not be used if you have heart disease, unless specifically instructed by your doctor.
If you wish to consider an alternative, feverfew is a popular herb for migraines. Several studies, but not all, support using feverfew for treating migraines. If you are interested in trying feverfew, make sure your doctor approves. Also, know that herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.
Back to TopSupport Groups
American Council for Headache Education - www.achenet.org
The National Migraine Association - www.migraine.org
National Headache Foundation - www.headaches.org
Back to TopOutlook (Prognosis)
Every person responds differently to treatment. Some people have rare headaches that require little to no treatment. Others require the use of several medications or even occasional hospitalization.
Back to TopPossible Complications
Migraine headaches generally represent no significant threat to your overall health. However, they can be chronic, recurrent, frustrating, and they may interfere with your day-to-day life.
Stroke is an extremely rare complication from severe migraines. This risk may be due to prolonged narrowing of the blood vessels, limiting blood flow to parts of the brain for an extended period of time.
Back to TopWhen to Contact a Medical Professional
Call 911 if:
You have unusual symptoms not experienced with a migraine before, like speech or vision problems, loss of balance, or difficulty moving a limb
You are experiencing "the worst headache of your life"
Call your doctor immediately if:
Your headache pattern or intensity is different
Your headache gets worse when you lie down
Also, call your doctor if:
Previously effective treatments no longer help
Side effects from medication occurs (irregular heartbeat, pale or blue skin, extreme sleepiness, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain, cramps, dry mouth, extreme thirst, or others)
You are likely to become pregnant -- some medications should not be taken when pregnant
Back to TopPrevention »
Avoid smoking
Avoid alcohol
Exercise regularly
Get enough sleep each night
Learn to relax and reduce stress -- try progressive muscle relaxation (contracting and releasing muscles throughout your body), meditation, biofeedback, or joining a support group
If you get at least three headaches per month, your doctor may prescribe medication for you to prevent recurrent migraines. Such prescription drugs may include:
Beta-blockers such as propranolol (Inderal)
Antidepressants, including tricyclics like amitriptyline (Elavil) or selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), or sertraline (Zoloft)
Anticonvulsants such as valproic acid (Depacon, Depakene), divalproex sodium (Depakote), or topiramate (Topamax)
Calcium channel blockers such as verapamil In-Depth Prevention »
Back to TopReferences »
Morantz C. Practice Guideline Briefs. Am Fam Physician. Mar 2005; 71(5); 1019-899.
Schroeder BM . AAFP/ACP-ASIM release guidelines on the management and prevention of migraines. Am Fam Physician. Mar 2003; 67(6): 1392, 1395-7.
Noble J, ed. Textbook of Primary Care Medicine. 3rd ed. St. Louis, MO: Mosby; 2001.
Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, MO: Mosby; 2002.
Goetz CG, Pappert EJ. Textbook of Clinical Neurology. 2nd ed. Philadelphia, PA: Saunders; 2003.See All References »
More Information on This Topic
Background
Prognosis
Causes
Risk Factors
Diagnosis
Treatment Approaches
Medications Used for Treatment
Prevention
Medications Used for Prevention
References
News & Features
Reporter's File
Expert Q & A
Questions for Your Doctor
Clinical Trials
Review Date: 11/21/2006Reviewed By: Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch). A.D.A.M. CopyrightThe information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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