Migraine Headache Transcript
Opening: This audio segment on migraine headache is brought to you by The Resource Center of the Department of Pain Medicine and Palliative Care at Beth Israel Medical Center in New York City, and is made possible through a generous grant from The Mayday Fund.
Migraine Headache -- What You Should Know
Migraine headache is different for each person. You may have very mild migraines. Others can be totally crippled by them.
The common features of a migraine are:
What Causes Migraine Headaches?
The cause of migraine headache is unknown. Experts think that migraine headache is an inherited condition that is also affected by your environment. The reason that migraines are mild in one person and severe in another is also not known. In any individual, many things may cause a headache to appear, including stress, hormonal changes, or disturbed sleep.
Who Gets Migraine Headaches?
About fifteen to twenty percent of women and five to six percent of men suffer from migraines. Like most patients, you might have gotten your first migraine headache as a teenager or a young adult. Many women say that headaches get worse before or during menstrual periods. Headaches tend to slowly get better after menopause. Being pregnant may improve, worsen, or have no effect at all on migraine.
Migraine With Aura and Without Aura
There are two kinds of migraines -- migraine with aura, which is called classic migraine, and migraine without aura, which is called common migraine. An aura happens for a short time right before the headache starts. You may see spots, zig-zag lines, or unusual colors. Arm or leg weakness, tingling or pins and needles in an arm or leg, and trouble speaking or understanding what someone else is saying happen less often. Auras usually end after less than an hour. Most patients don’t have an aura. If you have an aura for the first time, it is important that you be seen by a doctor.
How Is Migraine Headache Diagnosed?
Your doctor uses your description of the headache to make the diagnosis. These are the International Headache Society’s conditions for a migraine:
You’ve had at least five headache attacks that:
Lasted 4 to 72 hours (untreated or treated but the treatment didn’t work)
Had at least two of the following:
At least one of the following happened:
You were sick to your stomach and/or threw up
Light or sound bothered you.
Your medical history, physical exam and neurologic exam do not show a brain tumor, infection, or something wrong with a blood vessel. These are all very rare.
Treatments for Migraine
Drugs are the usual treatment for migraine. Drugs that you take when you get a headache are called abortive or symptomatic medicines. For milder headaches, these drugs include aspirin, acetaminophen, and nonsteroidal anti-inflammatory drugs. For more severe headaches, the usual drugs are the triptans, but others are used as well. Drugs that you take every day to try to prevent headache attacks are called prophylactic headache medications. These include beta-blockers, calcium channel blockers, antidepressants, anticonvulsants, nonsteroidal anti-inflammatory drugs, ergots, alpha-2 adrenergic agonists, and Feverfew. Speak with your doctor to find out what would be best for you.
Nondrug therapy can be very helpful for migraine. Biofeedback and stress management can be useful. Becoming aware of the headache triggers -- like certain foods and drinks, or stress or sleep problems, may be helpful in starting lifestyle changes that can reduce headache.
Some migraine patients don’t respond to routine care and may need a team approach involving headache specialists. This care can be found in headache and pain clinics.
We hope that this segment has provided you with some basic information about migraine headaches. Remember, with all the treatment options available, there’s every reason to stay hopeful your problem can be helped.