Migraine

Update of a Patient Note originally published in August 1995.

Download this Patient Note in PDF format

Every few weeks, you have a pounding headache, your vision gets blurry, and you feel nauseated. You end up going to bed until it's over, which can be hours or days later. Your pain could be caused by migraines, a common type of headache for which effective treatment is available.

What is migraine?
It is a disabling type of headache that occurs when a trigger, such as a change in hormone levels in the body, causes blood vessels in the brain to swell. Many people who think they have tension headaches or muscular headaches really have migraine, which is not harmful but can be severe enough to interfere with daily activities.

Who is most likely to have migraine?
More than 28 million people in the United States have migraine, and many of them had their first migraine in childhood or their teenage years. It affects up to 10% of children aged 5 to 15 years and 18% of men and women aged 30 to 49 years. Women are three times more likely than men to have migraine, and they often experience changes in their migraine pattern during menstruation, pregnancy, and menopause. About 5% of people older than 65 years get migraines.

Four out of five people who have migraines have other family members who also have this type of headache.

What are the symptoms of migraine?
For some people, migraine starts with an aura, which is a sensation of light or sound that isn't really there, 15 to 30 minutes before the headache pain begins. In general, migraine pain is pounding and affects only one side of the head. It can be mild, moderate, or severe and usually gets worse with physical activity or around light or sound. Nausea or vomiting is common.

How is migraine treated?
Migraine is treated with medication. It is important to take your medication early in a migraine attack, before it gets out of control. For some people, an over-the-counter painkiller such as acetaminophen (for example, Tylenol), a combination of acetaminophen, aspirin, and caffeine (for example, Excedrin Migraine), or a nonsteroidal anti-inflammatory drug such as ibuprofen (for example, Motrin) is all they need.

People with more severe headaches probably need a prescription drug specifically for migraine. Most often, a triptan is prescribed. Triptans come in pill, nasal spray, and injection forms. Your doctor may also prescribe a drug for nausea if you need it.

You might find that resting in a cool, dark room with an ice pack on your head helps relieve your pain. Call your doctor if a headache feels very different from others you've had, if it happens suddenly, or if you also have a fever, stiff neck, rash, seizures, or trouble speaking.

Is there any way to prevent migraine?
If you can find out which events trigger your migraines, you can possibly prevent them by avoiding these triggers. To help identify yours, keep a diary of when your migraines occur and what you were doing just before your symptoms developed. Common triggers include skipping meals, not getting enough sleep, drinking alcohol, consuming caffeine, and using headache painkillers more than two or three times a week. Unfortunately, some triggers, such as menstrual periods and changes in the weather, are beyond your control.

Exercising regularly, quitting smoking, or trying acupuncture or massage may also help keep migraines at bay.

Many people who get migraines benefit from regularly taking a drug prescribed by their doctor, such as an antidepressant or a beta blocker, as a way to prevent future attacks.

For more information on migraine American Council for Headache Education 16 Mantua Rd Mt Royal, NJ 08061 856-423-0258 http://www.achenet.org National Headache Foundation 820 N Orleans Suite 217 Chicago, IL 60610 888-643-5552 http://www.headaches.org

This information is not a substitute for medical treatment.

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