Migraine

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Overview

Migraine is not the same as the usual kind of headaches that most people have every now and then. A migraine attack starts suddenly with severe pain on only one side of your head. The pain is much worse than a normal headache and usually accompanied by other symptoms as well.

But these headaches are only considered to be migraines if the typical symptoms have occurred at least five times.

Migraines can greatly affect everyday life. Some people only get them occasionally, while others are knocked out by migraines on several days every month. Different types of medicine can help you cope with migraines.

Symptoms

Migraines, which affect children and teenagers as well as adults, can progress through four stages: prodrome, aura, attack and post-drome. Not everyone who has migraines goes through all stages.

Prodrome

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

Constipation

Mood changes, from depression to euphoria

Food cravings

Neck stiffness

Increased urination

Fluid retention

Frequent yawning

Aura

For some people, an aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They're usually visual but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and can last up to 60 minutes.

Examples of migraine auras include:

Visual phenomena, such as seeing various shapes, bright spots or flashes of light

Vision loss

Pins and needles sensations in an arm or leg

Weakness or numbness in the face or one side of the body

Difficulty speaking

Attack

A migraine usually lasts from 4 to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

Pain usually on one side of your head, but often on both sides

Pain that throbs or pulses

Sensitivity to light, sound, and sometimes smell and touch

Nausea and vomiting

Causes

The cause of migraine headaches is complicated and not fully understood. When you have a headache it’s because specific nerves in your blood vessels send pain signals to your brain. This releases inflammatory substances into the nerves and blood vessels of your head. It’s unclear why your nerves do that.

Risk factors

Several factors make you more prone to having migraines, including:

Family history. If you have a family member with migraines, then you have a good chance of developing them too.

Age. Migraines can begin at any age, though the first often occurs during adolescence. Migraines tend to peak during your 30s, and gradually become less severe and less frequent in the following decades.

Sex. Women are three times more likely than men to have migraines.

Hormonal changes. For women who have migraines, headaches might begin just before or shortly after onset of menstruation. They might also change during pregnancy or menopause. Migraines generally improve after menopause.

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Complications

Taking painkillers too often can trigger serious medication-overuse headaches. The risk seems to be highest with aspirin, acetaminophen and caffeine combinations. Overuse headaches may also occur if you take aspirin or ibuprofen (Advil, Motrin IB, others) for more than 14 days a month or triptans, sumatriptan (Imitrex, Tosymra) or rizatriptan (Maxalt, Maxalt-MLT) for more than nine days a month.

Medication-overuse headaches occur when medications stop relieving pain and begin to cause headaches. You then use more pain medication, which continues the cycle.

Prevention

If you’ve been diagnosed with migraine, there are a few options that may help you prevent a migraine attack. Some may work better for you than others:

Learn the foods, smells, and situations that trigger your migraine attacks and avoid those things when possible.

Stay hydrated. Dehydration can lead to both dizziness and headaches.

Avoid skipping meals when possible.

Focus on quality sleep. A good night’s sleep is important for overall health.

Quit smoking.

Make it a priority to reduce stress in your life.

Invest time and energy in developing relaxation skills.

Exercise regularly. Exercise has been linked to lowered stress levels.