Migraine Headaches
I have suffered from migraine headaches for 25 years. Mine last at least 72 hours or more. I am one of the third of migraine sufferers that has nausea and vomiting associated with the headache. I cannot tolerate any sound or light. I have to wear a sleep mask, and lay down with a cold compress on my forehead. I must stay in bed the entire time with absolutely no activity. I cannot eat or drink anything until my nausea passes. I can usually tell if a migraine is coming on. For years I have tried all kinds of non-prescription and prescription medications with no real relief. Only in the last year am I able to ease these headaches with a prescription medication called "Maxalt". I also have to limit my time in using the computer and avoid skipping meals.
A migraine is a type of headache marked by severe head pain usually on one side of the head lasting from several hours to as long as 72 hours or more.
Two types of migraines are recognized. Eighty percent of migraine sufferers experience "migraine without aura," formerly called common migraine. In "migraine with aura," symptoms are often most prominent on one side of the head, and may begin as early as 72 hours before the onset of pain.
The physiological basis of migraines has proved difficult to uncover. Genetics appear to play a part for many, but not all, for people with migraines. There are a multitude of potential triggers for a migraine attack, and recognizing one’s own set of triggers is the key to prevention.
The most widely accepted hypothesis of migraine suggests that a migraine attack is precipitated when pain-sensing nerve cells in the brain (called nociceptors) release chemicals called neuropeptides. At least one of the neurotransmitters, substance P, increases the pain sensitivity of other nearby nociceptors.
A wide variety of foods, drugs, environmental cues, and personal events are known to trigger migraines. It is not known how most triggers set off the events of migraine, nor why individual migraine sufferers are affected by particular triggers but not others.
Common food triggers include:
cheese
alcohol
caffeine products, and caffeine withdrawal
chocolate
intensely sweet foods
dairy products
fermented or pickled foods
citrus fruits
nuts
processed foods, especially those containing nitrites, sulfites, or monosodium glutamate (msg)
Environmental and event-related triggers include:
stress or time pressure
menstrual periods, menopause
sleep changes or disturbances, oversleeping
prolonged overexertion or uncomfortable posture
hunger or fasting
odors, smoke, or perfume
strong glare or flashing lights
The pain of a migraine is often present only on one side of the head, although it may involve both, or switch sides during attacks. The pain is usually throbbing, and may range from mild to incapacitating. It is often accompanied by nausea or vomiting, painful sensitivity to light and sound, and intolerance of food or odors. Blurred vision is common.
Once a migraine begins, the person will usually seek out a dark, quiet room to lessen painful stimuli. Several drugs may be used to reduce the pain and severity of the attack.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are helpful for early and mild headache. NSAIDs include acetaminophen, ibuprofen, naproxen, and others. A recent study concluded that a combination of acetaminophen, aspirin, and caffeine could effectively relieve symptoms for many migraine patients. One such over-the-counter preparation is available as "Exedrin Migraine".
More severe or unresponsive attacks may be treated with drugs that act on serotonin receptors in the smooth muscle surrounding cranial blood vessels. Serotonin, also known as 5-hydroxytryptamine, constricts these vessels, relieving migraine pain.
Alternative treatments are aimed at the prevention of migraine. Herbal therapy with feverfew (Chrysanthemum parthenium) may lessen the frequency of attacks. Learning to increase the flow of blood to the extremities through biofeedback training may allow a patient to prevent some of the vascular changes once a migraine begins. During a migraine, keep the lights low; put the feet in a tub of hot water and place a cold cloth on the occipital region (the back of the head). This draws the blood to the feet and decreases the pressure in the head. Ginger is another alternative and natural remedy for migraine sufferers. In India, a paste made from ginger powder is applied to the forehead temples. You can also take ginger extract or eat ginger candy or ginger ale. Ginger is also good in preventing nausea.
The frequency of migraines may be lessened by avoiding triggers. It is useful to keep a headache journal, recording the particulars and noting possible triggers for each attack.
Specific measures which may help include:
eating at regular times, and not skipping meals
reducing the use of caffeine and pain relievers
restricting physical exertion, especially on hot days
keeping regular sleep hours, but not oversleeping
managing time to avoid stress at work and home
managing your time in using the computer
Some drugs can be used for migraine prevention, including specific members of these drug classes:
beta blockers
tricyclic antidepressants
calcium channel blockers
anticonvulsants
prozac
monoamine oxidase inhibitors (mao)
serotonin antagonists