Enough to Make Your Head Hurt: Understanding Migraines

By Danielle Spano
Understanding Migraines

There are hundreds of types of headaches, with causes ranging from hunger to eye strain, hormones to hangovers, tension to illness and more. Understanding migraines and distinguishing between types is difficult, especially while experiencing one. Migraines, on the other hand, are a neurological disease classified as a primary headache disorder, affecting over 36 million people nationwide. Occurring in twice as many women as men, migraines typically begin during puberty. This affliction is not a one and done scenario; migraines are recurrent throughout one’s life, affecting those in their 30s and 40s most.

Is it a headache or a migraine?

With migraines affecting such a large portion of the population, how do you know if the pain in your head is a migraine or just a headache? While not exclusively, migraines typically affect just one side of the head with intense pain accompanied by symptoms of nausea, vomiting and sensitivity to light and sound. To make matters worse, migraines can be accompanied by other types of headaches to make diagnosis and treatment all the more difficult. Understanding migraines can be so hard because there are even subtypes of this disorder. The primary types are those with aura and without aura, or complicated and common migraines.

The National Institute of Neurological Disorders and Stroke accounts that nearly one-third of migraines sufferers experience auras, which are sensory warning signals (i.e. blurred/tunnel vision, nausea, numbness and tingling) that occur just prior to the migraine’s onset. Common migraines, those without aura, have no warning stage. Other migraine categories include acephalgic (a “silent” migraine that has severe aura symptoms without head pain), hemiplegic (aura symptoms with weakness or tingling on one side of the body), retinal (migraine with temporary vision loss in one eye) and chronic (varied migraine symptoms experienced more than 15 days of each month).

Avoiding triggers

Events, changes, foods and stimuli associated with migraine onset are called triggers. Triggers vary by individual and can even fluctuate from migraine to migraine. These triggers can occur up to eight hours before a migraine ensues, often making it difficult to determine what exactly caused the attack. Triggers can include stress, anxiety, hunger, hormone changes, caffeine withdrawal, changes in sleep patterns, smells, loud noises or bright lights. Foods, beverages and additives such as chocolate, dairy, MSG, nitrates, alcohol, tyramine, onions, nuts and some fruits can also act as triggers. Keeping a headache diary can help determine one’s typical triggers.

Treatment options

Headaches can be treated with NSAIDS (Nonsteroidal anti-inflammatory drugs) like aspirin or ibuprofen. Migraine treatment focuses on reducing attack frequency and then stopping them once underway. One significant migraine prevention method is to avoid known triggers. Pharmacological treatment includes two groups of medications — acute and prophylactic. Acute medicines taken when the attack occurs, such as over-the-counter pain or anti-nausea medication, help to relieve associated symptoms. “The combination of simple analgesics and caffeine can be helpful, but they should not be taking too often because they may trigger medication overuse headache, a condition that is difficult to treat,” Dr. Yulia Y. Orlova, assistant professor at the University of Florida department of neurology, said.

For chronic migraines, Botox injections in the head and neck can result in drastically reduced migraine frequency. “It changed my life,” said migraine sufferer Sandra Strasser. “I went from having migraines three to four times a week to maybe one or two a month.” Strasser explained that while not necessarily a pleasant process, the result certainly outweighs the means. As migraines differ from person to person, so does the effectiveness of treatments. Alternative methods such as acupuncture and herbal supplements have shown positive results in some patients. Always discuss new treatments with your doctor before trying them.


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