A migraine can be disabling — with symptoms so severe, all you can think about is finding a dark, quiet place to lie down. Up to 17 percent of women and 6 percent of men have experienced a migraine.
More than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache.
Causes of Migraine
Foods. Certain foods appear to trigger headaches in some people. Common offenders include alcohol, especially beer and red wine; aged cheeses; chocolate; fermented, pickled or marinated foods; aspartame; overuse of caffeine; monosodium glutamate — a key ingredient in some Asian foods; certain seasonings; and many canned and processed foods. Skipping meals or fasting also can trigger migraines.
Sensory stimuli. Bright lights and sun glare can produce head pain. So can unusual smells — including pleasant scents, such as perfume and flowers, and unpleasant odors, such as paint thinner and secondhand smoke.
A migraine begins when, for some reason, blood vessels in the brain narrow (constrict) temporarily. When that happens, the amount of blood and oxygen flowing to the brain drops. So the brain sends a message: “Hey guys, we need some more blood and oxygen here!”
Until recently, the general theory on the migraine process rested solely on the idea that abnormalities of blood vessel (vascular) systems in the head were responsible for migraines.
Symptoms of Migraine
Intense throbbing or dull aching pain on one side of your head or both sides.
Migraines typically begin in childhood, adolescence or early adulthood and may become less frequent and less intense as you grow older. In addition to physical suffering, severe headaches often mean missed school days and trips to the emergency department, as well as lost work time for anxious parents.
Most experts now agree that the term migraine should be used to refer to a chronic, recurrent neurological condition resulting in periodic attacks of head pain rather than the headache.
Changes in how a person sees, including blurred vision or blind spots, zig-zags of light or light flashes
Treatment of Migraine
The Food and Drug Administration (FDA) has approved three over-the-counter products to treat migraine. Excedrin® Migraine (a combination of aspirin, acetaminophen and caffeine) is indicated for migraine and its associated symptoms. Advil® Migraine and Motrin® Migraine Pain, both ibuprofen medications, are approved to treat migraine headache and its pain.
Ergots. Ergotamine (Ergomar) has been in use for more than 60 years and was a common prescription for migraine before triptans were introduced. Ergotamine is much less expensive, but also less effective, than triptans. Dihydroergotamine is an ergot derivative that is more effective and has fewer side effects than ergotamine.
Drug names and migraine headache treatments availability vary widely from the USA and UK. Migraine headache treatments fall into two broad categories: first with migraine treatments are analgesics and analgesic combinations and, secondly, migraine-specific therapies, such as the triptans, ergotamine and dihydroergotamine. Many of these are available only on prescription but there is a variety of therapeutic options available over the counter (OTC) and pharmacists can often advise patients about these.
Beta blockers (e.g., propranolol [Inderal®], atenolol [Tenormin®]) are the preferred medications. These drugs produce an effect on heart rate. They should not be taken by patients with asthma and should be used with caution in patients with diabetes.