Migraines are severe, pounding headaches associated with nausea and sensitivity to light and sound. They affect approximately 39 million Americans, costing an estimated $13 billion annually in lost productivity.
How can I tell the difference between a headache and a migraine?
A migraine usually begins above the eyes, typically affects one side of the head, and tends to throb intensely, especially with physical activity or when bending over. Some migraines have associated neurologic symptoms, known as auras, that disturb vision, language, and sensation.
What causes a migraine?
Previously thought to be caused by abnormal dilation of blood vessels, migraines are now considered a genetic disorder of the brain. Hormones, stress, weather, and certain medications can also worsen migraines.
What can I do to treat my migraine?
Many patients find it helpful to keep a diary to identify possible triggers, such as cheese, red wine, foods with MSG, and too much caffeine. Over-the-counter pain treatments might actually increase headache frequency. Eating regular meals and getting plenty of sleep may help.
Treating migraine attacks within the first hour of onset provides the best opportunity for success. Many patients improve with a nonsteroidal anti-inflammatory medication, like ibuprofen or naproxen. Prescription medications include the triptan class of drugs, and others used to suppress nausea.
For severe, long-lasting, and frequent migraines, preventive prescription medications may help. More recently, Botox injections, commonly used for smoothing wrinkles, have been demonstrated to reduce chronic migraine headaches. There is no known cure for migraines, but most disappear later in life.
DR. JONATHAN SMITH is a fellowship-trained headache specialist on the faculty at UK HealthCare.