What are migraines?
Migraines are severe, incapacitating headaches usually (but not always) beginning on one side of the head. They are often accompanied by extreme sensitivity to light, sound and smells, nausea and vomiting, sleep disruption, as well as anxiety and depression. In its full-blown state, simple activities such as combing hair or shaving can be painful. Sometimes a migraine can be preceded by an "aura" (a visual disturbance that appears as flashing lights, zig-zag lines) or by a temporary loss of vision. Approximately 10% of all Americans suffer from migraines, affecting women (mostly during the reproductive years) three times more often than men. The tendency to experience migraines often runs in families and may occur at any age; they usually begin between the ages of 10 and 40 and diminish after age 50. Migraine is often misdiagnosed as sinus headache (very rare source of headache)and sometimes as tension headache.
What are the causes?
Much about the causes of headaches in general is not clear, but scientists now believe that migraines may be linked to inherited abnormalities. Researchers have also found that migraines may be caused by functional changes in the trigeminal nerve system (a major cranial nerve pathway) and by imbalances in certain neurotransmitters (brain chemicals that transmit signals between nerve cells in the brain and spinal cord).
It is well known that migraines are frequently brought on by "triggers." Migraine sufferers usually have recurring attacks, as frequently as several times a week, or as little as every few years. The triggers for recurrent migraines cover a wide range including stress or depression, inadequate sleep, irregular meals or certain foods, bright lights or excessive noise, hormonal changes, weather changes, or even daily use of headache-relieving medication.
Are migraines preventable?
There are medications that can be prescribed to decrease the frequency of attacks. Healthy lifestyle changes can also reduce the number and severity of migraines. Obviously, avoiding the activities, foods or situations that have triggered migraines in the past is one of the best prevention tools. Get yourself into new routines for sleep, exercise, and meals, and if you smoke, stop. Also, estrogen-based medications, such as birth control pills or hormone replacement therapy, may need to be reduced or replaced with other methods.
What treatment options are available?
The management of migraine headaches has improved dramatically in the last decade. Although there's still no cure, certain medications can help reduce the frequency of migraine (as stated above) and others can fairly reliably stop the pain once it has started. Injection procedures can abort or at least reduce migraine severity. Non-pharmacological approaches, such as nutritional counseling, hypnotherapy, massage therapy, and acupuncture, can also reduce symptoms and frequency. For those patients whose migraine pain remains unresponsive to all other treatment techniques,
peripheral nerve electrical stimulation (neuromodulation) may provide dramatic relief but requires a minor surgical procedure.
