Migraine Headache Health Article

Symptoms

Migraine without aura may be preceded by elevations in mood or energy level for up to 24 hours before the attack. Other pre-migraine symptoms may include fatigue, depression, and excessive yawning.

Aura most often begins with shimmering, jagged arcs of white or colored light progressing over the visual field in the course of 10–20 minutes. This may be preceded or replaced by dark areas or other visual disturbances. Numbness and tingling are common, especially of the face and hands. These sensations may spread, and may be accompanied by a sensation of weakness or heaviness in the affected limb.

Migraine pain 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 also common.

The pain tends to intensify over the first 30 minutes to several hours, and may last from several hours to a day, or longer. Afterward, the affected person is usually weary, and sensitive to sudden head movements.

Diagnosis

Ideally, migraine is diagnosed by a careful medical history. Unfortunately, migraine is underdiagnosed because many doctors tend to minimize its symptoms as "just a headache." According to a 2003 study, 64% of migraine patients in the United Kingdom and 77% of those in the United States never receive a correct medical diagnosis for their headaches.

So far, laboratory tests and such imaging studies as computed tomography (CT scan) or magnetic resonance imaging (MRI) scans have not been useful for identifying migraine. However, these tests may be necessary to rule out a brain tumor or other structural causes of migraine headache in some patients.

Treatment

At the onset of symptoms, the migraine sufferer should seek out a quiet, dark room and attempt to sleep. Placing a cold, damp cloth or a cold pack on the fore-head may help. Additionally, tying a headband tightly around the head can relieve migraines.

Migraine headaches are often linked with food allergies or intolerances. Identification and elimination of the offending food or foods can decrease the frequency of migraines and/or alleviate these headaches altogether.

Alternative treatments for migraine include:

• Acupressure. Pressing on the Gates of Consciousness (GB 20) points can relieve migraine.
• Acupuncture. A National Institutes of Health (NIH) panel concluded that acupuncture may be a useful treatment for headache.
• Aromatherapy. The essential oil rosemary eases migraine pain.
• Autogenic training. Autogenic training is a form of self-hypnosis developed in Germany in the 1930s that has been shown in several studies to relieve the pain of migraine.
• Cognitive behavior therapy.
• Herbals. Valerian (Valeriana officinalis), passion-flower (Passiflora incarnata), feverfew (Chrysanthemum parthenium), ginger, ginkgo (Ginkgo biloba), goldenseal (Hydrastis canadensis), hawthorn (Crataegus oxyacantha), linden, wood betony (Stachys officinalis), skullcap (Scutellaria lateriflora), or cramp bark (Viburnum opulus) may relieve migraines.
• Hydrotherapy. Contrast showers, in which a short hot shower is followed by a longer cold shower, may halt an oncoming migraine. A hot enema can temporarily relieve migraine pain.
• Naturopathy. Migraine headaches are one of the most common reasons for consulting naturopathic practitioners. Naturopaths typically treat migraine with a combination of nutritional therapy and mind/body techniques.
• Relaxation techniques. Meditation, yoga, hypnosis, visualization, breathing exercises, or progressive muscular relaxation may halt the progression of a migraine.
• Supplements. Clinical studies have shown that vitamin B₂ (riboflavin), magnesium, 5-HTP, or melatonin can reduce the severity of migraines.
• Transcutaneous electrical nerve stimulation (TENS).

Allopathic treatments

Nonsteroidal anti-inflammatory drugs (NSAIDs) acetaminophen (Tylenol), ibuprofen (Motrin), and naproxen (Aleve) are helpful for early and mild headache. Excedrin Migraine is a combination product that is indicated for migraine headache.

More severe or unresponsive attacks may be treated with ergotamine (botulinum toxin), dihydroergotamine, sumatriptan (Imitrex), beta-blockers and calcium channel-blockers, antiseizure drugs, antidepressants (SSRIs), meperidine, or metoclopramide. Some of these drugs are also available as nasal sprays, intramuscular injections, or rectal suppositories when vomiting prevents taking the drug by mouth.

Sumatriptan and other triptan drugs (zolmitriptan, rizatriptan, naratriptan, almotriptan, and frovatriptan) should not be taken by people with any kind of vascular disease because they cause coronary artery narrowing. Otherwise these drugs have been shown to be very safe.

Continued use of some antimigraine drugs can lead to "rebound headache," marked by frequent or chronic headaches, especially in the early morning hours. Rebound headache can be avoided by using antimigraine drugs under a doctor's supervision, with the minimum dose necessary to treat symptoms. Tizanidine (Zanaflex) has been reported to be effective in treating rebound headaches when taken together with an NSAID.