When Is a Headache a Migraine? Video Transcript

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When Is a Headache a Migraine?
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, Richard B. Lipton MD

Summary

Migraine headaches can do more than ruin your day - they can interfere with your life. But migraines can be managed. Learn what can be done to prevent attacks and what steps to take when a migraine headache occurs.

Webcast Transcript

RICHARD LIPTON, MD: Headache, far and away, is the most common human affliction, and in the United States, there are 28 million people who have migraine, which is perhaps the most disabling form of primary headache.

ANNOUNCER: Hippocrates described the symptoms of migraine as far back as 400 BC. While centuries have passed and quantum strides in medicine have been made, migraine is still turning some lives upside down.

RICHARD LIPTON, MD: Migraine headaches tend to be one-sided, throbbing, moderate or severe pain that are made worse by routine physical activities. And some people talk about headbanger headaches, but all that refers to a quality of pain that's throbbing. And, in fact, during migraine attacks, the blood vessels become inflamed and dilated. And, in many people, the pulsing or throbbing pain is actually coordinated with the pulse, because what's triggering the pain is the blood vessel stretching every time the heart beats.

Migraine attacks are always accompanied by something other than the pain; people may have nausea, sensitivity to light, sensitivity to sound. Some people have sensitivity to odors. And in 20 percent, the aura, or the visual display.

ANNOUNCER: That unusual "aura" is an unwelcome light show that can accompany migraine.

RICHARD LIPTON, MD: The most common kind of aura is the visual aura, which often consists of spots of light or zigzag lines or a graying out of vision. And, in a textbook case of aura, those features may begin in a small part of the visual world and then expand to encompass a greater and greater part of the visual world.

ANNOUNCER: Experts can't really predict who it will strike, although it does run in families. And it even happens to kids who might have stomach pain with their headache.

RICHARD LIPTON, MD: When children have abdominal migraine, the diagnosis is very long-delayed, because it just gets written off as, "Oh, he's got another episode of the flu, it's something he ate."

ANNOUNCER: Migraines don't last forever, although it can feel that way.

RICHARD LIPTON, MD: Migraine headaches last four to 72 hours. On average, untreated, they last 24 hours. Treated, it depends how good your treatment is, but they could last as little as ten minutes. On average, migraine attacks occur once or twice a month.

ANNOUNCER: We also know that a wide range of factors can precipitate an attack.

RICHARD LIPTON, MD: It's important to know that triggers vary enormously from person to person and there's a very, very long list of triggers, including dietary triggers. Chocolate is actually quite an important one.

Oftentimes, shifting body rhythms is a trigger. Traveling to high altitude can be a trigger as well. Some people find that travel and shifts in time schedules, too much sleep, too little sleep. Falling barometric pressure, which is something that happens in anticipation of a rainstorm.

A lot of the things that people notice, they don't tell their doctors, because they're afraid their doctors will think that they're making foolish or crazy connections.

ANNOUNCER: Hormones can also figure into sparking migraines, which may help explain why they affect more women than men.

RICHARD LIPTON, MD: Many women find that they get headaches the day before menstrual flow begins or the day that flow actually begins. And that effect, we believe, is an effect of estrogen withdrawal.

ANNOUNCER: So is there anything you can do limit the amount of the attacks? You can pay close attention to finding and avoiding triggers by keeping a daily log.

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