If you’re affected by migraine pain, you’re not alone. Over a three-month period, it’s estimated that 17 to 23 percent of Americans have at least one migraine. People with active epilepsy are twice as likely as the general population to have migraine pain.
How Are Migraines Diagnosed?
A migraine is a type of headache that has different symptoms that are usually more intense than the more common tension headache.
To diagnose migraine headaches, your doctor will confirm the following information:
- You can answer yes to at least two of the following questions:
- Does the headache appear just on one side?
- Does the headache pulse?
- Is the pain moderate or severe?
- Does routine physical activity aggravate the pain, or is the pain so bad you have to avoid that activity?
- You have a headache with one or both of the following:
- nausea or vomiting
- sensitivity to light, sound, or odors
- You’ve had at least five of these headaches lasting four to 72 hours.
- The headaches aren’t caused by another disease or condition.
Less commonly, sights, sounds, or physical sensations accompany a migraine.
Risk Factors to Consider
Migraines are about three times more common in women than men.
Headaches, and migraines in particular, are more common among people with epilepsy than among the general population. At least one study estimates that one in three people with epilepsy will experience migraine headaches.
A person with epilepsy who has close relatives with epilepsy is more likely to experience a migraine with aura than someone without such relatives. This suggests that there’s a shared genetic link creating susceptibility to the two conditions.
Other characteristics may increase the likelihood of a seizure associated with a migraine. These include the use of antiepileptic drugs and having high body mass index.
Can Migraines Lead to Seizures?
Scientists don’t completely understand the connection between migraines and seizures. It’s possible that an epileptic episode may have an effect on your migraines. The opposite can also be true. Migraines may have an effect on the appearance of seizures. Researchers haven’t ruled out that these conditions appear together by chance. They’re investigating the likelihood that the headaches and epilepsy both arise from the same underlying factor.
To analyze any possible connection, doctors look carefully at the timing of a migraine to note whether it appears:
- before seizure episodes
- during seizure episodes
- after seizure episodes
- between seizure episodes
If you have epilepsy, it’s possible to experience both migraine and non-migraine headaches. Because of this, your doctor must consider your symptoms to determine whether your migraine and seizure are related.
How Are Migraines Treated?
Common drugs used to treat an acute attack of migraine pain include ibuprofen, aspirin, and acetaminophen. If these drugs aren’t effective, you might be prescribed a number of alternatives, including a class of drugs known as triptans.
If your migraines persist, your doctor may prescribe other medications.
Whatever drug regimen you and your doctor choose, it’s important for you to know how to navigate a medication program and to understand what to expect. You should do the following:
- Take medications exactly as prescribed.
- Expect to start with a low dose and increase gradually until the drug is effective.
- Understand that headaches probably won’t be eliminated altogether.
- Wait for four to eight weeks for any significant benefit to occur.
- Monitor the benefit that appears in the first two months. If a preventive drug provides marked relief, the improvement may continue to increase.
- Maintain a diary that documents your drug use, pattern of headache pain, and the impact of the pain.
- If the drug is successful for six to 12 months, your doctor may recommend gradually discontinuing the medication.
Migraine therapy also includes management of lifestyle factors. Relaxation and cognitive behavioral therapy have been shown to be useful in treating headaches, but research is continuing.
How Are Migraines Prevented?
The good news is that you may be able to avoid migraine pain. Prevention strategies are recommended if your migraine pain is frequent or severe and if every month, you have one of the following:
- a headache on at least six days
- a headache that impairs you on at least four days
- a headache that severely impairs you for at least three days
You might be a candidate for prevention for less severe migraine pain if every month you have one of the following:
- a headache for four or five days
- a headache that impairs you on at least three days
- a headache that severely impairs you for at least two days
An example of being “severely impaired” is being on bed rest.
There are several lifestyle habits that may increase the frequency of attacks.
You should do the following to help avoid migraines:
- Avoid skipping meals.
- Eat meals regularly.
- Establish a regular sleep schedule.
- Make sure you get enough sleep.
- Take steps to avoid too much stress.
- Limit your caffeine intake.
- Make sure that you get enough exercise.
- Lose weight if you’re overweight or obese.
Finding and testing medications to prevent migraine pain is complicated by the cost of clinical trials and the complex relationship between seizures and migraines. There’s no one strategy that’s the best. Trial and error is a reasonable approach for you and your doctor in the search for your best treatment option.
What Is the Outlook?
Migraine pain is most common in early and middle adulthood and declines substantially afterward. Both migraines and seizures can take a high toll on an individual. Researchers continue to examine these conditions alone and together. Promising research is focused on diagnosis, treatment, and the how our genetic background might affect each of these.