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Migraine Causes, Symptoms, Prevention And Treatment

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A migraine is a headache that often affects one side of the head and can be extremely painful, throbbing, or pulsating. High light and sound sensitivity, as well as nausea and vomiting, are usually accompanying symptoms. The pain from a migraine attack might be so acute that it interferes with your daily activities and can last for hours or even days.

In some people, an aura, a warning indication, may emerge before or at the same time as the headache. You may experience speech difficulties, tingling on one side of your face, arm, or leg, as well as visual problems like bright flashes or blind areas.

Some migraines can be prevented or made more tolerable with medication. It may be beneficial to take the right drugs, practice self-care, and make dietary and lifestyle modifications.

Causes

Although the exact causes of migraines are still not known, genetics and environmental factors seem to be involved.

A significant pain pathway, the trigeminal nerve, and its interactions with the brainstem may play a role. The same may be true for serotonin, which helps your neurological system handle pain, and other chemical imbalances in the brain.

Serotonin's involvement in migraines is being researched. Other neurotransmitters, such as calcitonin gene-related peptides, also contribute to migraine pain (CGRP).

Headache causes

There are numerous factors that might cause migraines, such as:

Female hormonal changes. As oestrogen levels change, such as before or during menstruation, during pregnancy, or after menopause, many women appear to suffer from headaches.

One hormonal medication that can exacerbate migraines is oral contraceptives. Yet, some female users find that they have migraines less frequently when taking these drugs.

Drinks. Examples of these are beverages with a lot of alcohol, particularly wine, and coffee with a lot of caffeine.

Stress. Stress at work or home might result in migraines.

Sensory arousal. Migraines may also be brought on by loud noises and bright or flashing lights. Strong odours like perfume, paint thinner, secondhand smoke, and others can cause headaches in certain people.

Sleep pattern changes. For certain people, sleep deprivation or excessive sleep can cause migraines.

Physical elements. Vigorous physical activity, especially sexual activity, can cause migraines.

The weather changes. A change in the weather or barometric pressure might trigger a migraine.

Medications. Oral contraceptives and vasodilators like nitroglycerin can exacerbate migraines.

Foods. Aged cheeses, salty foods, processed foods, and skipping meals can all trigger migraines.

Additions in food. Examples include the artificial sweetener aspartame and the food preservative monosodium glutamate (MSG).

How to check if you have Migraine?

Frequently, migraines go unidentified and untreated. Keep a record of your attacks and the drugs you took to treat them if you often suffer migraine symptoms. Then make an appointment with your doctor to discuss your headaches.

See your doctor if your headache pattern changes or if they suddenly start to feel different, even if you have a history of headaches.

See your doctor straight away or go to the emergency department if you have any of the following symptoms of a more serious medical condition:

  • A thunderclap-like headache that comes on suddenly and sharply
  • A headache accompanied by a fever, a stiff neck, disorientation, convulsions, double vision, numbness or paralysis in any part of the body, and seizures are all indications of a stroke.
  • Following a head injury, headache
  • A recurring headache that gets worse when you cough, work up a sweat, strain, or make an abrupt movement
  • A new headache appears beyond the age of 50.

Risk Factors

You are more likely to experience migraines due to a number of reasons, including:

Family background. You have a good likelihood of getting migraines if you have a family member who does.

Age. Although they can start at any age, adolescents are frequently the first to experience migraines. The frequency and severity of migraines tend to peak in your 30s and progressively decline over the ensuing decades.

Sex. Women get migraines three times as frequently as men do.

Hormonal adjustments. Migraine sufferers may experience headaches that start either before or soon after the start of their period. Moreover, they might alter throughout menopause or pregnancy. Following menopause, migraines usually get better.

Symptoms

Migraines, which can go through four stages—prodrome, aura, attack, and postdrome—can also affect children and teens. Not every migraine sufferer experiences each stage.

Prodrome

You may detect little alterations one or two days prior to a migraine that indicates an impending migraine, such as:

  • Constipation
  • Mood swings between joy and despair
  • Hunger pangs
  • Neck discomfort
  • More frequent urination
  • Retention of fluid
  • Often yawning
  • Aura

For some people, auras can occur either before or during a migraine. Auras are transient signs of the neurological system. Whilst they may contain other disturbances as well, the bulk of them are visual. Each symptom frequently begins lightly, gets worse over a short period of time, and lasts for up to 60 minutes.

Auras associated with migraines include:

  • Visual phenomena like seeing different shapes or bright
  • Light dots or flashes
  • Loss of vision
  • Needles and threads 
  • Sensations in an arm or leg
  • Speaking difficulty
  •  Weakness or numbness on one side of the body, the face, or both

A migraine commonly lasts 4 to 72 hours if ignored. Each has a unique migraine experience. Every month, migraines might strike sporadically or regularly.

Symptoms of a migraine include:

  • You get regular head pain on both sides, although usually only on one.
  • A throbbing or pulsing pain
  • Smell, touch, and occasionally light and sound sensitivity
  • Nausea and diarrhoea

Post-drome

You can experience post-migraine drowsiness, confusion, and fatigue for up to a day. Some people claim to feel happy. A sudden head movement could result in

on the anguish once more.

Treatments

The goal of migraine treatment is to lessen symptoms and prevent future attacks.

There are numerous drugs available to treat migraines. There are two major groups of medications used to treat migraines:

Drugs that reduce pain. These drugs, which are also known as acute or abortive treatments, are given during migraine attacks with the goal of stopping symptoms.

Preventative drugs. To lessen the severity or frequency of migraines, several kinds of medications are frequently taken daily.

Your options for treatment depend on your medical history, the frequency and intensity of your headaches, if you have nausea or vomiting when you have them, how incapacitating they are, and whether they are accompanied by other medical issues.

Medicines for pain alleviation

When taken as soon as a migraine attack begins, medications used to treat it function best.

The following medicines can be used to treat it:

Drugs that reduce pain. Some of the over-the-counter or prescription medications available are aspirin or ibuprofen (Advil, Motrin IB, and others). They may result in headaches from prescription overuse if used for an extended period of time, as well as ulcers and gastrointestinal bleeding.

Excedrin Migraine is a type of migraine drug that contains caffeine, aspirin, and acetaminophen. It may be effective, but often just for treating mild migraine pain.

Triptans. Because they block the brain's pain pathways, prescription medications including sumatriptan (Imitrex, Tosymra) and rizatriptan (Maxalt, Maxalt-MLT) are used to treat migraines. When given as tablets, injections, or nasal sprays, they can reduce a variety of migraine symptoms. Individuals who are at risk for a stroke might not be secure.

Dihydroergotamine (D.H.E. 45, Migranal). For migraines that often last longer than 24 hours, this medication, which is available as a nasal spray or injection, is best effective when administered soon after the onset of migraine symptoms. Nausea and vomiting that come with migraines may get worse as a side effect.

Avoid dihydroergotamine if you have kidney or liver disease, coronary artery disease, high blood pressure, or any of these conditions.

Lasmiditan (Reyvow). This more recent oral tablet has been given the green light to treat migraines with or without aura. Lasmiditan dramatically reduced headache pain during pharmacological studies. Those using lasmiditan are advised not to drive or handle machinery for at least eight hours since it can have a sedative effect and cause dizziness.

Ubrogepant (Ubrelvy). Agonist of the oral calcitonin gene-related peptide receptor is recommended for the management of adult patients with acute migraine with or without aura. It is the first medication of this kind to be approved for treating migraines. Ubrogepant was found to be more effective than a placebo in clinical trials at reducing migraine pain and other symptoms such as nausea and sensitivity to light and sound two hours after administration. The usual adverse effects include extreme drowsiness, nausea, and dry mouth.

Drugs that are opioids. Narcotic opioid drugs may be useful for migraine sufferers who are unable to take other migraine medications. They are often only used if no other therapies work because they can be quite addictive.

Anti-nausea medication. They might be useful if your migraine with aura is accompanied by nausea and vomiting. Chlorpromazine, metoclopramide (Reglan), and prochlorperazine are all anti-nausea medications (Compro). They are generally given pain medicines.

Several of these medicines should not be used while pregnant. Avoid using any of these medications if you are pregnant or trying to get pregnant without first consulting your doctor.

Preventative drugs

Drugs can lessen the frequency of migraine attacks. In the case that you experience frequent, protracted, or severe headaches that do not improve after therapy, your doctor may advise preventive drugs.

The goal of preventive medicine is to lessen the frequency, severity, and duration of migraine attacks. Options consist of:

Medicines that reduce blood pressure. They include beta-blockers like metoprolol tartrate and propranolol (Inderal, InnoPran XL, among others) (Lopressor). Verapamil (Verelan), a calcium channel blocker, can aid in the prevention of migraines with aura.

Antidepressants. Amitriptyline, a tricyclic antidepressant, can stop migraines in their tracks. Other antidepressants may be recommended in place of amitriptyline due to its side effects, which include tiredness.

Anti-seizure medications. If you experience less frequent migraines, valproate plus topiramate (Topamax, Qudexy XR, etc) may be helpful.

Nevertheless, adverse symptoms like nausea, changes in weight, and dizziness are all possible with migraines. Pregnant or trying to become pregnant women should avoid taking these drugs.

Shots of Botox. For certain adults, onabotulinumtoxinA (Botox) injections every 12 weeks can help avoid migraines.

Monoclonal antibodies to CGRP. Newer medications for the treatment of migraines include Aimovig, Ajovy, Emgality, and Vyepti. They are injected monthly or every three months. An injection site reaction is the most typical side effect.

If these medications are appropriate for you, ask your doctor. Several of these medicines should not be used while pregnant. Do not use any of these medications if you are pregnant or trying to get pregnant without consulting a doctor first.

Complications of Migraine

Using medications excessively might cause severe headaches due to drug abuse. Combinations of aspirin, acetaminophen, and caffeine appear to carry the greatest risk. If you use aspirin or ibuprofen (Advil, Motrin IB, etc.) for more than 14 days in a month or triptans, such as sumatriptan (Imitrex, Tosymra), rizatriptan (Maxalt, Maxalt-MLT), for more than nine days in a month, headaches may also result from overuse.

Medication-overuse. When painkillers stop working as intended to reduce pain, headaches result. Following that, you take additional painkillers, which keeps the cycle going.

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Page last reviewed: Mar 30, 2023

Next review due: Mar 30, 2025

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