Introduction

Migraines are a severe type of headache that affects over 30 million Americans, with a 3:1 ratio of women to men.  In some cases, these painful headaches are preceded or accompanied by an aura, such as flashes of light or blind spots.  Migraine pain can be excruciating and may incapacitate you for hours or even days.

Although the exact cause of migraine is unclear, there is evidence that dysfunction of the trigeminal nerve (the nerve responsible for sensation in the face, forehead, and anterior scalp) and imbalances of certain neurotransmitters in the brain, especially serotonin, play a role in the development of migraine headaches.  In addition, genetics also appears to play a role in the development of migraine headaches.

Symptoms

  • Moderate to severe headache with a pulsating or throbbing quality, usually on only one side of the head
  • Sensitivity to light (photophobia)
  • Sensitivity to sound (phonophobia)
  • Nausea with or without vomiting
  • Pain is aggravated by physical activity
  • Pain is disabling

Migraine Triggers

  • Hormone changes (menstrual migraine) & pregnancy
  • Foods: Alcohol, chocolate, MSG, aspartame (Equal), caffeine, aged cheeses
  • Stress
  • Environmental: changes in barometric pressure, altitude, or season
  • Sensory stimulation: bright light, sun glare, powerful scents
  • Physical exertion
  • Lack of sleep

Treatments

  • Abortive medications to stop the pain after the headache has started
  • Prophylaxis medications to prevent or reduce the incidence and severity of the headaches
  • Botox
  • Nerve blocks (trigeminal, occipital, cervical)
  • Identification and avoidance of triggers
  • Regular exercise
  • Quit smoking