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Migraine headaches

A migraine is a severe headache with symptoms that may include a throbbing pain affecting the front or side of the head, nausea, vomiting and light sensitivity.

Each migraine can last from four hours to three days.

Migraines are common, affecting around one in every five women and around one in every 15 men in the UK.

What causes migraine headaches?

The exact causes of migraine headaches are unknown, but the headaches are linked to changes in the brain as well as to genetic causes. Experts believe that migraines may be caused by inherited abnormalities in certain areas of the brain. People with migraines may inherit the tendency to be affected by certain migraine triggers including fatigue, bright lights and weather changes. Additional possible triggers include:

  • Emotional stress
  • Sensitivity to specific chemicals and preservatives in food. Certain foods, beverages and food additives may be responsible for triggering up to 30% of migraines. Mature cheeses, alcoholic beverages, nitrates (sometimes found in processed meats), and monosodium glutamate (MSG) have been linked to migraines.
  • Caffeine. Excessive caffeine consumption or withdrawal from caffeine can cause headaches when the caffeine level abruptly drops. The blood vessels seem to become sensitised to caffeine. When caffeine is not ingested, a headache may occur. Caffeine itself is often helpful in treating acute migraine attacks.
  • Changing weather conditions. Storm fronts, barometric pressure changes, strong winds and altitude changes have been linked to migraines.
  • Menstrual periods
  • Tension
  • Excessive fatigue
  • Skipping meals
  • Changes in usual sleep patterns

What are the symptoms of migraines?

The pain of a migraine can be described as a pounding or throbbing. The headache often begins as a dull ache and develops into a throbbing pain. The pain is usually aggravated by physical activity. Migraine pain can be classified as mild, moderate, or severe. Some other associated symptoms of migraine headaches include:

Types of migraines

There are several types of migraine headaches, including:

  • Migraine with aura: This type is usually preceded by an aura. Most often, an aura is a visual disturbance (outlines of lights or jagged light images).
  • Migraine without aura: This type accounts for 80% of migraine headaches. There is no aura before the migraine headache.
  • Status migrainosus: This is the term used to describe a long-lasting migraine that does not go away on its own.

How are migraines treated?

People with migraine headaches can manage mild-to-moderate attacks at home with the following strategies:

  • Applying a cold compress to the area of pain
  • Resting with pillows comfortably supporting the head or neck
  • Drinking a moderate amount of caffeine
  • Trying certain over-the-counter headache medications
  • Resting in a room with little or no sensory stimulation (light, sound, odours)
  • Withdrawing from stressful surroundings
  • Sleeping

When these efforts do not help, migraine headaches may be eased with prescription medications. Migraines can be treated in two ways: with abortive therapy or preventive therapy.

The goal of abortive therapy is to prevent a migraine attack or to stop it once it starts. Some abortive therapies include:

Analgesics like ibuprofen and paracetamol. Anti-emetic medication may be required.

Triptans (5HT1 agonists) reverse the widening of blood vessels that is believed to cause the headache and include almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan and zolmitriptan.

Ergot alkaloids like ergotamine tartrate.

Preventive treatments are considered if migraine headaches occur more than once a week. These medications are meant to lessen the frequency and severity of the migraine attacks. Preventive treatment medications include:

 

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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on August 05, 2016

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