Your Health

Migraine Headaches

What are migraine headaches?

Migraine headaches are severe, recurring headaches that usually affect one side of the head and are often accompanied by symptoms such as nausea and vomiting. While they are painful, migraines are not life threatening. In most cases, treatment can reduce the frequency and severity of migraines.

What are the symptoms?

Most migraine headaches fall into two categories: common migraines and classic migraines.

Common migraines

Common migraines account for over 80% of all migraine headaches. People with common migraines usually feel severe, throbbing pain on one side of the head, although the pain may occur on both sides. Other common symptoms include nausea, vomiting, and visual sensitivity to light. Some people may feel weak or have difficulty talking and some get diarrhea. Common migraines often start upon waking in the morning and may last for several days.

Classic migraines

Classic migraines account for approximately 15% of all migraines. Symptoms are similar to common migraines, but episodes generally start with an aura. Auras may consist of a combination of visual and other sensory symptoms. Visual sensations may include flashing lights, slowly spreading blind spots, or geometric patterns such as zigzag lines. Other sensations may include numbness or tingling in the arms and legs. The headache usually starts 15–30 minutes after the aura ends. Classic migraine episodes last about six hours.

What triggers migraines?

Intense stress or emotional distress may trigger migraines. An episode may even start when you relax following a major task or intense work. For some women, menstrual hormones cause monthly migraine episodes, typically just before or during their periods.

Other factors that may trigger migraines include:

  • irregular work hours or social events
  • irregular eating habits (for example, skipping meals)
  • lack of sleep or sleeping later than normal
  • intense or sudden physical exertion
  • travel
  • changes in weather or atmospheric pressure
  • tobacco smoke (including second-hand smoke)
  • bright or flickering lights

Foods

Certain foods trigger episodes in as many as 25% of migraine sufferers. These foods include:

  • alcohol (particularly beer and red wine)
  • chocolate
  • caffeine
  • aspartame
  • monosodium glutamate (MSG)
  • tyramine (a natural chemical found in foods such as yogourt, sour cream and aged cheeses)
  • nitrates
  • nuts

Medications

Certain medications such as birth-control pills and some heart medications (for example, nitroglycerin) may trigger episodes. Some pain medications may cause chronic daily migraine headaches (rebound migraines) if used too frequently (more than four days a week).

What are the risk factors?

Approximately one in six Canadians get migraine headaches. Migraines affect three times as many women as men. You are more likely to experience migraines if you have a parent or sibling with migraines.

How is it diagnosed?

A doctor can diagnose migraines by asking about symptoms and performing a physical exam. Your doctor may order tests to rule out other types of headaches.

How can I prevent migraines?

The best way to prevent migraines is to avoid triggers. You can identify your triggers by keeping a daily diary as part of your overall prevention and treatment plan. Try to figure out the kinds of triggers that precede your migraine episodes.

How can I treat migraines?

Your prevention and treatment plan should include lifestyle modifications and medications that help you deal with your migraines. Work with your doctor or Peoples pharmacist to find the techniques and medications that are best for your situation. Know your triggers. Even if you can’t prevent your migraines entirely, you should be able to reduce their frequency and intensity.

When you do get a migraine, try the following strategies:

  • Apply a cold cloth or ice pack to your head.
  • Rest in a quiet, dark room.
  • Sleep.

Lifestyle modifications

Making adjustments in your lifestyle (for example, getting enough sleep or avoiding alcohol) can help you eliminate the triggers you have identified in your daily diary. If your episodes start occurring more often or last longer, refer back to your diary and reconsider possible triggers. If this does not help, work with your doctor to adjust your treatment plan. Also, check with your doctor if the type of episodes you experience changes — you may be developing a different type of headache. This is especially important if you are over 50 because serious types of headaches are more common at that stage of life.

Medications

Migraine medications fall into two categories: symptom relief and prevention. It is important to use medications properly. If you use too little they may not be effective. If you use too much they may be dangerous or even make your migraines worse. Ask your Peoples pharmacist about the best way to use your medications.

Symptom-relief medication

Pain relievers only work if you take them as soon as you start getting a migraine. The following medications have been found to be effective:

  • mild migraines - ASA, ibuprofen or acetaminophen
  • moderate migraines - a combination of acetaminophen and caffeine or ASA and caffeine
  • more severe migraines - acetaminophen with codeine or ASA with codeine

If you experience nausea, dimenhydrinate (Gravol) can help control it. You can get dimenhydrinate from your Peoples pharmacist without a prescription. If it doesn’t work, ask your doctor about stronger prescription medications.

You may be able to stop some migraines with prescription medications such as ergotamine or 5-HT receptor agonists. Ask your doctor or Peoples pharmacist if these medications may be appropriate for you. Your doctor can prescribe them as oral tablets, nasal sprays, or injections.

Prevention medication

Some people experience frequent migraines (more than three a month) that don’t respond to treatment or have migraines that interfere with their ability to function. Daily prescription medications such as propranolol or naproxen can decrease migraine frequency.

Treating emergency migraines

If you experience a particularly bad migraine, you may need to visit a hospital or clinic for emergency medications.

Where can I find out more about migraines?

For more information about your medications or other health issues:

  • talk to your Peoples pharmacist
  • read People First, a health magazine of practical information available free from your local Peoples Drug Mart or Peoples Pharmacy

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