Migraines and Headaches: Types, Relief, Treatment

Introduction

Migraine is a chronic neurological disease characterized by recurrent moderate to severe headaches, often in association with a number of autonomic nervous system symptoms. Typically, the headache affects one half of the head, is pulsating in nature, and lasts from 2 to 72 hours. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. Physical activity generally worsens the pain.

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Many people who have migraines experience pain in their temples, or behind an eye or ear; there is potential for any part of their head to be involved. Migraines may cause additional symptoms such as nausea, vomiting, and sensitivity to sound or light. Some people who experience migraines also see flashing lights, spots, or experience a temporary loss of vision.

A person may experience a migraine at any point during the day, although they often start in the morning. The pain associated with a migraine may last from a few hours up to a couple of days. Some people experience migraines as frequently as once or twice a week, while others only get them once or twice annually. Migraines are not usually a threat to the person's overall health, although they can interfere with everyday living. The causes of migraines are not known at this time, although there are some things that are more common in people who experience them. Migraines commonly affect people between the ages of fifteen and fifty-five who have a family history of them. They are more common in women than men, and they tend to become less severe and frequent as people age.

Difference Between Headache and Migraine

A, 'Tension Headache,' differs from a Migraine in that it is less severe and is rarely disabling. Tension headaches present mild-to-moderate pain, are distracting but not debilitating, present a steady ache, and may involve one side of the person's head. Migraines may also have mild-to-moderate pain, but can also involve moderate-to-severe pain. Tension headaches can involve both sides of a person's head, but rarely include a sensitivity to sounds or light, nausea, or vomiting.

Migraines present intense, pounding or throbbing pain that is debilitating with a steady ache. Migraines may also involve one side of a person's head. Migraines can involve both sides of a person's head, and can involve sensitivity to sounds or light, nausea, or vomiting. Things such as stress and fatigue can start either a tension headache or a migraine. Both of these types of headaches can also be triggered by changes in a person's body hormone levels, certain foods, or even changes in the weather.

Headaches respond differently to treatment with medications. While there are some over-the-counter medications that are used to treat tension headaches that may assist with migraines, the drugs that are often used to treat migraines do not work in treating tension headaches for the majority of people. Telling the difference between a tension headache and a migraine cannot be achieved by the frequency of their occurrence. Both types of headaches may happen at irregular intervals. In rare instances, both forms of headaches can occur on a daily or almost daily basis.

Is it a Migraine or a Sinus Headache?

Some people mistake a sinus headache for a migraine due to the pressure and pain on their sinuses, as well as the watery eyes they experience and the nasal congestion. There are some questions that can help to differentiate between the two types of headaches:

• Is the pain moderate-to-severe
• Am I experiencing any nausea
• Am I experiencing any sensitivity to light

If the answer to two or more of these questions in addition to experiencing the sinus symptoms is, 'yes,' then you most likely have a migraine with sinus symptoms. True sinus headaches are rare and usually occur with a sinus infection. Sinus infections commonly present in addition with additional symptoms such as thick nasal secretions which are green, yellow, or blood-tinged, and a fever. Sinus headaches frequently go away when treatment for an associated sinus infection is received.

When to Seek Help

There are times when a headache can be a signal of a more serious issue. Contact a doctor if your headache disrupts your work, school life, or home life, or if you have had several headaches each month and each of them lasts several hours or days. You should also contact a doctor if you experience nausea, vomiting, numbness, tingling, loss of vision or other sensory problems in association with the headaches you have. If you have pain around your ear or eye, have a severe headache with a stiff neck, experience a headache with confusion or a loss of alertness, or one with convulsion - definitely contact a doctor. If you have a headache after experiencing a blow to the head, or you used to be headache-free but now have numerous headaches, be sure to contact a doctor.

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Types of Migraines

Migraines are classified by the types of symptoms a person experiences in association with them. The two most common types of migraines that people experience are, 'Migraine With Aura' and 'Migraine Without Aura.' Other, less common, types of migraines include, 'Abdominal Migraine', 'Basilar Artery Migraine', 'Cartidynia', 'Headache-Free Migraine', 'Ophthalmoplegic Migraine/Ocular Migraine', and 'Status Migrainosus'. There are some women who experience migraines either before or during menstruation; these migraines are referred to as, 'Menstrual Migraines.' Menstrual migraines could be related to hormonal changes. Many women who have experienced menstrual migraines do not experience them during pregnancy, or experience migraines less often, while other women experience migraines for the first time during pregnancy, or after menopause.

• Migraine with Aura: Characterized by a neurological phenomenon (aura) that is experienced ten to thirty minutes before the headache. Most auras are visual and are described as bright shimmering lights around objects or at the edges of the field of vision or zigzag lines, castles, wavy images, or hallucinations. Others experience temporary vision loss. Non-visual auras include motor weakness, speech or language abnormalities, dizziness, vertigo, and tingling or numbness of the face, tongue, or extremities.
• Migraine without Aura: The most prevalent type and may occur on one or both sides of the head. Tiredness or mood changes may be experienced the day before the headache. Nausea, vomiting, and sensitivity to light often accompany migraine without aura.
• Abdominal Migraine: Most common in children with a family history of migraine. Symptoms include abdominal pain without a gastrointestinal cause (may last up to 72 hours), nausea, vomiting, and flushing or paleness. Children who have abdominal migraine frequently develop typical migraine as they age.
• Basilar Artery Migraine: Involves a disturbance of the basilar artery in the brain stem. Symptoms include severe headache, vertigo, double vision, slurred speech, and poor muscle coordination. This type occurs primarily in young people.
• Carotidynia: Also called lower-half headache or facial migraine, produces deep, dull, aching, and sometimes piercing pain in the jaw or neck. There is usually tenderness and swelling over the carotid artery in the neck. Episodes can occur several times weekly and last a few minutes to hours. This type occurs more commonly in older people.
• Headache-free Migraine: Characterized by the presence of aura without headache. This occurs in patients with a history of migraine with aura.
• Ophthalmoplegic Migraine: Begins with a headache felt in the eye and is accompanied by vomiting. As the headache progresses, the eyelid droops and nerves responsible for eye movement become paralyzed. Ptosis may persist for days or weeks.
• Status Migraine: A rare type involving intense pain that typically lasts longer than seventy-two hours. The patient may require hospitalization.

Causes of Migraines

Researchers into the causes of migraines believe that they are due to abnormal changes in levels of substances which are naturally produced in a person's brain. Then the levels of these substances are increased, they may cause inflammation, resulting in blood vessel swelling. Swollen blood vessels then press on nearby nerves, causing pain. Still, the exact causes of migraines remains unknown. Genetic involvement has also been linked to migraines. Persons who experience migraines may have genetic factors that control functions of their brain cells associated with migraines.

What is known is that persons who do experience migraines react to various factors and events, referred to as, 'triggers.' These triggers vary depending on the individual and do not always lead to a migraine. Combinations of triggers, not necessarily a single one, are more likely to initiate a migraine. An individual's response to triggers can also vary between migraines. People who experience migraines have found that they may be triggered by numerous things. These triggers include:

• Lack of or too much sleep
• Skipped meals
• Bright lights, loud noises, or strong odors
• Hormone changes during the menstrual cycle
• Stress and anxiety, or relaxation after stress
• Weather changes
• Alcohol (often red wine)
• Caffeine (too much or withdrawal)
• Foods that contain nitrates, such as hot dogs and lunch meats
• Foods that contain MSG (monosodium glutamate), a flavor enhancer found in fast foods, Broths, seasonings, and spices
• Foods that contain tyramine, such as aged cheeses, soy products, fava beans, hard sausages, Smoked fish, and Chianti wine
• Aspartame (NutraSweet and Equal)

Keeping a diary of the things that trigger a migraine, as well as additional things, can help you to work with your doctor to treat them. In a diary, you should track:

• The time of day your headache started
• Where you were and what you were doing when the migraine started
• What you ate or drank 24 hours before the attack
• Each day you have your period, not just the first day (This can allow you and your doctor to See if your headaches occur at the same or similar time as your period.)

Facts and Statistics

In the United States direct costs have been estimated at $17 billion, Nearly a tenth of this cost is due to the cost of triptans. Including $15 billion in indirect costs, of which missed work is the greatest component. In those who do attend work with a migraine, effectiveness is decreased by around a third. Negative impacts also frequently occur for a person's family.

• Migraines are more common in women at 19% than men at 11%.
• Chronic migraines occur in approximately 1.4 to 2.2% of the population.
• During perimenopause symptoms often get worse before decreasing in severity.
• Rates of migraines are slightly lower in Asia and Africa than in Western countries.
• While symptoms resolve in about two thirds of the elderly, in between 3 and 10% they persist.
• Globally, approximately 15% of the population is affected by migraines at some point in life.
• In women migraines without aura are more common than migraines with aura, however in men the two types occur with similar frequency.
• In the United States, about 6% of men and 18% of women get a migraine in a given year, with a lifetime risk of about 18% and 43% respectively.
• In Europe, migraines affect 12 to 28% of people at some point in their lives, with about 6 to 15% of adult men and 14 to 35% of adult women getting at least one yearly.
• In children, about 1.7% of 7-year-olds and 3.9% of those between 7 and 15 years have migraines, with the condition being slightly more common in boys before puberty.

Discussions with your doctor about the triggers of the migraines and additional information concerning them will help your doctor to determine the appropriate treatment for you. Knowing the things to avoid triggering a migraine will help you to prevent known triggers. Awareness of the differences between the types of headaches and additional information can help you to stay as migraine and headache-free as possible.

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