How can I tell if I'm getting a migraine headache? Are there any effective treatments available?

Answers (3)

Dr. Andrea Ruman, MD (Internist) answered (10/14/2010)

A migraine headache is a group of neurological symptoms that usually includes a severe, recurring, intense, throbbing pain on one side of the head that can be very debilitating. Attacks can last between 4 and 72 hours. The actual headache is commonly accompanied by one or more of the following symptoms: visual disturbances, nausea, vomiting, dizziness and extreme sensitivity to sound, light, touch and smell.

Most often, migraines affect people between the ages of 15 and 55, and are most common in women between the ages of 20 and 45. They're usually first diagnosed in people in their 20s and 30s.

Initially it was believed that migraines were caused by the dilation and constriction of blood vessels in the head. But new research suggests that a migraine is actually a disorder involving nerve pathways and brain chemicals.

There are two ways to approach the treatment of migraines with drugs: relieving migraine symptoms as they occur (called "abortive" or "acute" treatment) and prevention. Many people with migraines use both forms of treatment. Over-the-counter (OTC) medications like aspirin, acetaminophen, NSAIDs (like ibuprofen), or a combination of all three, may relieve mild migraine pain for some people. If these OTC medications don't work, then prescription medications called "triptans" may be effective as they can help abort/stop a migraine and its symptoms during the attack (though they shouldn't be used if you have heart disease or high blood pressure).

For people who experience frequent migraines (i.e. four or more a month), preventative treatments may be helpful to reduce the number of attacks and lessen the intensity of their pain. Common medications include topamax, propranolol and elavil. These medications must be taken daily in order to prevent the onset of a migraine headache. Also, Botox (Botulinum toxin type A) is sometimes used for treatment of chronic migraines. Studies have had mixed results with respect to effectiveness; however, some headache specialists believe that it can be helpful for some people.

For some people, infrequent migraines can progress to chronic daily attacks, particularly with overuse of OTC and prescription headache medications. To prevent your occasional migraines from becoming a persistent pounding headache, avoid using painkillers and triptans more than two to three days per week on a weekly and indefinite basis. If you're having daily headaches, see your doctor.

If you think you have migraines, check out other risk factors associated with the headaches here

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Jonathan Lopez, MD (Neurologist) answered (6/16/2012)

Both of the above answers are great. As many of us with migraines have experienced, migraine is so much more than "just a headache". The most frequent other symptom reported is nausea. For me and many of my patients, the nausea is actually worse than the headache. Sometimes it is so intense that it causes someone having a migraine to vomit. Other common symptoms include feeling intensely bothered by light, sounds, or smells. If you don't have any of the above symptoms, you probably have some other type of headache. There is often a "prodrome", or a set of symptoms that occurs before the headache. While the headache often lasts a few hours to a few days, symptoms of dizziness, nausea, and general ickiness can occur up to 24-48 hours in advance of a headache. Then, anywhere from about an hour before the headache to soon after it starts, some people experience other unusual feelings, such as vision changes, numbness, tingling, or weakness on one side of their body or face, dizziness, and sometimes even confusion. If you experience any of those symptoms with your headaches, if you have any new symptoms, or if your headaches are so frequent or intense that they are interfering with your work or personal life, you should definitely discuss it with a doctor. The treatment process begins by trying to identify anything that might be triggering your headaches, such as stress, lack of sleep, smoking, strong smells, or foods (chocolate and cheese are two big culprits). Sometimes, as Peggy points out, avoiding these things can help you avoid having to take medicine to prevent your headaches or stop them once they have started.