Approximately 45 million Americans suffer from episodic headaches, and of them, 28 million meet the diagnostic criteria for migraine.
Dr. Elizabeth Minto, assistant professor of neurology at the University of South Alabama College of Medicine and a neurologist with USA Physicians Group, says that migraines can be debilitating. Migraines affect the U.S. economy by more than $40 million every year due to missed work and decreased productivity.
For many, it is difficult to distinguish between a “normal” headache and a migraine. According to Dr. Minto, the pain and symptoms of a migraine headache are different than those of a routine headache, such as a tension headache.
“A tension headache tends to be more of a dull, constant pain,” she said, “usually a 2-3/10 in intensity”. “But a migraine causes intense throbbing and sensitivity to the environment, such a light, sound, or activity. With a migraine, you sometimes can’t go on with your normal routine.”
According to Dr. Minto, a migraine is a headache that lasts from four to 72 hours and has at least two of the following qualities:
• Unilateral location (on one side of the head)
• Pulsating or throbbing quality
• Moderate to severe pain intensity
• Aggravated by exertion
Migraines are also associated with sensitivity to smell or sound, as well as nausea or vomiting. Some migraines are preceded or accompanied by sensory warning symptoms (aura), such as flashes of light, blind spots, or tingling in an arm or leg.
Dr. Minto said it is important to understand that a migraine is a vascular headache. “It’s triggered by a vascular change in the brain,” she said. “A blood vessel becomes dilated and causes chemicals to be released and spread. That’s why migraines escalate the way they do.”Although migraines can happen to anyone, Dr. Minto said they are typically more common in women. They also tend to occur in members of the same family.
A non-prescription way to ease the symptoms of a migraine, said Dr. Minto, is to lie down in a dark room and take a nap. “Typically, sleep will help break a migraine,” she said. “There is also some evidence that over-the-counter herbal supplements such as butterbur and feverfew can help prevent migraines from occurring as frequently.”
But to treat the cause of a migraine – not just alleviate the symptoms – a variety of medications are available, safe, and effective.
Dr. Minto said most of the prescription medicines that can stop a migraine work by constricting blood vessels. “Just taking Tylenol doesn’t typically help a migraine,” she said. “Excedrin works well because it has caffeine in it, which can help to reverse the dilation of blood vessels in the brain.” In addition, Triptans – a class of prescription drugs – specifically help to stop a migraine once it starts.
Preventive medications are also available and can be taken on a daily basis to reduce the severity and frequency of migraines. Daily preventative medications are recommended for those patients that suffer from migraines more often than once a week on average.
You may be able to prevent migraine attacks or diminish their frequency if you understand what specifically triggers them. According to Dr. Minto, certain things are thought to trigger migraine attacks in some people. “A lot of people have noticed that chocolate, aged cheeses and alcohol – especially wine – can trigger migraines because of the chemicals they contain.”
Keeping a headache diary can help you identify and monitor the possible migraine triggers you encounter. “Once your particular headache pattern is documented, you and your doctor can modify your treatment and lifestyle appropriately,” Dr. Minto said. She suggests noting the date of the migraine, how long it lasted, what it felt like, and what medicines you took for it.
According to Dr. Minto, if you are getting headaches or taking medications more than once a week, you should consider seeing a neurologist.
A neurologist will complete a detailed history and perform a physical exam, as well as look for red flag symptoms accompanying your headaches, to see if imaging of the head might be indicated. These red flag symptoms include focal neurological symptoms such as loss of vision, going weak or numb on one side; losing consciousness or having seizures, numbness, or a headache that worsens and doesn’t go away for more than a few days.
For more information on migraines, click here.
To make an appointment with Dr. Minto, call (251) 660-5108.