Headaches are a common cause for visits to a doctor, and headache pain has consistently been one of the leading reasons for visits to the emergency room for years. One common and severe cause of headaches is a migraine headache.
Migraine headaches approximately affect up to 25% of women and up to 10% of men. These types of headaches are characterized by a moderate to severe head pain and may present with a wide variety of symptoms. The mnemonic “POUND” can be used to remember the most common symptoms that distinguish migraines from other causes of headache. It stands for the following:
· “P”-pulsatile sensation of the headache
· “O”-one day duration (typically)
· “U”-unilateral (confined to one side of the head)
· “N”-nausea and/or vomiting typically accompany the headache
· “D”-disabling, affecting the ability to function
Other than these symptoms, patients may notice worsening of the headache during physical activity (such as walking, climbing stairs, etc.), sensitivity to light and sounds, or sensory symptoms called an aura. The aura can take the form of speech changes, numbness in the arms/legs, or even vision changes such as flickering lights or spots in your vision.
There are many things that can trigger a migraine headache. These include hormone changes for women (during their menstrual cycle or with menopause), caffeine and alcohol use, stress, foods (processed foods, food additives such as artificial sweetener), weather/temperature changes, and changes to your sleep pattern (too much or too little).
If you have a migraine, there are many available treatments. If the headache is mild, frequently over the counter medications such as acetaminophen (Tylenol) and the anti-inflammatory medications ibuprofen or naproxen can help. Other at home treatments that may be helpful include using ice packs/heat packs on your head or neck, finding a quiet and dark room to relax in, and trying to sleep.
If the headache is more severe, you will need to have your doctor evaluate you. After making sure the headache is not from another serious cause, your doctor may recommend medications more specific for migraines. These might include a class of medications called triptans, which cause constriction of blood vessels and decrease the release of inflammatory chemicals that cause migraines. Other newer medications (calcitonin gene related peptide antagonists) are now available that block different proteins involved in migraine and may be more effective for some patients. If an emergency room visit is necessary for treatment, IV medications are available for treatment.
If you find yourself having frequent migraines, changes in your lifestyle can be helpful in migraine prevention. Keeping a headache diary of the things that you did or ate prior to a migraine happening can help you identify the things that are triggering your headache. Avoidance of those triggers may prevent future headaches. In addition, sleeping on a consistent schedule, exercising regularly, reducing stress, and eating healthy are helpful, not just for migraines, but for your overall health.
If your migraines are happening more frequently than several times a month, and you are not experiencing improvement with the above recommendations, your doctor may prescribe medications for migraine prevention. Taken daily, these medications may reduce migraine frequency and severity.
As always, see your physician if you think you are having migraines to obtain a diagnosis and to discuss treatments that are best for you.
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