A migraine headache is usually an intense, throbbing pain on one, or sometimes, both sides of the head. Most people with migraine headache feel the pain in the temples or behind one eye or ear, although any part of the head can be involved. Besides pain, migraine also can cause nausea and vomiting and sensitivity to light and sound. Some people also may see spots or flashing lights or have a temporary loss of vision.
Types of migraine
The two forms seen most often are migraine with aura and migraine without aura.
Migraine with aura – classical migraine.
With a migraine with aura, a person might have these sensory symptoms (the so-called “aura”) 10 to 30 minutes before an attack:
• Seeing flashing lights, zigzag lines, or blind spots
• Numbness or tingling in the face or hands
• Disturbed sense of smell, taste, or touch
• Feeling mentally “fuzzy”
Only one in five people who get migraine experience an aura. Women have this form of migraine less often than men.
Migraine without aura -common migraine.
You seek medical advice if you have:
• You have several headaches per month and each lasts for several hours or days
• Your headaches disrupt your home, work, or school life
• You have nausea, vomiting, vision, or other sensory problems such as numbness or tingling
• You have pain around the eye or ear
• You have a severe headache with a stiff neck
• You have a headache with confusion or loss of alertness
• You have a headache with convulsions
• You have a headache after a blow to the head
• You used to be headache-free, but now have headaches a lot
Treatment of Migraine
Medicine. There are two ways to approach the treatment of migraines with drugs: stopping a migraine in progress called acute treatment and prevention. Many people with migraine use both forms of treatment.
Acute treatment. Over-the-counter pain-relief drugs such as aspirin, acetaminophen, or NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen relieve mild migraine pain for some people. If these drugs don’t work for you, try
Two classes of drugs that doctors often try first are:
• Triptans, which work by balancing the chemicals in the brain. Examples include sumatriptan , zolmitriptan etc. Triptans can come as tablets that you swallow, tablets that dissolve on your tongue, nasal sprays, and as injections. They should not be used if you have heart disease or high blood pressure.
• Ergot derivatives (ergotamine tartrate and dihydoergotamine), which work in the same way as triptans. They should not be used if you have heart disease or high blood pressure.
Prevention. Some medicines used daily can help prevent attacks.
• Antidepressants, such as amitriptyline
• Anticonvulsants, such as divalproex sodium
• Beta-blockers, such as propranolol
• Calcium channel blockers, such as verapamil
These drugs may not prevent all migraines, but they can help a lot.
Lifestyle changes. Practicing these habits can reduce the number of migraine attacks:
• Avoid or limit triggers.
• Get up and go to bed the same time every day.
• Eat healthy foods and do not skip meals.
• Engage in regular physical activity.
• Limit alcohol and caffeine intake.
• Learn ways to reduce and cope with stress.
Alternative methods. Biofeedback has been shown to help some people with migraine. It involves learning how to monitor and control your body’s responses to stress, such as lowering heart rate and easing muscle tension. Other methods, such as acupuncture and relaxation, may help relieve stress. Counseling also can help if you think your migraines may be related to depression or anxiety. Some people find the following useful: a cold cloth on your head, rubbing or applying pressure to the spot where you feel pain, and massage or other relaxation exercises.
• If you take migraine medicine, take it right away.
• Drink fluids, if you don’t have nausea during your migraine.
• Lie down and rest in a dark, quiet room, if that is practical.
Women who use acute pain-relief medicine more than two or three times a week or more than 10 days out of the month can set off a cycle called rebound headache. As each dose of medicine wears off, the pain comes back, leading the patient to take even more. This overuse causes your medicine to stop helping your pain and actually start causing headaches. Rebound headaches can occur with both over-the-counter and prescription pain-relief medicines. They can also occur whether you take them for headache or for another type of pain.