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Classic migraines
begin 10-30 minutes before the arrival of the actual headache,
with a phenomenon known as an aura. People experiencing an aura
may feel pins and needles, have trouble speaking, have muscle
weakness, and commonly have visual disturbances — seeing
things such as flashing lights, zigzag lines, bright spots, or a
loss of part of their field of vision. Common migraines aren't
preceded by an aura, but people may experience some mental
fuzziness, mood changes, fatigue, and the unusual retention of
fluids beforehand.
Both types of migraine bring intense pain,
often along with an increased sensitivity to light. Migraine is
also sometimes accompanied by diarrhea, increased urination,
nausea and vomiting. The pain of a migraine usually lasts 1 to 2
days, but can last 3 or 4 days.
Researchers previously thought that migraines
were brought about by blood flow changes to the brain, but Dr.
Silberstein says that recent studies of blood flow don't support
this view. "Blood flow changes do occur in migraines,"
he says, "but it's not a disorder caused by blood
flow." One study last year found that the meninges, the
thin membranes surrounding the brain, are inflamed during a
migraine attack; scientists now believe that this is the source
of migraine pain. Exactly how this inflammation occurs is
unknown.
What is known is that migraines are triggered
in susceptible people by certain environmental factors: stress
and anxiety, diet, physical exertion, sleep extremes, head
trauma, and hormonal changes. Not everyone gets migraines from
these things, of course. Dr. Silberstein says that some people
seem to have a genetic predisposition to getting migraines. This
potential for getting migraines is then set off by something in
their environment.
Migraines usually begin between the ages of 5
and 35, and their peak prevalence is between the ages of 35 and
45. Some people can get as many as 10 migraines a month, but the
average is around 1.5 per month. Although athletic men such as
basketball's Kareem Abdul-Jabbar and football's Terrell Davis
have had migraines, they are more prevalent among women. Women
start getting migraines more than men after their first
menstrual period, highlighting the effect that hormones can have
on the condition. According to Dr. Silberstein, migraine occurs
in 4 percent of both boys and girls, 6 percent of men, and 18
percent of women. Menopause can reduce the incidence of
migraines, but hormone replacement therapy, which many women
undergo to counteract the effects of menopause, can increase
their incidence.
What to do
If you are a migraine sufferer, there are
several things you can do to combat your migraines. First, try
to maintain a regular routine, going to sleep and waking up at
the same time every day. Try to keep your caffeine intake
constant from day to day, including weekends. Exercise
regularly, quit smoking if you smoke, and try to identify any
environmental triggers that may bring on your headaches (see
box). Riboflavin (vitamin B2) is an often overlooked remedy for
migraine prevention, according to Dr. Silberstein. He says that
400 milligrams (mg) a day may begin to prevent migraines within
a couple of months.
During a migraine attack, using cold packs or
pressing on the bulging artery that is sometimes found in front
of the ear may provide temporary relief for some. There are also
several drugs that your doctor can recommend to prevent or treat
migraines. Dr. Silberstein cautions against taking too much
over-the-counter medicine for your headaches; that can actually
add to the problem by increasing the frequency of your
headaches. "If you have very frequent headaches," he
stresses, "you need help." — a report from The
NIH Word on Health, June 2000.
Is it a Migraine?
There are three general types of headaches:
| |
Migraine |
Tension |
Cluster |
| Characteristics: |
throbbing pain, often preceded by an
aura;
more prevalent in women |
steady ache |
severe, coming in groups over weeks or
months; mainly attack men |
| Pain in: |
one or both sides of head |
both sides of head |
one side of head, often centering around
one eye |
| Severity: |
mild, moderate or severe |
mild or moderate |
very severe |
| Other symptoms: |
may experience sensitivity to light,
sound, and odors; nausea; vomiting; diarrhea; visual
disturbances; fever, chills, aching, sweats |
no |
nasal congestion; drooping eyelid;
watery, teary eye |
Remember that headaches can also be caused by
underlying medical problems such as tumors or meningitis. Make
sure to see your health professional if your attacks:
- start after age 50
- are different or more severe than past
attacks
- are triggered by coughing or bending
- are linked to a stiff neck and fever
- are accompanied by blurred vision or
speech, or numbness, tingling or muscle weakness
- make it difficult for you to think or
remember
- cause severe vomiting
- follow a severe head injury
Sources: National Institute of Neurological
Disorders and Stroke, Food and Drug Administration, American
Medical Association
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