Migraine

Migraines are complex neurological conditions that are often mistaken for regular headaches. While they can manifest as intense headaches, migraines are also characterized by additional symptoms such as nausea, sensitivity to light and sound, and visual disturbances. Uniquely, a migraine can occur without any headache at all. Migraines are unpredictable and can last from 4 to 72 hours, greatly affecting one's ability to work, study, or perform daily tasks. There are various types of migraines, including migraines with aura—featuring changes in vision, sensation, or speech—and those without aura, brainstem aura, retinal migraines, hemiplegic migraines, menstrual migraines, chronic migraines, and even abdominal migraines.

Causes

The exact cause of migraines is still not completely understood, though research is gradually shedding light on the condition. During a migraine, the brain undergoes specific changes, though the mechanisms remain under investigation. Genetics and environmental factors can increase the likelihood of experiencing migraines. Triggers vary among individuals and may include:

• Stress

• Changes in sleeping or eating habits

• Certain odors

• Hormonal changes, especially those linked to menstrual cycles

• Specific foods, such as chocolate, and beverages like alcohol

Keeping a headache diary can help identify personal triggers and patterns that might lead to migraines.

Symptoms

Migraine symptoms can vary greatly from person to person and from one episode to another. Common symptoms include:

• Headache pain, typically on one side of the head, though it can affect both sides and often worsens with physical activity

• Nausea and vomiting

• Sensitivity to light, sound, movement, or odors

• Vision changes like shimmering lights or blind spots

• Aura experienced by about one-third of sufferers, including visual disturbances, weakness, or tingling sensations in limbs, usually appearing within an hour before the headache starts

• "Prodrome" and "postdrome" phases, marked by mood swings, energy level changes, appetite alterations, and concentration or vision difficulties

Diagnosis

For those suspecting migraines, it is crucial to consult a healthcare professional for a proper diagnosis. This involves discussing your symptoms and medical history thoroughly. Keeping a headache diary is often recommended to monitor the frequency and pattern of the migraines. Usually, imaging tests and blood tests are unnecessary unless ruling out other potential headache causes is required.

Treatments

Migraine management involves both medication and lifestyle changes. Healthcare professionals have developed the SEEDS guide to help remember vital lifestyle adjustments:

• Sleep: Get adequate, quality rest.

• Exercise: Engage in physical activity 3 to 5 times a week for 30 to 60 minutes.

• Eat: Consume regular, nutritious meals, stay hydrated, and keep caffeine consumption low or stable.

• Diary: Maintain a migraine diary to track instances and treatment responses.

• Stress: Participate in stress-reduction activities, such as cognitive behavioral therapy (CBT), mindfulness, and relaxation techniques.

Alternative therapies, including acupuncture, may help reduce attack frequency. Behavioral techniques like CBT or biofeedback can be beneficial. Supplements like Magnesium, Riboflavin, and Coenzyme Q10 have shown promise in prevention. Neurostimulation devices may also be an option in treating or preventing migraines.

Medications

Medications play a crucial role in managing migraines. Here's a look at the options:

• Acute Migraine Medications: Used at the first sign of a migraine, these are most effective early:

• Over-the-counter options, such as Ibuprofen and Acetaminophen

• Prescription medications, including triptans and newer treatments targeting calcitonin gene-related peptide (CGRP)

• Preventive Migraine Medications: Aimed at reducing the frequency or severity of migraines:

• Antidepressants

• Beta blockers

• Antiepileptics

• CGRP monoclonal antibodies and receptor agonists

• Botox Injections: Approved by the FDA for chronic migraines (headaches on more than 15 days per month with at least 8 being migraines)

Preventive medications, including CGRP inhibitors and Botox, require a prescription from a healthcare provider.