Relief for the most misunderstood headache of all: the migraine
They've been torturing us for thousands of years. Galen, a Greek physician who lived around 150 AD, was the first person to describe the excruciating pain of a migraine. It is believed that Lewis Carroll, the author of Alice in Wonderland, experienced a rare pre-migraine syndrome that distorts an individual's world — where people and objects seem to get bigger and smaller, exactly as the characters appeared in Alice in Wonderland.
More common than you think
Symptoms
The first step is the right diagnosis
Getting relief
Headaches come in many shapes and sizes
Use your head when dealing with a severe headache
More common than you think
Today, 23 million Americans hang their heads in agony because of migraines, ruining their ability to work and enjoy life.
Manzoor Abidi, MD, chief of neurology, Virtua West Jersey Hospitals, says: "Contrary to popular belief, migraines are actually under diagnosed. Many people who think they are experiencing a sinus headache or an allergy headache are really having a migraine."
Symptoms
Part of the confusion is that migraine symptoms vary. Dr. Abidi says: "While it's true that a migraine can be a throbbing headache affecting one side of the head, only 25 to 30% of migraines occur this way. A migraine can also attack both sides of the head, and make the person sensitive to light and sound. Often, a migraine is accompanied by nausea and vomiting. All the sufferer wants to do is lie down in a cool, dark quiet room."
Migraines can affect children as young as age 4. And, more women than men experience them, often occurring at puberty when hormonal changes begin. There are also different types of migraines. A migraine with aura is when the sufferer experiences a warning that the migraine is coming on, like seeing flashing or zigzag lights. A migraine without aura is simply a migraine without the early warning.
The first step is the right diagnosis
Karen Scardigli, DO, Virtua neurologist explains: "Taking a detailed patient history is the key to making a correct diagnosis. Migraines run in families, so if a mother has them, chances are her child may too." The next step is to conduct a complete physical and, when appropriate, perform tests such as a CT scan (computed tomography), MRI (magnetic resonance imaging) or EEG (electroencephalography) to rule out more serious possibilities.
While physicians still don't know all the reasons a migraine occurs, they have uncovered some triggers. "We do know that lack of sleep or stress can cause one," says
Seth M. Keller, MD, Virtua neurologist, "and food is a common culprit - chocolate, red wine, and caffeine can trigger a real head-bender." Dr. Keller often recommends that patients keep a food diary to see which foods are associated with their headaches.
Migraine relief is a many-splendored thing
Fortunately, up to 90% of all people who suffer from migraines can be effectively treated. Treatment falls into three categories: lifestyle changes, symptomatic treatment, and preventative care. Lifestyle changes include avoiding food triggers as well as reducing stress and regulating the sleep cycle. Symptomatic treatments include over-the-counter migraine medications as well as new, highly specific prescription medications called "triptans."
Preventive medications are often recommended for individuals who suffer more than two migraines a week. Certain antidepressants and antiseizure medications, as well as beta blockers and channel blockers can help prevent the onset of a migraine.
Headaches come in many shapes and sizes
Headaches can also be the result of stress and tension, sinus problems, head injuries, and TMJ (temporomandibular joint dysfunction). Arthritic problems or a herniated disc can also cause them. Tension headaches are the ones most people experience. They are characterized by an aching and tight feeling in the forehead, and in the back of the head and neck. Over-the-counter aspirin, ibuprofen and acetaminophen can help relieve the pain.
Cluster headaches are also fairly common and produce a severe, throbbing pain in one eye and tend to occur in groups. Cluster headaches are often treated preventatively with medications such as calcium channel blockers, corticosteroids and lithium.
However, any continuous headache that persists for no apparent reason or intuitively strikes a person as out of the ordinary is a signal something may be wrong. To stay on the safe side, it's important to consult with a family physician or neurologist. As Dr. Abidi says: "I don't just treat the headache, I treat the whole person."
Use your head when dealing with a severe headache
Certain headaches require the immediate attention of a physician. If you or someone you know experiences any of the following symptoms, call your family physician or get to the nearest emergency room. If you are alone, call 911: You may be in no condition to drive and may need help immediately.
- A severe headache accompanied by slurring of words, confusion, blindness in one eye, nonsense talk, loss of memory or loss of strength in a limb.
- A headache that persists after a head injury.
- A severe headache that comes out of the blue and could be characterized as an incapacitating, terrible headache.
- A headache accompanied by a stiff neck and fever.
- A headache associated with visual field changes such a double vision or a decrease in peripheral vision.