By Spoorthi Velagapalli, MD ***
Migraines affect approximately 15 percent of the general population. The headaches typically appear between the ages of 10 and 46, but may also occur later in life even if the individual has no history of such headaches.
A migraine is often accompanied by nausea, vomiting or sensitivity to light or sound. Severe migraines can be pulsating or throbbing. They can be debilitating but are not usually associated with a life-threatening condition. Often, they are worsened by physical exertion, sneezing or straining.
What triggers a migraine?
Migraines may be triggered by alcohol, allergic reactions, bright lights, certain odors or perfumes, changes in hormone levels (which can occur during a woman’s menstrual cycle or with the use of birth-control pills), inadequate sleep or changes in sleep patterns, exercise, loud noises, physical or emotional stress, and exposure to cigarette smoke. Certain foods and food preservatives (such as aspartame, tyramine and nitrites) can also spark migraines in some people.
Why does a migraine happen?
Scientists used to believe migraines were due to changes in blood vessels within the brain. Today, the evidence indicates that the attacks actually begin in the brain itself, involving changes in various nerve pathways and chemicals that affect blood flow in the brain and surrounding tissues.
Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant, especially during the last two trimesters of pregnancy. These headaches also can worsen in severity during peri-menopause but improve after menopause.
What is an aura?
Some people experience a warning symptom, called an aura, before the actual headache begins. An aura is usually vision disturbances but can also present as numbness, weakness or speech problems that last from five to 25 minutes.
What should you do about migraines?
Talk with your doctor if you experience recurring migraines. During diagnosis, your physician may ask about your symptoms and family history. A complete physical exam also may be performed to determine if your headaches are due to muscle tension, sinus problems or other issues.
Is there a cure?
There is no specific cure for migraines. The goal of treatment is to prevent them by helping you avoid or change your triggers. Rest, hydration and adequate sleep are also important. Mild migraines may be treated with over-the-counter medications like aspirin, ibuprofen, naproxen and acetaminophen that have been approved by your physician. Remember, too, that taking too much pain medication can prolong or worsen your headaches.
Spoorthi Velagapalli, MD, specializes in primary care and internal medicine at the Virginia Mason Clinic in Bellevue. Phone: (425) 637-1855.