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: