The Coast News Group
Scripps Health Watch

Knowing signs & triggers of migraines can help optimize treatment

In the United States, nearly 30 million people suffer from the excruciating and often debilitating pain of migraine headaches. For many, the pain lasts for several days and is disruptive to daily activities.Migraines are more common in women than men, as up to 30 percent of women report having them. Also, they appear to have a genetic component, as two-thirds of patients say migraines run in their family. Yet as common as these headaches may be, fewer than half of sufferers are aware that their headaches are in fact migraines. Many people mistake them for severe tension headaches or sinus headaches, and don’t seek proper medical treatment.The ID Migraine™, a simple three-question test developed by a team of migraine researchers, has been shown to effectively identify migraine sufferers. People who answer yes to at least two of the following questions most likely have a migraine:

Has a headache limited your activities for a day or more in the last three months?

Are you nauseated or sick to your stomach when you have a headache?

Does light bother you when you have a headache?

In addition to nausea and sensitivity to light, migraineurs may have neurological symptoms known as auras. Shortly before the headache sets in, about fifteen percent of patients experience flashing lights, broken or kaleidoscope-like vision, garbled speech, muscle weakness, numbness or balance problems.

Mild migraines can be successfully treated with over-the-counter pain relievers such as aspirin, acetaminophen or non-steroidal anti-inflammatory (NSAID) medications. Read the labels; some products marketed specifically for migraine headaches have exactly the same ingredients as the regular version but may cost more.

If over-the-counter medications aren’t effective, the next step is to see a headache specialist, such as a neurologist, who can treat the problem with prescription medication if needed.

Professional treatments are either abortive or preventive. Abortive treatments aim to stop the pain once the migraine has begun; they may be taken as pills, injections or nasal spray. Until recently, opiates such as oxycodone or hydrocodone were commonly prescribed for migraine, but these drugs have a significant risk of misuse or overuse, and can lead to a progression of more frequent and difficult-to-treat headaches. Triptans, another type of abortive medication, specifically target serotonin and generally work very quickly.

Preventive medications aim to reduce the frequency of migraines by stopping them before they start. These include beta-blockers, calcium channel blockers, antidepressants and anti-seizure medications.

In 2010, the FDA approved Botox injections to help prevent migraine headaches in adults. When administered by physicians every 12 weeks or so, Botox has been shown effective in reducing the frequency of migraine headaches by up to 70 percent.

Knowing what might trigger a migraine can help prevent one. Common factors include stress, dehydration, weather changes, strong odors and bright lights. Dietary triggers include red wine, monosodium glutamate (MSG), excessive caffeine, preserved meats with nitrates and nitrites, and foods that contain tyramine, such as aged cheeses. Keeping a log of headaches and potential triggers can help identify the culprits.