Migraine headaches remain something of a medical mystery, affecting about 12 percent of Americans, according to the National Institutes of Health and National Institute of Neurological Disorders and Stroke.
They can affect anyone, but the likelihood of suffering migraine headaches increases if you are a woman, have a family history of migraines or have other medical conditions such as depression, bipolar disorder, anxiety, sleep disorders or epilepsy.
There are a number of triggers for the condition, including stress, anxiety, hormonal changes in women, bright flashing lights, loud noises, strong smells, medicines, too much or not enough sleep, caffeine and foods.
Food triggers can include alcohol, chocolate, aged cheeses, monosodium glutamate, some fruits and nuts, fermented to pickled goods and cured or processed meats.
A migraine headache is characterized by four stages: prodrome, aura, attack and post-drome.
Not all sufferers go through all four stages.
In the prodrome stage, one or two days before a migraine subtle changes may be noticeable, including:
- Food cravings such as caffeine.
- Mood changes.
- Uncontrollable yawning.
- Fluid retention.
- Increased urination.
Some people experience aura, visual phenomena that includes seeing flashing or bright lights, zigzag lines and blindspots.
Some people also experience muscle weakness.
The aura stage usually last between 20 and 60 minutes and may happen just before or during the headache stage.
Some people only experience the aura without the headache.
The headache stage usually starts gradually then becomes more severe, with a throbbing or pulsing pain, usually on one side of the head.
Other symptoms may include:
- Increased sensitivity to light or sound.
- Nausea and vomiting.
- Worsened pain when you move, cough or sneeze.
NIH also reports migraines are more common in morning.
For many years migraines were thought to be caused by dilation and constriction of blood vessels in the head, and treatment included blood thinners.
Medical investigators now believe some migraines may have a genetic cause, but there are still a lot of unknowns about the condition.
Treatment now focuses on prevention of attacks using medications and behavioral changes and relieving symptoms.
Several drug therapies have been approved by the FDA for preventing and treating migraine, with and without aura.
In recent years, botulinum toxin A (Botox) has been effective in preventing chronic migraine.
Behavioral changes shown to be effective include stress management techniques, exercise and relaxation techniques.
Neurologist Dr. Yvonne Rollins with Heart of the Rockies Regional Medical Center said that in women the condition can be hormone related.
Some women start having symptoms near puberty.
She said those cases are less worrisome than when a woman is in her 40s or 50s and begins experiencing migraine symptoms.
She said it is important to see a doctor when headaches seem to be occurring frequently or with more intensity.
She said some people can get neurological symptoms that seem like a stroke.
When severe headaches occur after age 40, she said imaging is used to determine there is not a bleed or another problem present, which can present the same symptoms.
There are a variety of triggers for migraine, she said, and “everybody’s different.”
New classes of treatments, including Botox for sufferers of more than 15 headaches a month, have been successful.
For frequent sufferers, getting on regular medication is important to manage the condition, she said.