By Ayla Ryan
Migraine attacks are believed to begin in the nerve pathways and with neurotransmitters such as adenosine, a vasodilator, in the brain affecting cerebral blood flow.
Affecting more women than men, migraines are often preceded by an “aura” of symptoms including visual disturbances, in either one or both eyes. Auras can consist of temporary blind spots, blurred vision, eye pain, and bright spots and usually indicate that a migraine is on its way.
Migraines can also be accompanied by nausea, vomiting, fatigue and photo sensitivity.
Migraines can be limited to one side of the head, or affect both sides and can last anywhere from 6 to 48 hours. Symptoms may continue even after the migraine has passed.
There are various triggers for migraines that can be dependent on the sufferer, him or herself. Common triggers include alcohol, recreational drugs, bright lights, loud noises, perfumes, changes in hormones (such as with hormone replacement therapies, oral contraceptives, or based on a woman’s menstrual cycle), inadequate sleep, overexertion, stress, smoking, processed or fermented foods, MSG, chocolate and so on. Triggers can vary from person to person.
It is important to remain hydrated through a migraine attack, especially if it is accompanied with vomiting.
Many patients find it eases some of the pain to rest in an absolutely silent and pitch black room with a cool cloth over the forehead.
A cup of strong coffee can also help reduce the duration and effects of a migraine. Caffeine acts as an adenosine blocker, allowing the brain’s vascular system to return to normal levels of cerebral blood flow. Interestingly enough, caffeine from coffee can actually worsen headaches in some people. This can sometimes be due to dehydration.
Since caffeine can worsen dehydration, it is important to drink more water if this happens to you.
There are pharmaceutical treatments for migraines as well.
There are two main types of migraine medication available via prescription. For frequent attacks, there are preventative drugs available such as amitriptyline, a tricyclic anti-depressant, beta blockers, seizure medication such as gabapentin or topiramate, and selective norepinephrine reuptake inhibitors such as venlafaxine.
All drugs come with side effects and it is important that you do not take any drugs without consulting your doctor first to see if the benefits of the medication outweigh the potential side effects.
Also available are abortive medications designed to stop migraine attacks. These should be taken at the first onset of an aura or as soon as possible after the onset of a migraine.
There are three types of commonly prescribed abortive migraine medicines.
Most commonly prescribed are triptans, a class of drug that acts as a vascular constrictor. Isometheptene, another commonly prescribed abortive medication works by constricting blood vessels similarly to triptans, however it is contraindicated for people with liver diseases.
Ergot based drugs contain ergotamine which is often used to synthesize lysergic acid diethylamide. It is not quite as effective as triptans as an abortive treatment.
While you may believe your headache is a migraine, migraines are not just “really bad headaches” but downright debilitating and can severely reduce a patient’s ability to function effectively within their environment.