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Migraines – Diagnosis And Treatment

Many people think of migraines as just a really bad headache, but this is inaccurate. Migraines are actually a neurological disease that involves a number of troubling neurological symptoms. Around 12% of American adults suffer from migraines, which are painful and often debilitating. As a result, it’s important to understand what causes them, how they present and how they can be prevented and treated. 

Causes of Migraines 

Migraine causes are not fully understood, but both genetics and environment seem to be factors. Some research indicates that they can be caused by changes in the brainstem and by the brainstem’s interactions with the trigeminal nerve, which is a major pain pathway. Additionally, chemical imbalances – for example serotonin – may play a role. 

The good news, however, is that while research is still ongoing to more fully understand the causes of migraines, we do know many of the triggers. Common triggers include: 

  • hormonal changes in women (pregnancy, menopause, hormonal medications)
  • certain foods and drinks (high-sodium foods, alcohol, food additives)
  • stress
  • certain medications 
  • physical exertion (sports, sex, etc.)
  • changes in wake-sleep patterns (getting too little or too much sleep)
  • changes in the environment (change in weather, change in barometric pressure)

While all triggers cannot be avoided, identifying particular triggers and working to minimize or avoid them can help to provide migraine relief by decreasing their frequency and severity. 

Migraine Symptoms

Everyone experiences migraines differently, but there are some common symptoms and patterns that many patients experience. Migraines can be broken down to four stages, with the important caveat that all patients do not experience all stages or symptoms. 

The first stage is Prodrome, which occurs 1-2 days before a migraine and includes some subtle changes and warnings that a migraine is coming. These changes can include constipation, mood changes, food cravings, a stiff neck, increased thirst and urination and frequent yawning.

The second stage, Aura, occurs before or doing a migraine. Most people do not experience aura, which includes a number of nervous system symptoms and can include sensory, motor and visual disturbances. Some examples of these disturbances include seeing bright spots, vision loss, a pins and needles sensation and hearing noises. 

The most commonly discussed stage of migraines is the Attack, which can last anywhere from 4 to 72 hours. During the attack, patients have a throbbing or pulsing pain in one or both sides of their head. The pain can also be accompanied by nausea and vomiting, sensitivity to light and sounds (and less commonly smells and touches), blurred vision and lightheadedness. 

The final stage, Post-drome, occurs after the attack and lasts for around 24 hours. During this phase, patients can experience a sense of being worn out or a sense of elation. In addition, they might feel confusion, moodiness, dizziness, weakness and sensitivity to light and sound. 

Preventing and Treating Migraines

There are three main approaches to migraine treatment: acute treatment, which attempts to stop a migraine once it begins; preventive treatment, which attempts to decrease the number of migraines, lessen their intensity or prevent them altogether; and complementary treatment, which is non-drug therapy used primarily for prevention. 

For many, the most effective migraine treatment begins with prevention. One of the first steps necessary to prevent migraines is identifying any particular triggers. Some triggers can be avoided through lifestyle changes – for example, avoiding certain foods or activities. And while all triggers can’t be avoided, additional lifestyle modifications can nevertheless help to prevent migraines. For example, establishing a daily schedule for sleeping and eating at specific times or incorporating regular exercise into your routine can help with prevention. 

Medications and migraine pills can be used in conjunction with lifestyle changes to both prevent and treat migraines. Additionally, new treatment options are regularly being developed, including nerve-stimulation devices and “Learning to Cope” (LTC) treatments, which involve gradually exposing patients to certain triggers to help desensitize them. 

Injection therapy can also be an effective way to treat pain from migraines. These injections use a drug made from a neurotoxin produced by Clostridium botulinum, Botox, to weaken specific muscles or block nerves. Through targeted local injections, the botulinum toxin can weaken certain muscles in the face that are part of the trigeminovascular system, which is believed to play a part in the pain of migraines. The effects of these injections can last anywhere from 3-12 months, and they are an increasingly popular way to combat migraine pain. 

If you are experiencing migraines, call us today for a consultation. We will conduct a full physical exam and thoroughly discuss all of your symptoms in order to properly diagnose your condition. After an initial diagnosis, we’ll create a comprehensive treatment plan to help provide you migraine reilef. Migraines can be debilitating and can keep you from many daily activities. As a result, it’s important to diagnose them and receive migraine treatment as soon as possible. 

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