Migraine Headaches
What Causes Migraines? One theory is
that certain events or substances (triggers)
can set off an imbalance of naturally occurring chemicals such as
serotonin. Serotonin plays
many
roles in the body and it can have an effect on the blood vessels. When
serotonin levels are high, blood vessels constrict (shrink). When
serotonin levels fall, the blood vessels dilate (swell). As shown
in the graphic, the area around these blood vessels becomes
inflamed and irritates nerve endings. This dilation (expansion) and
irritation may account for the throbbing pain you experience in your
temple or behind your eye.
The chemical imbalance theory is not the only one. Some Investigators
now believe that migraine may be caused by inherited abnormalities in
certain cell populations in the brain. Using new imaging technologies,
scientists can see changes in the brain during migraine attacks.
According to the National Institute of Neurological Disorders and
Stroke, Scientists believe that there is a migraine pain center
located in the brainstem, a region at the base of the brain. As neurons
fire, surrounding blood vessels dilate and become inflamed, causing the
characteristic pain of a migraine.
Migraine Facts: Migraine headaches are
less common than tension-type headaches. Nevertheless, migraines afflict
25 to 30 million people in the United States alone.
- As many as 6% of all men and up to 18% of all women
(about 12% of the population as a whole) experience a migraine headache
at some time.
- Roughly three out of four migraine sufferers are
female.
- Among the most distinguishing features is the
potential disability accompanying
the headache pain of a migraine. The simple act of moving may be
difficult and
pain may be aggravated or worsen from any activity.
- Migraines are felt on one side of the head by about
60% of migraine sufferers and
the pain is typically throbbing in nature - as though one’s pulse is
beating severely in the head. The pain usually begins at the temple and
can spread downward to the eye, face and neck.
- Nausea, with or without vomiting, as well as
sensitivity to light, sound and certain odors often accompany migraines.
- Auras - a group of telltale neurological symptoms -
sometimes occur before the head pain begins. Typically, an aura involves
a disturbance in vision that may consist of brightly colored or blinking
lights in a pattern that moves across the field of vision. A loss of
sensation in one or more body parts or even oss of speech can occur.
About one in five migraine headache sufferers experiences an aura.
- Ophthalmic migraine - Some people
experience flashes of light that appear as jagged lines or "heat waves"
in both eyes, often lasting 10-20 minutes. If a headache follows
the flashes, it is called a migraine headache. However, jagged lines or
"heat waves" can occur without a headache. In this case, the light
flashes are called ophthalmic migraine or migraine without headache.
- Usually, migraine attacks are occasional, or
sometimes as often as once or
twice a week.
How are migraines related to
menstruation?
Menstrual migraines have been related to the drop in the
female hormone, estrogen, immediately before the start of the menstrual
flow. Doctor Brian Somerville noted that premenstrual migraine regularly
occurred during or after the time when the female hormones, estrogen and
progesterone, decreased to their lowest levels.
What are some migraine triggers in women? Birth control
pills as well as hormone replacement therapy during menopause have been
recognized as migraine triggers. As early as 1966, investigators noted
that migraine can become more severe with birth control pills containing
high doses of estrogen.
What are the treatment options for menstrual migraine?
The medications of choice in the treatment of
menstrual migraine are NSAIDS. Therapy with the NSAID should be started
2 to 3 days before the onset of the menstrual flow (menses) and
continued through the flow. Because the therapy is of short duration,
the risk of gastrointestinal effects is limited.
General Treatment: Headaches can be
managed with proper medication, diet, exercise and lifestyle
modification. When headaches occur occasionally (one time a week),
over-the- counter
medications, a "time out" for relaxation or a short nap will likely
provide pain relief. In fact, most people with occasional
headaches will select a nonprescription "over-the-counter" (OTC) pain
reliever from their pharmacy or supermarket shelves.
Available without prescription, OTC pain relievers contain powerful,
effective ingredients. There are several different groups of OTC pain
relievers including combination products:
- Aspirin products
- Acetaminophen products
- NSAIDs such as ibuprofen and naproxen sodium products
- Combination products such as those that contain OTC pain relievers
and caffeine
Each group has specific advantages and side effects. The most
appropriate way to
select a medication or combination of medications is to weigh the
desired effect against potential side effects. Most OTC pain relievers
are available in tablets, caplets and geltabs. While all forms of a
medication are equally effective, some may be easier to swallow than
others.
Note: If you take medications for
any other medical condition (such as high blood pressure, arthritis,
diabetes, ulcers or even acne) be sure to check with your physician or
pharmacist before taking an OTC pain reliever. It is important to make
certain that adding a pain reliever to the medicines you already take
will not result in undesirable drug interactions.
| Sources: |
1) American Stroke Association |
2) Cleveland
Clinic |
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Vision & Health Newsletter courtesy of:
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Dr. Philip Smith & Associates
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1855 1st Ave #100 San Diego, CA 92101
619-297-4331 |
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