The symptoms are
intense throbbing pain often on one side of the head, which may
spread to the entire head, neck and shoulders. Sometimes bright
spots, flashing lights or zigzag patterns may be seen prior to the
headache.
The headache is often present on awakening and may be accompanied
by nausea, vomiting, dizziness and tingling in the lips. Bright
lights and noises become unbearable. The headache is due to swelling
of the blood vessels that go to the scalp and brain. Before
swelling, the blood vessels first tighten up, decreasing the amount
of blood going to the brain. This produces the visual disturbances
and in severe attacks may cause paralysis, and loss of ability to
speak. During attacks, some people become pale, with bloodshot eyes
and runny nose.
Migraine headaches occur most
often when unwinding from stress such as during weekends or holidays. In some
women, migraine headaches coincide with their menstrual cycle. Get enough rest
and minimize stress. Avoid irregular eating habits (which may decrease your
blood sugar), certain medications e.g. birth control pills, nitrates. About 20%
of migraine sufferers have a sensitivity to certain beverages and foods.
Beverages which can trigger an attack include red wine, beer, whiskeys, scotch,
tanin containing beverages e.g. apple juice and caffeinated drinks such as
coffee, tea and colas, chocolate or cocoa. Foods which can trigger an attack
include dairy services such as milk, buttermilk, cream, sour cream, yogurt,
hard/aged cheeses, cheddar, brie, processed cheeses, fats and lard.
Meats/poultry triggers include processed meats containing sodium nitrite (e.g.
hot dogs, bologna), aged, cured smoked, marinated meats, organ meats (e.g.
chicken livers).
Fish triggers include smoked or dried fish, pickled herring.
Vegetable triggers include broad beans, most peas, onions, pickles, olives,
sauerkraut. Grains/breads that may precipitate an attack include yeast breads,
#003366 breads and sourdough. Soup triggers include any soup containing the
additives MSG or yeast and soups from bouillon cubes. Fruit triggers include
citrus fruits, other fruits e.g. bananas, figs, raisons, papaya, kiwi, plums,
pineapples, avocados. Deserts triggers include chocolates, ice cream,
cookies/cakes made with yeast, potato chip services, nuts. Additives such as MSG
and other flavor enhancers, artificial sweeteners, seasonings and spices may
sometimes be dietary triggers.
Start a headache diary for everything you eat or drink and all the
medications you take. By checking the diary later you may be able to find out
which foods or medicines are bringing on the attacks. If you have menstrual
migraine, you may obtain relief by wearing a low dosage (one-fifth of the birth
control dosage) estrogen patch on your buttocks. This is worn for three to nine
days or during the time you normally get the migraine attack. The estrogen patch
evens out the hormonal level, which usually drops just before your cycle starts.
If you have more than two migraine attacks a month, you may need to take
migraine prevention medications. Serotonin blockers such as Sansert,
antidepressants such as Elavil or Paxil, beta-blockers such as Inderal help to
prevent migraine attacks when taken regularly. Riboflavin (Vitamin B2) has been
shown to prevent migraines when taken regularly. Take 200 mg twice daily. This
may also be combined with Valerian root to get a restful nights sleep (1000 mg
at bedtime). Another herbal medication that may help prevent and treat migraine
headache is feverfew. Take one to three capsules daily. It takes a few weeks to
notice the effects. Feverfew is available at your local health food store. The
label should state that it contains 0.2% parthenolide - the active ingredient.
Apply a cold cloth or ice pack to
your head, or splash your face with cold water. Take over the counter pain
relievers such as Excedrin or prescription pain relievers, such as Fioricet
(which is a combination of caffeine, acetaminophen, and butalbital). Relax if
possible. Lie down in a quiet, dark room for several hours. Listen to soft
music, sleep or meditate. Your doctor may prescribe vasoconstrictor drugs such
as Ergostat. Ergostat tablets are taken sublingually which means you place the
tablet under your tongue. Medications such as Inderal or Ergostat are more
effective if taken at the onset of an attack. Carry your medications with you at
all times.
If you cannot tolerate Ergostat due to your medical condition e.g.
hypertension or the side effects such as increasing headache or cold
extremities, your doctor may prescribe Imitrex, Zomig or Midrin tablets - three
other types of vasoconstrictor medications with fewer side effects. Imitrex is
available as an injection and a nasal spray. D.H.E. (Dihydroergotamine ) is
another effective migraine drug that is given by injection. The nasal spray
formulation is called Migranal and is made by Novartis. You may call the company
hotline at 888 697-3543 to obtain a free video on how to use D.H.E. spray.
Migranal may be expensive and if you cannot afford the price, a compounding
pharmacists can make up generic D.H.E. nasal spray for you at a fraction of the
price. Other medications used to treat migraine attacks include capsaicin
(0.075% ointment applied in the affected side of your nostrils), lidocaine nose
drops, antidepressants, beta-blockers e.g. Inderal and medications such as
Phenergan or Reglan to treat nausea and vomiting. A strong but gentle
anti-inflammatory medication is Tolmetin sodium. It is 10 times stronger than
Motrin and very effective if part of the migraine pain is due to inflammation.
Strong short acting painkillers such as Vicodin ES or Norco 10 may be given.
With severe pain, your doctor may prescribe strong long acting painkillers such
as Oxycontin.
Call your Doctor if your headache is
associated with crossed eyes, paralysis or inability to speak or if
it persists for more than 24 hours.