The Basics: Migraine Symptoms, Triggers, and Treatments
Is It a Migraine or Just a Headache?
Headache specialist Brian Grosberg, MD, director of the Montefiore Headache Center, gives the rundown on migraine symptoms, phases, and more.
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Taryn Winter Brill, Everyday Health:If you've ever had a severe headache, you know the pain can be debilitating. But is it a migraine? Here are some answers to frequently asked questions.
What causes a migraine?
Brian Grosberg, MD, Montefiore Headache Center:We don't know why people have migraines. We know there's a strong genetic base for it. There's a large family history.
EH:Who gets migraines?
Dr. Grosberg:Migraines can occur even in children or adolescents. Boys generally get it before girls before puberty, and then afterwards, there's a divide where young women experience them certainly more often than men. Anywhere between [the ages of] 25-55. Can people get them after 50? Yes, but that's something that needs to be looked at because it's less common.
EH:What are the symptoms of migraines?
Dr. Grosberg:Well, that can vary from person to person with migraines. And the reason for that is there are four phases to migraines. Not all people have all four phases, but there are four phases that are there.
The first phase is a premonitory phase, where hours or days before the headache comes on, people experience symptoms — tiredness, yawning, craving certain foods, irritability, urinating more or less, moving your bowels more or less. It's like the calm before the storm, where people can clue in that something's going on. For that, people may end up being able to treat at that time to help prevent a headache.
The next phase is an aura phase. An aura is a reversible neurologic symptom. The most common type of aura with migraines is a visual aura, where people may experience shimmering lights on one side of their visual field or spots, specs, or wavy lines. This is only present in about 25 percent of migraine sufferers.
If people don't have an aura, then they'll end up going on to a headache phase, where they experience not only the pain of the migraine, [but also] sensitivity to light [and] sounds, nausea, or vomiting,
And then finally when the pain is gone, they may experience a postdromal phase, almost like a hangover. They feel malaise, tired. And that also might last for a period of time.
EH:What are the treatment options?
Dr. Grosberg:From a non-medication standpoint, the key is keeping a headache diary with the frequency of all days of head pain or headache, to keep track of the occurrence of those headaches, whether it's early morning that wakes them up from sleep, or morning, afternoon, or night. Then, at the same time, we look at triggers. For a number of women, actually a large percentage, their period may end up being a cause of their headaches.
EH:Are migraines curable?
Dr. Grosberg:Unfortunately, migraines aren't curable. Migraine is a chronic, neurological condition. It's a brain disorder. But for patients working with an appropriate headache specialist and defining a treatment plan that works best for them, migraines can be managed very, very effectively.
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