Migraines Migraines

What is a migraine?

Migraines are more common in adults than children, but a large number of adults start having them as children. Also, some people have migraines at some point in their lives, such as adolescence, but don't go on to have them on a regular basis.

The classic migraine takes the form of a severe, throbbing headache. It is usually accompanied by sensitivity to bright lights and loud noises, nausea and/or vomiting, a sensation of dizziness, and pale complexion. Many people can sense an oncoming attack of a classic migraine: they may see spots, experience smells (otherwise known as auras), or want to lie down in a dark room.

Another form of migraine is the common migraine, which is more dull and diffuse than the classic.

What are its causes?

The migraine is a complex process and much research is being done on its causes and prevention. On a microscopic level, a migraine involves perturbation of the lining cells of the cerebral blood vessel, which leads in a cascade of events to the constriction and throbbing dilation of the blood vessels.

Migraine triggers can include stress, sleep deprivation and immune stimulation against viral or other infections (see below: "How Can I Avoid a Migraine From the Start?"). Several naturally produced substances, such as serotonin and CGRP (calcitonin gene-related protein) play a role in the migraine cascade. PET scans show that a circuit of pain receptors within the brain are activated, intensifying the migraine experience for most people.

How should I treat a migraine?

To stop a migraine, you'll want to "calm" the blood vessels that are throbbing.

Pressure and massage points:

  • Rub the side of the head, right by the temple
  • Rub the eyebrows outward, and/or press hard on the inner, lower eyebrow
  • Massage the back of the head, or the muscle connecting the shoulders to the back of the head
  • Rub the palms, especially the base of the thumb
  • Soak the feet in warm water

Anti-Inflammatory Medicines

Pain-relievers

Ibuprofen, in the form of Motrin or Advil, is much better than acetaminophen (Tylenol), and will block some of the inflammatory mediators (cytokines) that are involved in the migraine process. It is important to take one of these pain-relievers at the first sign of a migraine.

Anti-histamines

Since the release of histamines is a part of what causes migraines, taking an anti-histamine like Benadryl will help. Dimetapp will also work.

Since the blood vessel involved is dilated, something with caffeine is often helpful. Adults can try coffee or tea; for kids, try Coca-Cola or tea. Spicy foods also help some people (try a little tabasco sauce in a bowl of soup).

How can I avoid a migraine from the start?

Stress, fatigue, and certain foods or medicines are well-known triggers for migraines. For some kids, exercising at the end of the day, and/or not drinking enough fluids will be the trigger. For others, extremely bright light (i.e. being at the beach without sunglasses), or loud/noisy places, or simple exhaustion can bring one on. Some women also get headaches at certain points in their menstrual cycle.

Any viral or bacterial infection can bring on a headache. As the immune system activates to fight the infection, immune chemicals called interleukins are mobilized, and these have subtle interactions with the cells that line the blood vessels. Anything that mobilizes the immune system can inadvertently bring on a migraine in some people.

Foods that are commonly known triggers are those containing MSG, nitrates (hot dogs), tyramine (beer, aged cheese) or sulfites (red wine). It is important for the person to scrutinize their diet, and try to see if any patterns are developing. Keeping a food/headache diary can help identify triggers.

When faced with a migraine, take one step at a time. Try to figure out what the trigger or triggers are, and focus on making the throbbing headaches fade away.