Migraine Syndrome

Migraine syndrome is a potentially disabling disorder that affects approximately 32 million Americans, most of them women. It is characterized by repeated, severe headaches. However, the headache is only one symptom of this genetically based neurological disease. In fact, a migraine headache is just the opposite of a typical headache. A migraine is caused by expansion of the blood vessels, and a non-migraine is brought on by constriction.

Symptoms

• Symptoms of migraine can include extreme sensitivity to light, nausea and vomiting. Often, sufferers report auras and/or premonitions (cravings, drowsiness and mood changes) hours before a headache strikes.

Triggers

• The causes of migraine can be categorized as either controllable or uncontrollable triggers. Controllable triggers include bright light, foods (chocolate, cheese, processed foods), alcohol, smells and smoke. Stress, fatigue or medications may also play a role. Common uncontrollable triggers are weather, particularly falling barometric pressure, and hormonal changes, such as reduced levels of estrogen that typically occur at the onset of a woman's menstrual cycle. Imbalances in brain chemicals might also be a factor. Migraine headaches are most likely to develop when the two types of triggers overlap, such as when low barometric pressure coincides with a woman's monthly period.

Diagnosis

• Diagnosis of migraine is difficult. Your doctor will want to know if there is a family history of the disease, as well as a list of your current medications. He may also perform tests to rule out other causes of headache.

Treatment

• There is no known cure for migraine. The usual recommendations are to become familiar with the signs and symptoms that a headache is approaching. Over-the-counter pain relievers used to treat migraines include NSAIDs, such as ibuprofen (Advil, Motrin) or aspirin. For more severe pain, triptans, ergot or opiates might be prescribed. Anti-nausea medications may also be helpful. Patients experiencing more than a couple of attacks a month sometimes find relief from taking a preventative drug on a regular basis. Classes of preventative drugs include beta blockers, antidepressants, anti-seizure medications and antihistamines.

Prognosis

• Migraine sufferers should carefully maintain a headache diary to keep track of which factors trigger their symptoms and avoid triggers that seem to precipitate an attack, especially in combination. Along with pain-relieving drugs, relaxation exercises such as yoga and meditation, as well as getting sufficient sleep, are sometimes effective. Alternative therapies include acupuncture, biofeedback and massage.