Migraine Headache

What is a migraine headache?

A migraine is a severe headache. The pain can be so severe that it interferes with your daily activities. A migraine can last a few hours up to several days. The exact cause of migraines is not known. It may be caused by changes in your body chemicals and extra sensitive nerves in your brain.

What can trigger a migraine headache?

  • Sunlight, bright or flashing lights, loud noises, smoke, or strong smells

  • Certain foods or drinks like chocolate, hard cheese, red wine, or alcohol. Foods that contain gluten, nitrates, MSG, or artificial sweeteners may also trigger migraines.

  • Heat, humidity, or changes in the weather

  • Hormone changes from birth control pills, pregnancy, menopause, or during a monthly period

  • Stress, eye strain, oversleeping, or not getting enough sleep

  • Skipping meals or going too long without eating

What are the warning signs that a migraine headache is about to start?

Warning signs usually start 15 to 60 minutes before the headache does. The most common migraine warning signs include:

  • Visual changes, often called auras. Your vision may blur or things may look different. You may have blind spots that last for a short amount of time. You may also see bright spots, lines, or have hallucinations.

  • Unusual tiredness or frequent yawning

  • Tingling in an arm or leg

What are the signs and symptoms of a migraine headache?

A migraine headache usually begins as a dull ache around the eye or temple (on the side of the forehead near the hairline). You may also have the following:

  • Pain in your head that may increase to the point that you cannot do everyday activities

  • Pain on one or both sides of your head

  • Throbbing, pulsing, or pounding pain in your head

  • Nausea and vomiting

  • Sensitivity to light, noise, smells

How is a migraine headache diagnosed?

Your caregiver will ask about your medical history and examine you. You may need any of the following tests:

  • Neurologic exam: Your caregiver will check how your pupils react to light. He may check your memory and your hand grasp and balance.

  • CT scan: An x-ray uses a computer to take pictures of your brain. You may be given dye before the pictures are taken to help caregivers see the pictures better. Tell caregivers if you are allergic to iodine or shellfish. You may also be allergic to the dye.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your head and blood vessels. You may be given dye to help the pictures show up better. Tell caregivers if you are allergic to iodine or shellfish. You may also be allergic to the dye. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell caregivers if you have any metal in or on your body.

How is a migraine headache treated?

There is no cure for migraines. The goal of treatment is to reduce your symptoms. Take medicine as soon as you feel a migraine begin.

  • Pain medicine: You may need medicine to take away or decrease pain. You may need a doctor's order for this medicine. Do not wait until the pain is severe before you take your medicine.

  • Migraine medicines: These are used to help prevent a migraine or stop it once it starts.
  • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting. They can also help relieve pain.

How can I manage my symptoms?

  • Rest: Rest in a dark, quiet room. This will help decrease your pain.

  • Ice: Ice helps decrease pain. Use an ice pack or put crushed ice in a plastic bag. Cover the ice pack with a towel and place it on your head where it hurts for 15 to 20 minutes every hour.

  • Heat: Heat helps decrease pain and muscle spasms. Use a small towel dampened with warm water or a heating pad, or sit in a warm bath. Apply heat on the area for 20 to 30 minutes every 2 hours. You may alternate heat and ice.

How can I prevent another migraine headache?

  • Keep a headache diary: Write down when your migraines start and stop. Include your symptoms and what you were doing when a migraine began. Record what you ate or drank for 24 hours before the migraine started. Describe the pain and where it hurts. Keep track of what you did to treat your migraine and whether it worked. Bring this log with you each time you see your caregiver.

  • Do not smoke: If you smoke, it is never too late to quit. Tobacco smoke can trigger a migraine. It can also cause heart disease, lung disease, cancer, and other health problems. Quitting smoking will improve your health and the health of those around you. If you smoke, ask for information about how to stop.

  • Do not drink alcohol: Alcohol can trigger a migraine. It can also interfere with the medicines used to treat your migraine.

  • Get regular exercise: Exercise may help prevent migraines. Talk to your caregiver about the best exercise plan for you.

  • Manage stress: Stress may trigger a migraine. Learn new ways to relax, such as deep breathing.

  • Stick to a sleep schedule: Go to bed and get up at the same time each day.

  • Eat regular meals: Include healthy foods such as fruit, vegetables, whole-grain breads, low-fat dairy products, beans, lean meat, and fish. Avoid trigger foods like chocolate, hard cheese, and red wine. Foods that contain gluten, nitrates, MSG, or artificial sweeteners may also trigger migraines. Caffeine, which is often used to treat migraines, can also trigger them.

What are the risks of a migraine headache?

Your symptoms can interfere with your daily activities. This can affect the quality of your life. You may have anxiety or feel depressed. Rarely, severe migraines may cause a stroke.

When should I contact my caregiver?

Contact your caregiver if:

  • Your migraines interfere with your daily activities.

  • Your medicines or treatments stop working.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a headache that seems different or much worse than your usual migraine headache.

  • You have a severe headache with a fever or a stiff neck.

  • You have new problems with speech, vision, balance, or movement.

  • You feel like you are going to faint, you become confused, or you have a seizure.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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