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What to Do About Migraines


Migraines are more than just bad headaches. Migraine is a neurological condition that may cause a variety of symptoms. Headaches are just one of those symptoms. Some other symptoms include nausea with or without vomiting, trouble speaking, numbness or tingling, and sensitivity to light and/or sound. Because migraine is a complex neurological condition, it cannot be treated in the same way as regular headaches, but some treatment options are available.

What to Do About Migraines [infographic]

The Stages of a Migraine

Migraines may have up to four stages. The first symptoms can become noticable a day or two before the onset of the headache.

The first and earliest stage of a migraine, called the prodrome stage, may not be painful at all. Instead it may include any of the following symptoms:

  • food cravings
  • depression
  • fatigue or low energy
  • frequent yawning
  • hyperactivity
  • irritability
  • neck stiffness

The next stage of migraine occurs in those who tend to have migraines with an aura. These symptoms may be severe and frightening. They can often be mistaken for other neurological conditions. Aura symptoms include:

  • a tingling or prickling feeling in the face, arms, or legs
  • slurred speech or difficulty speaking
  • visual disturbances including flashes, bright spots, and seeing shapes
  • A temporary loss of vision, typically in only one eye

The most painful stage of a migraine is the attack phase. Sometimes this phase overlaps or includes the aura phase. While the most common symptom during this phase is head pain, there are other symptoms that may occur. These symptoms can last for hours or even days. These symptoms include:

  • pain on one side of the head, either front, back, right, left, or temples
  • dizziness
  • nausea with or without vomiting
  • throbbing or pulsing head pain
  • sensitivity to light and sounds
  • feeling faint

The final phase of a migraine is the postdrome phase. This phase occurs after the attack phase has subsided. It may include pronounced changes in mood. Some people may feel happy or even euphoric. Others may feel fatigued or apathetic. In addition, there may be a continuing dull headache.

The exact length of these stages varies among patients. Sometimes a stage can be skipped. In some instances, many symptoms of migraine may occur without the head pain.

What Causes Migraines

The root cause of migraines is not fully understood. In fact, neuroscientists are not even in agreement as to the exact mechanism of migraines, or what happens in the brain during a migraine. However, experience has shown that there are some triggers that can bring on a migraine. Some of these triggers include a decrease in the neurotransmitter serotonin in the brain.

Sudden changes in the environment are one possible trigger. These include bright lights, loud noises, unusual smells, extreme heat or weather changes, and changes in barometric pressure.

Other triggers are related to physical and emotional stress. These may include changes in sleep patterns, skipped meals, intense exercise or physical activity, dehydration, traveling, and excess mental or emotional stress.

Another set of triggers involves foods and chemicals that are ingested. These triggers include smoking, alcohol use, certain foods, and medications such as oral contraceptives and nitroglycerin.

In women, hormonal changes related to menstruation, pregnancy, and menopause may also trigger migraines.

With such a wide variety of possible triggers you can see why scientists have a hard time narrowing down a single cause of migraines. While there is certainly a physiological change during migraines, researchers have not been able to pin down the exact neurological cause of migraines.

Migraines Vs Tension Headaches

While migraines are sometimes referred to as a type of headache, they are actually very different from standard tension headaches. A regular tension headache usually includes mild to moderate pain on both sides of the head. It is also generally a steady ache, as opposed to throbbing or pulsating pain.

Migraines have a unique set of symptoms that sets them apart from tension headaches. Symptoms unique to migraines include:

  • pain that is moderate to severe
  • pain that is pounding or throbbing
  • pain that affects only one side of the head
  • pain that makes it impossible to do your usual activities
  • nausea with or without vomiting
  • the various symptoms of an aura
  • increased sensitivity to light and/or sound

Diagnosing a Migraine

The symptoms or a migraine can mimic a number of other neurological disorders. In some instances, even bad tension headaches can be mistaken for migraines. To positively diagnose migraines, the International Headache Society has set out some guidelines.

The most common type of migraine is a migraine without aura, previously called a “common migraine”. 75% of people who experience migraines experience migraines without aura. To diagnose this kind of migraine the following symptoms must be present in at least five separate attacks:

  • a headache that lasts 4 to 72 hours
  • a headache with at least two of the following:
    • pain on only one side of the head
    • pain that is pulsating or throbbing
    • pain that is moderate to severe
    • pain that gets worse with movement such as walking
  • a headache with at least one of the following:
    • light sensitivity
    • sound sensitivity
    • nausea with or without vomiting or diarrhea

Finally, to positively diagnose a migraine, other medical causes must be eliminated. A migraine can only be diagnosed when there is no other diagnosis that could be causing headaches.

In about 25% of migraine sufferers, migraines are accompanied by an aura. This is referred to simply as migraine with aura, although it has previously been called a “classic migraine”, “complex migraine”, or “hemiplegic migraine”.

The main characteristic of a migraine with aura is that the aura goes away or is reversible. If symptoms of an aura persist, it may indicate other medical problems, such as stroke, and requires immediate medical attention.

Migraines with aura must include at least one of these symptoms:

  • visual disturbances (the most common type of aura)
  • numbness or tingling in the body, face, or tongue
  • dizziness
  • problems speaking
  • weakness or difficulty moving that lasts up to 72 hours
  • problems in only one eye

Other aura symptoms fall under the category of brainstem disturbances and may include:

  • unclear speech or difficulty talking
  • vertigo
  • ringing in the ears or tinnitus
  • problems hearing
  • double vision
  • inability to control body movements
  • decreased consciousness

Treatments for Migraines

Traditionally, the main type of treatment for severe and chronic migraines was medication. Depending on the age and health factors of the migraine sufferer, a doctor may suggest over the counter medications or prescribe a stronger medication. There are a wide variety of medications used to prevent and to treat migraines.

More recently, the FDA has approved the use of BOTOX to treat chronic migraines. Chronic migraines are defined as migraines that occur for at least 4 hours a day on 15 more days out of every month. This type of chronic migraine can be debilitating and treatment can be life changing.

When BOTOX is used to relieve chronic migraines, 31 injections are made at seven specific areas around the head and neck. These injections relax certain muscles and can reduce the severity of future headaches. The injections last about 12 weeks, after which they must be repeated.

If you are interested in BOTOX treatment for chronic migraines, it is important to speak to a doctor who specializes in this procedure. The excellent doctors at Midtown Neurology are trained in the use of BOTOX to relieve symptoms of severe headaches and migraines.

Midtown Neurology is TrustDALE certified, so you can trust that they are among the best providers in their field. In addition to providing the service, they know hot to work with your insurance provider to ensure that your procedure is covered. So if you suffer from severe headaches or migraines, contact Midtown Neurology today to find out how your can stop suffering and start enjoying life.