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Migraine (cont.)

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What causes migraines?

The specific cause of migraines is not known, but there may be fluctuations in certain neurotransmitters, chemicals that send messages between brain cells. These changes may predispose some people to develop migraine headaches.

What triggers migraines?

Many factors have been identified as migraine triggers. The normal hormone fluctuations which occur with regular menstrual cycles may predispose some women to experience migraine headaches. Some types of oral contraceptives (birth control pills) can trigger migraines. Various foods, including red wines, aged cheeses, nitrates (preservatives used in smoked meats), monosodium glutamate, artificial sweeteners, chocolate, and even dairy products have been implicated in triggering migraine headaches in susceptible individuals. Some patients find that oversleeping, stress, or exposure to strong stimuli such as bright lights, loud noises, or strong smells can lead to a migraine headache. Changes in barometric pressure have been described as leading to migraine headaches as well.

Not every individual who has migraines will experience a headache when exposed to these triggers. If a person is unsure what his or her specific triggers might be, maintaining a headache diary can be beneficial to identify those individual factors which lead to migraine.

What are the signs and symptoms of migraines?

The International Headache Society defines episodic migraine as being unilateral, pulsing discomfort of moderate-to-severe intensity, which is aggravated by physical activity and associated with nausea and/or vomiting as well as photophobia and/or phonophobia (sensitivity to light and sound). A migraine headache typically lasts for several hours up to several days.

Many patients describe their headache as a one-sided, pounding type of pain, with symptoms of nausea and sensitivity to light, sound, or smells (known as photophobia, phonophobia, and osmophobia). In some cases, the discomfort may be bilateral. The pain of a migraine is often graded as moderate to severe in intensity. Physical activity or exertion (walking up stairs, rushing to catch a bus or train) will worsen the symptoms.

Up to one-third of patients with migraines experience an aura, or a specific neurologic symptom, before their headache begins. Frequently, the aura is a visual disturbance described as a temporary blind spot which obscures part of the visual field. Flashing lights in one or both eyes, sometimes surrounding a blind spot, have also been described. Other symptoms, including numbness or weakness along one side, or speech disturbances, occur rarely.

Eye pain which is different from sensitivity to light is not a common component of migraine. If eye pain is a persistent symptom, or if eye pain is present and accompanied by blurred vision or loss of vision, then prompt evaluation is recommended.

In comparison, a tension headache is described as being bilateral and the pain is not pulsating, but feels like pressure or tightness. While severity can be mild-to-moderate, the headache is not disabling and there is no worsening of the pain with routine physical activity; additionally, there is no associated nausea, vomiting, photophobia, or phonophobia.

No specific physical findings are found when patients are experiencing a routine migraine headache. If an abnormality is identified on physical examination, there should be suspicion of another cause for the headache.

Medically Reviewed by a Doctor on 1/31/2014

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Migraine - Triggers Question: What are your migraine headache triggers?
Migraine - Symptoms Question: What migraine headache symptoms do you experience?
Migraine - Treatment Question: What kind of treatment do you get for your migraines? Does it help?
Migraine - Relief Question: Do self-care measures give you relief from your migraine headaches? What do you do?
Migraine Headache - Causes Question: Discuss the triggers for your migraine headaches.
Source: MedicineNet.com
http://www.medicinenet.com/migraine/article.htm

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