About Migraines A migraine is a severe headache that tends to recur with symptoms like nausea and vomiting. The pain is usually on one side of the head and there is an added sensitivity to bright lights and noises. Moving around can make the headaches feel worse. Although, there are many forms of migraine headaches, classic and common are the two major varieties. People with migraines are called migraineurs.
About 15% of the population is affected by migraines. Three times more women than men are affected. Over 80% of migraineurs have family members who are regularly afflicted with migraines. Prominently migraines are of three types. They are:
without aura (common migraine): Accounting for 80% of all migraine headaches, no aura is seen before this common migraine affects an individual.
Migraine with aura (classic migraine): Usually preceded by an aura, this type of migraine is generally much worse than a common migraine. Usually, an aura is said to be a visual disturbance, that is, outlines of lights or jagged light images. Status migrainosus: Generally, a long-lasting migraine, it does not go away by itself. Causes of Migraine headaches The medical fraternity thinks that the migraines are caused by a chemical or electrical problem in certain parts of the brain. A key element of a migraine headache is blood flow change in the brain. According to hypothesis, the nervous system responds to a trigger such as stress by creating spasms in the nerve-rich arteries at the base of the brain. The spasms constrict several arteries supplying blood to the brain, including arteries from the scalp and the neck. As these arteries tighten, the flow of blood to the brain is reduced. At the same time, platelets clump together and release a chemical called serotonin which also acts as a powerful constrictor of arteries. This further reduces blood and oxygen supply to the brain. In reaction to this, some arteries in the brain expand to meet the brain's energy needs. This dilation is believed to cause migraine headaches. Because, tend to run in families, it can be assumed that genetic factors may also contribute to a person's susceptibility to migraines. Headache triggers can be things that are eaten, smelt, heard or seen. They are :
Stress and time pressure, major hassles and losses, anger and conflict
Smells and fumes, tobacco smoke, light glare or dazzle and weather changes
Monthly periods, birth control pills, estrogen therapy and too much, too little or interrupted sleep
Hunger, fasting and specific foods or beverages
Excessive activity
Certain medications
Certain foods that might trigger a migraine:
Aged Cheese
Bananas, figs and raisins
Beer, wine and hard liquor
Caffeine as well as caffeine withdrawal and chocolates
Dairy products such as ice cream, milk, yogurt, cheese, whipped cream and sour cream
Fermented and pickled foods
Monosodium glutamate (MSG), seasoned salt, canned soups, TV dinners, processed meats, and some processed nuts and snack chips
Most citrus fruits like oranges, grapefruit and lemons
Nuts and peanuts
Onions
Pea pods or lima beans
Processed meats, deli sandwich meats, hotdogs and other nitrite-containing meats
Saccharin or aspartame in diet foods or diet sodas and drinks
Sulfites in shrimp and processed potatoes, like boxed mashed potato mix
Yeast-containing products, such as fresh breads and donuts
Medicines that might trigger a migraine headache are:
Cimetidine (brand name: Tagamet)
Estrogens (including birth control pills)
Fenfluramine (brand name: Pondimin)
Indomethacin (brand name: Indocin)
Nifedipine (brand name: Adalat, Procardia)
Nitroglycerin (brand name: Nitrostat)
Pain killers (either overuse or withdrawal from them)
Migraine Guide Having ridden the migraine train on several occasions, you may have an aura the acts like a warning whistle of the approaching headache. The pain builds slowly and steadily until you are in no position to tolerate the bright light and loud noises. You may even feel nauseated or end up vomitting. Lying down in a dark, quiet room is the only means that will help you ride it out. While scientists still debate the exact mechanisms in the brain that cause migraines, there progress has helped them find treatment medications that may either be taken as soon as a migraine comes on or taken on a daily basis to help prevent migraines. This guide will help you weigh the pros and cons of a variety of treatments, to help determine the best course of action for your migraine. Although, much can be done to prevent the onset of migraines like avoid triggers, exercise regularly and keep stress under control - most people with migraines will need medication. Providentially, medication options for migraines have expanded greatly in the last decade which helps keep migraine disruption to a minimum. Migraine medications can be divided into two broad categories of . They are:
Acute - Taken after the onset of a migraine
Preventive - Taken every day to ward off migraines
Many women who have migraines and headaches seem to watch their head pain disappear during pregnancy. Almost 70% of women with a history of migraine headaches improve during this time. Unfortunately, 30% don't improve. They stay the same or get worse. Let's be clear..I am talking about moderate to severe headaches that are not relieved by Tylenol.
The headache in pregnancy may become more frequent and more severe as estrogen levels rise in the first trimester. If you are one of these women, you might improve if under the care of both your OB/GYN and a neurologist.
If this is a new onset of headaches or migraines then this could be an emergency. Please call your doctor and tell them if you have headaches you've never had before. A moderate to severe headache in pregnancy should be taken seriously. High blood pressure during pregnancy can be serious and could cause a bad headache. Conditions such as this are bad for the mother and the baby.
Treatment of Migraine in Pregnancy
As mentioned, these headaches can be severe. If accompanied by nausea and vomiting that should be treated too to avoid stress on the baby. Tylenol with codeine is the drug of choice during the first trimester, to be used at the onset of the migraine. Additionally, you can be on daily medication during this time. We usually place our patients on Inderal (propranolol) low dose, 10-20mg per day to start. Usually a low dose like this is sufficient. Rarely, we do use low doses of an anti-seizure drug and although these medications are not recommended for pregnancy, once again the risk to the both the mother and baby must be weighed.
Can you have triptans, like Imitrex, while you are pregnant? We get this question alot and generally speaking NO you cannot take your triptan during this time. Most OB/GYN's and primary care physicians would agree.
HOWEVER...if your headaches are so severe the Tylenol with codeine, or even Lortab, is not working, then you should see a headache specialist. ONLY A NEUROLOGIST, working with your OB/GYN should determine if you can have a triptan during pregnancy.
Although medication should be avoided during pregnancy, if the risk to you is greater then the condition should be treated. Severe pain of chronic headache increases adrenaline levels. This increases the baby's heart rate and your blood pressure rises.
Occasionally, we do prescribe daily medication for mothers who have severe pain with nausea and vomiting. This should be guided by both your OB/GYN and your headache specialist.
MRI and CT Scans During Pregnancy
Many people ask me about MRI's, CT scans and being pregnant. You should not have a CT of the brain while pregnant. This is a form of X-Ray and is not good for the forming fetus.
But, if a doctor deems it is necessary you can have an MRI or MRA of the brain. MRI's use magnetic fields. MRA's are similar but only look at the arteries in the brain, not the brain itself, like MRI's. MRI's are not generally done when you are pregnant and we do not do them if the diagnosis is clear cut..such as a recurrence of migraines. But if needed, we do them right away. Rarely, I have seen brain tumors and aneurysms (out pouching of arteries) in pregnancy. Remember, medical intervention is warranted if the health of the mother is at risk. If you are in trouble, the baby is in trouble.
Speak to your provider about your headaches. Headaches and pregnancy is not something to just be endured. This should be one of the happiest times of your life, not one of the most miserable.
Both John Linney & Mary Betz are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
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Mary Betz has sinced written about articles on various topics from Car Accidents, Migraine Headaches and Baby Shower. Mary K. Betz, MS RPA-C is a practicing Physician Assistant in neurology who specializes in headache medicine. . Mary Betz's top article generates over 18100 views. to your Favourites.