Dr. M.J. Bazos, MD Patient Handout

HEADACHE, MIGRAINE

About Your Diagnosis

Migraine headaches are intense, recurrent headaches that may occur at any age but usually begin between the ages of 10 and 30 years. The precise cause is unknown, but it is hereditary in 60% to 80% of patients with migraine. The attacks occur less often with advancing years, and remission in patients older than 50 years is common.

Living With Your Diagnosis
Some individuals have a prodrome or a symptom that alerts them that a headache is developing. This may occur hours to days before a headache and may disappear shortly before the headache appears or may merge with it. Common prodromal symptoms include change in mood, hyperactivity, sluggishness, fatigue, changes in appetite, or nausea. In addition to the prodrome, many patients have an aura, a subjective sensation or motor phenomenon, before their headaches. Auras usually last 10–30 minutes, and the headache frequently follows within the hour. The most common type of aura is a visual disturbance such as flashes of light, flickering lights, or a blind spot. Migraine headaches usually affect one side of the head and are throbbing. Typically, migraines last from 4 to 72 hours. Many individuals have nausea, vomiting, and hypersensitivity to light and sound during the headache. If you have a prodrome or aura that precedes your headaches, you should take your migraine medication as soon as possible. Early treatment is the key to faster relief of the headache. Many patients link their migraine attacks to certain dietary items, particularly chocolate, red wine and port, cheese, onions, fatty foods, and acidic foods (oranges, tomatoes, etc.). Some of these foods are rich in tyramine, an amino acid, which has been incriminated as a provoking factor in migraine. Avoiding these items may reduce the chances of a migraine attack.

Treatment
There are many options for treating migraine headaches. Individuals who have frequent migraines may need to take preventive medication such as beta blockers, calcium channel blockers, antidepressants, anticonvulsants, nonsteroidal anti-inflammatory drugs, or hormones. If your migraines are infrequent, you may take medication only when needed. Your doctor will select the best therapy for you.

The DOs
• Keep a diary/calendar of your headaches and any events that seem to cause them.
• Take your medication as prescribed as soon as you feel a migraine developing.
• Get plenty of rest.

The DON’Ts
Many factors have been found to aggravate or precipitate migraine headaches. The following should be avoided:
• Stress.
• Changes in sleep habits.
• Fatigue.
• Certain dietary items such as alcohol (especially red wine), chocolate, cheese, Nutrasweet, and caffeine.
• Strong sensory stimuli (bright glare, loud noise, etc.).

When to Call Your Doctor
• If your headache lasts longer than usual, is more intense than usual, or is resistant to the medication that normally works for you.
• If you have severe vomiting that cannot be controlled with your medication.
• If you have a fever with your headache.
• If you have any problems associated with your medication.