Migraine Headaches

Overview

Your symptoms can last a few hours or more than a day.

Women experience migraines three times more than men. About 12 percent of the United States population suffers from migraines on a regular basis. Migraines can run in families, and in people with depression, anxiety, bipolar disorder, sleep disorders and epilepsy.

Migraine Triggers

Although neurologists do not fully understand the cause, you may trace your migraines to certain triggers, including:

• Hormonal changes
• Stress
• Food
• Irregular sleep patterns
• Sudden weather changes
• Physical exertion
• Medicines

Migraine Types

There are two major types of migraines:

• migraines with auras
• migraines without auras

Symptoms depend on the type.

In migraines with auras, you have difficulty seeing and may temporarily lose part or all of their vision. You may see flashing lights or have stomach pain, tingling or numbness in your hands or face. Auras usually appear before your headache and act as a warning sign of the coming migraine. Some people experience auras with no headache pain. Research shows people who experience migraines with auras have higher risk for stroke.

Migraines without auras are the most common type of migraines. Your headache pain usually comes without warning and you feel it on one side of your head. You may also have nausea and increased sensitivity to light and sound.

Treatment

At IU Health, experienced neurologists diagnose migraines through gathering your medical history and giving you a thorough neurological exam. In some cases, your physician may also conduct magnetic resonance imaging (MRI), computed tomography (CT) or laboratory studies to rule out other underlying conditions.

Neurologists usually recommended treatment if you suffer four or more severe headaches a month. Your treatment for migraines focuses primarily on prevention and management of triggers.

You can take pain medicine as soon as you start having migraine symptoms to reduce the severity and duration of them. A number of medicines can relieve you from migraine pain. Migraine-relief medicines include:

• Triptan drugs, such as sumatriptan or rizatriptan, which increase the level of serotonin in the brain. Triptan medicines come in tablets, nasal spray and injections.
• Ergot derivative medicines, which bind to serotonin receptors in the brain. They work best if taken during the early stages of a migraine and come in nasal spray or injection.
• Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, can reduce pain.
• Narcotics provide temporary pain relief.

Some people develop headaches as a result of overuse of migraine medication. At IU Health, experienced specialists will help you manage medicines to avoid both migraine-related pain and over-usage.

Preventive medicines can lessen the frequency of migraines and may prove successful if you experience migraines weekly. A number of medicines primarily used to treat other conditions can prevent migraines. Medicines for migraine prevention include:

• Anticonvulsants, primarily used to treat epilepsy, are also effective at preventing migraines.
• Beta blockers and calcium channel blockers, used to treat high blood pressure but also to prevent migraines.
• Antidepressants, as they increase the production of serotonin.

Botulinum Injections

At IU Health, physicians also offer botulinum toxin A injections as a preventive treatment for some forms of migraines. This FDA-approved treatment can reduce migraine frequency if you get chronic migraines and it can reduce your dependence on medicine.

During treatments, which typically occur once every three months, your physician will inject botulinum toxin into the muscles of the brow, eyes, forehead and the side and back of the head.