A migraine headache can cause intense throbbing or a pulsing sensation in one area of the head that can last from hours to days and can be accompanied by nausea, vomiting and extreme sensitivity to light and sound. Approximately 3.2 million Americans are estimated to live with chronic migraines and only 20 percent of people with chronic migraines are properly diagnosed and treated. Chronic migraines can cause people to lose time at work, school and with family.
Usually, migraines have four stages, but all may not be present. Migraine stages include prodrome, aura, headache and postdrome.
Prodrome symptoms present one or two days before a migraine attack and can be characterized by constipation, depression, food cravings and irritability. Aura is usually associated with seeing flashes of light, but some people can have pins-and-needles sensations in an arm or leg and speech or language problems. The migraine attack can last from hours to days. It is characterized by pain on one side or both sides of the head along with sensitivity to light, sounds and sometimes smells; nausea and vomiting; blurred vision; and even lightheadedness. The postdrome, or final phase, is after a migraine attack, and it is most commonly associated with fatigue.
There is a genetic predisposition for migraines in about 80 percent of patients. Hormonal changes in women, food additives, drinks, stress, changes in wake-sleep pattern, intense physical exertion, changes in the environment and medications can all trigger a migraine.
The treatment for chronic migraines can include preventative medications that need to be taken on a regular basis to decrease frequency and intensity of the headaches and pain relieving medications that are designed to stop symptoms that have already begun. Preventative medications include cardiovascular drugs, antidepressants and anti-seizure drugs. In October 2010, the Food and Drug Administration approved BOTOX ® for the treatment of migraines.
BOTOX® (onabotulinumtoxinA) is a prescription medicine covered by most insurance plans. It is injected into 31 sites in the forehead, head and neck every three months to prevent headaches in adults with chronic migraines who have 15 or more days each month with headaches lasting 4 or more hours each day. Having this injection performed by an experienced physician can decrease potential side effects such as droopy eyes, double vison and even bruises at the injection sites.
If you have a history of headaches, see your doctor if the frequency and intensity of symptoms changes or if your headaches suddenly feel different. You should contact your doctor if you experience a severe and abrupt headache or if you have a headache associated with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking. Also seek medical attention if you have headaches after a head injury; if your headache is worse with coughing, exertion, or sudden movements; or if you are older than 50 and you are experiencing a new headache pain.