Migraine Headaches

What Are Migraines?

A migraine is a type of headache that recurs (keeps coming back), and also causes other symptoms. The pain is often throbbing and can happen on one or both sides of the head. People with migraines can feel dizzy or sick to their stomachs. They may be sensitive to light, noise, or smells.

Migraines can be disabling, and teens with migraines often need to skip school, sports, work, or other activities until they feel better.

Experts believe that the likelihood of getting migraines runs in the family. If you have a parent who gets migraines, you have a greater chance of having them than someone who doesn't have that family history.

What Causes Migraines?

The exact cause of migraines isn't known. Scientists think that they happen because some neurons (nerves in the brain) stop working properly and send the wrong signals. This may affect the nerve system that regulates pain.

Whatever the cause, experts do agree that different things trigger (set off) migraines in people who have them.

Common migraine triggers include:

• stress
• changes in hormone levels, such as from periods or birth control pill use
• skipping meals
• dehydration
• too much caffeine or withdrawal from caffeine (suddenly having less caffeine than usual)
• some foods (alcohol, cheese, citrus fruits, pizza, chocolate, ice cream, etc.)
• sudden changes in sleep patterns
• smoking
• weather changes

What Happens During a Migraine?

Every migraine begins differently. Sometimes people get a warning that a migraine is on its way. A few hours or even days before the actual headache, people might feel funny or "not right. They might crave different foods, or feel thirsty, irritable, tired, or even full of energy. This is called a "premonition."

Some people get auras. These are neurological symptoms that start just before the headache and last up to an hour. An aura is different in every person, but it often affects vision. For example, a person might:

• have blurred vision
• see spots, colored balls, jagged lines, or bright flashing lights
• smell a certain odor
• feel tingling in a part of their face

Once the headache starts, light, smell, or sound may bother people with migraines or make them feel worse. Sometimes, if they try to continue with their usual routine, they may become nauseated and vomit. Often the pain begins only on one side of the head, but it might eventually affect both sides. Trying to do physical activities can make the pain worse.

Most migraines last from 30 minutes to several hours; some can last a couple of days.

How Are Migraines Diagnosed?

Your doctor will ask a lot of questions to see what might be causing the symptoms, and will examine you, paying particular attention to the neurological exam. They may ask you to keep a headache diary to help figure out what triggers your headaches. The information you record will help the doctor figure out the best treatment.

Sometimes, doctors may order blood tests or imaging tests, such as a CAT scan or MRI of the brain, to rule out medical problems that might cause a person's migraines.

How Are Migraines Treated?

Migraine headaches and their triggers can vary a lot between people. Treatment can depend on how severe the headaches are, how often they happen, and what symptoms a person gets with them.

Usually it helps to lie down in a cool, dark, quiet room. Your doctor may prescribe pain relief medicine or medicines that help with nausea and vomiting. Some people need preventive medicines that are taken every day or right at the start of a headache to reduce the number and severity of the migraines.

Some doctors teach a technique called biofeedback to their patients with migraines. This helps a person learn to relax and use the brain to gain control over certain body functions (like heart rate and muscle stress) that cause tension and pain. If a migraine begins slowly, some people can use biofeedback to remain calm and stop the attack.

Adding other non-medicine therapies to the treatment plan, such as acupuncture or herbs, helps some people with migraines. But ask your health care provider about these before trying them. This is especially true of herbal treatments because they can affect how other medicines work.

Can Migraines Be Prevented?

You can't prevent every migraine. But learning your triggers and trying to avoid them can help. Take a break from activities that might start a migraine, such as using the computer for a long time. If you know that some foods are triggers, skip them. Some people find that cutting back on caffeine or drinking a lot of water can help prevent migraines.

Plan for the things you have to do — especially during stressful times like exams — so you don't feel overwhelmed when things pile up. Regular exercise also can reduce stress and make you feel better.

The more you understand about your headaches, the better prepared you can be to fight them.