Migraine Headache Treatment

Most migraines hit one side of the head and cause throbbing or pulsing pain. Nausea, vomiting, and a strong dislike of light and sound often come with it. An attack can last from hours to days. The pain can be bad enough to stop your usual activities.

Some people get a warning sign called an aura before or with the headache. Medicine can ease migraine pain and prevent some migraines. The right medicine, together with self-care and lifestyle changes, may help.

At Padda Institute, our goal is to find the root cause of migraines. We review your history and exam first. We might order a test if the exam shows no neurologic warning signs, such as papilledema (swelling at the back of the eye). Talk with our specialists today.

Some people get auras before or during migraines. Auras are nerve symptoms that go away on their own.

Examples of migraine auras include:

• Vision changes, such as seeing odd shapes, bright spots, or flashes of light
• Vision loss
• A pins-and-needles feeling in an arm or leg

Left untreated, a migraine can last from 4 to 72 hours. How often they come varies from person to person. Migraines might hit once a month or many times a month.

You might have these symptoms during the migraine:

• Pain usually on one side of your head, but sometimes on both sides
• Nausea and vomiting
• Pain that throbs or pulses
• Being bothered by light, sound, and sometimes smell or touch

You may feel tired, foggy, and washed out for up to a day after a migraine. Some people feel strangely happy instead. A sudden head movement can briefly bring the pain back.

Migraines go undiagnosed and poorly treated far too often. If you get them often, keep track of each attack and how you handled it. Book a visit with a specialist about your headaches.

• See your doctor if the pattern of your headaches changes or if they feel different.
• A sudden, severe headache, like a thunderclap.
• Fever, stiff neck, confusion, seizures, double vision, numbness, or weakness in any part of the body. Any of these might mean a stroke.
• A headache that won’t quit and gets worse after coughing, exercise, straining, or a sudden movement.
• New headache pain after 50 years of age.

There is no single known cause of migraines. Genes and your surroundings may play a part. Changes in the brainstem may affect the trigeminal nerve, a major pain pathway. Imbalances in brain chemicals such as serotonin, which helps your nerves manage pain, might also play a role.
Common migraine triggers include:

• Hormonal changes in women: Many women get headaches when their estrogen levels swing, such as before or during periods, pregnancy, or menopause.
• Drinks: Examples are alcohol, mainly wine, and too much caffeine, such as coffee.
• Stress: Migraines can be brought on by stress at work or at home.
• Changes in sleep: Too little or too much sleep can cause migraines in some people.
• Changes in the weather: A change in weather or air pressure can set off a migraine.
• Food additives: The artificial sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods, can trigger migraines in some people.

The goal of migraine headache therapy is to ease symptoms and stop future attacks. Do not take any medicine without your doctor’s prescription. Two types of medicine treat migraines:

• Analgesics (pain relievers): These drugs, often called acute or abortive therapy, are given during an attack to ease symptoms.
• Medication for prevention: These drugs are taken on a regular basis, typically daily, to make migraines less severe or less frequent.

• Triptans: Prescribed drugs such as rizatriptan (Maxalt, Maxalt-MLT) and sumatriptan (Imitrex, Tosymra) treat migraine because they block pain pathways in the brain. As pills, shots, or nasal sprays, they can ease many migraine symptoms. People at risk of strokes or heart attacks should not use them.
• Dihydroergotamine (D.H.E. 45, Migranal): This drug comes as a nasal spray or a shot. It works best when taken soon after symptoms start, for migraines that tend to last longer than 24 hours. Side effects might include migraine-related nausea and vomiting.
• Opioid Medications: Narcotic opioid drugs might help people who can’t take other migraine drugs. They are highly addictive. They are usually used only when everything else has failed.
• Anti-nausea Medications: These help when migraine with aura comes with nausea and vomiting. Chlorpromazine, metoclopramide (Reglan), or prochlorperazine (Compro) are anti-nausea drugs. They are usually taken with pain medicine.

Padda Institute has the most experienced migraine specialists working in St. Louis area. Specialists trained in nervous system disorders work together to bring the best migraine treatment we can.