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Alternative namesMigraine - common; Headache - migraine (common)
DefinitionCommon migraine is a disorder involving recurrent headaches , which may be accompanied by symptoms other than headache but which rarely include a preliminary warning (called an aura).
Causes, incidence, and risk factors
Migraine headaches affect about 6 out of 100 people. They are a common type of chronic headache. They most commonly occur in women and usually begin between the ages of 10 and 46. In some cases, they appear to run in families.
Migraines occur when blood vessels of the head and neck spasm or constrict, which decreases blood flow to the brain. Minutes to hours later, the blood vessels dilate (enlarge), resulting in a severe headache. Inflammation around the blood vessels also occurs in some cases.
Common migraine accounts for almost all migraine headaches. Common migraine may be accompanied by symptoms other than headache but only rarely includes any preceeding symptoms (aura). Migraine may also appear as classic migraine (a migraine preceded by other symptoms) and other rare forms.
Multiple mechanisms trigger the spasm and subsequent blood vessel dilation. Attacks of migraine headache may be associated with:
Foods that have been associated with migraine in some people include foods containing the amino acid tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, some beans), chocolates, nuts, peanut butter, fruits (avocado, banana, citrus fruit), onions, dairy products, baked goods, meats containing nitrates (bacon, hot dogs, salami, cured meats), foods containing monosodium glutamate (an additive in many foods), and any processed, fermented, pickled or marinated foods.
Signs and tests
A health care provider should be consulted to rule out other disorders that may be causing the headache if the headache:
Migraine headache may be diagnosed by the health care provider based on the pattern of symptoms, history of migraines in the family and response to treatment. A physical examination will reveal no detectable abnormalities.
There is no cure for common migraine. The goals of treatment include controlling the symptoms and preventing further attacks.
Over-the-counter analgesics may reduce pain if they are taken early in the development of the headache . If mild analgesics are ineffective, vasoconstricting or other medications may be beneficial. Ergotamine tartrate preparations constrict the arteries of the head and may be used alone or in combination with other drugs such as caffeine (Cafergot), phenobarbital, or Fioricet.
Propoxyphene or other medications that relieve pain or inflammation may provide relief for some people. Nausea should be treated early with Reglan, Compazine, or other anti-emetics.
Several medications may need to be tried before a medication that is effective in preventing migraine is found. Imitrex (sumatriptan) and other triptans have been found to be very effective in the treatment of migraine if taken at the beginning of an attack. It is self-administered as an injection under the skin or can be taken as a pill.
Support GroupsFor other organizations that provide information about migraine, see migraine resources .
Common migraine does not indicate a life-threatening disorder. It usually is painful and annoying at the time it occurs. It may be chronic and recurrent, which can interfere with a person's lifestyle.
Rarely, severe migraine may result in a stroke, possibly due to prolonged constriction of blood vessels. Some people may have side effects of medications. A physician should choose the appropriate medications based on symptoms and other conditions.
Calling your health care provider
See your health care provider if symptoms of migraine are severe, persistent, or recurrent. Call if any other new symptoms develop or there is a change in the severity or pattern of symptoms.
Call your health care provider if previously effective treatments no longer are helpful, or if symptoms indicating side effects of medications occur, including irregular heartbeat , pale or blue skin color, extreme sleepiness or sedation, persistent cough , depression , fatigue , nausea , vomiting , diarrhea , constipation , stomach pain or cramps, dry mouth, extreme thirst , or others.
Also, call if you are taking an ergotamine-containing medication, and you are likely to become pregnant. (These medications should not be taken when pregnant.)
PreventionThe occurrence of common migraine may be reduced in high-risk people who avoid factors that have been associated with previous migraine . Preventive (prophylactic) medications may be advised for some people (see Treatment).
Update Date: 11/14/2002Elaine T. Kiriakopoulos, M.D., M.Sc., Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT