Migraine Insights: Understanding Triggers, Symptoms and Effective Treatments

Migraine Insights: Understanding Triggers, Symptoms and Effective Treatments

By Monica Hauger, FNP

Do you or someone you care about suffer with migraine headaches? If so, you are not alone. The American Headache Society (AHS) estimates there are 37 million Americans who live with migraine headaches, and migraines are ranked as the second leading worldwide cause of disability. Migraines are not something that you can see, and many people suffer in silence, unaware of treatment options. I personally live with migraines, as do my daughter and my husband. I am all-too-familiar with the symptoms that migraines cause and how they impact people’s lives.

Migraines are headaches that, untreated, last between 4 to 72 hours. They are often described as a throbbing headache on one side of your head, but can also be on both sides. These types of headaches are moderate to severe in intensity, and — in addition to the pain — come with at least one other symptom such as light sensitivity, sound sensitivity, nausea or vomiting. Not everyone who suffers with migraines will experience the same symptoms.

Although less common, some patients will also have an aura. An aura is a symptom that occurs before the headache starts and is usually described as visual changes like wavy or squiggly lines. Symptoms that are not associated with migraines are fever, chills, night sweats, weight loss, double vision, body pain or weakness. These are just some of the symptoms that need to be evaluated by a health care provider and could be a sign of something serious.

Migraines come in four stages: prodrome, aura, headache and postdrome. Prodrome is the first stage in a migraine attack and can last for hours to days, though not every individual has symptoms in this stage. People who do experience symptoms might have food cravings, increased urination or be more tired than normal. Aura is the next stage and can present as changes in smell or state, flashing lights or a funny feeling. Headache is the next phase, and although most people with migraines have no warning (no symptoms in prodrome or aura), all suffer with headache and at least one additional symptom. Prodrome is the last phase — which I like to call the “hangover phase” because most people describe a feeling of tiredness or lack of focus — but others may have mood changes that can range from depressed to euphoric.

Although there is not a cure, there are many treatments for migraines. Treatments are classified as acute and preventative. Anyone who gets migraine headaches needs an acute treatment option. There are lots of choices for acute treatments, but some of the most common are triptans (and one ditan), gepants, ergots and anti-inflammatories — all of which your health care provide can explain. Individuals who have four or more headache days a month need to consider adding a preventative medication in addition to the acute medication. Preventative medications help prevent someone from having as many migraines, but need to be taken regularly. These preventative medications can come in pills, injections or infusions. There are multiple classes of medications that can be used for prevention, such as beta blockers, anticonvulsants and CGRP inhibitors. Botox is another therapy that is specifically for people who have chronic migraines (15 or more headache days a month). These are not all the possible treatments, and it is always best to work with your health care provider to find the best treatment for you.

Many people with migraines are able to identify something that triggers their migraine. Triggers can be anything as simple as a change in diet, exercise or sleep. Once the triggers are identified, lifestyle changes can be made to decrease migraine frequency.

If you or someone you care about wants more information about migraines, please visit the American Headache Foundation website, which was created by AHS. A headache diary can also be downloaded to start recording symptoms of migraine and can be taken to your next appointment with your health care provider. Start the conversation about migraine with your nurse practitioner or other health care provider because treatment is out there, and it can make all the difference.

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