Chronic Migraines
Migraines are severe and often debilitating headaches that are estimated to impact over 3.2 million men, women and children in the United States. Migraines often begin between childhood and early adulthood, and tend to progress over four stages: Pro-drome, Aura, Attack, and Post-drome, though not all patients experience all stages.
A chronic migraine diagnosis falls under the Chronic Daily Headaches condition, and is defined by:
- Headaches that occur at least 15 days a month
- A headache lasting at least four hours that occurs on at least eight days a month.
Warning Signs & Symptoms
No two migraines are identical, but most share similar trajectories and common characteristics, including:
- Pain on one or both sides of the head
- Pulsating, throbbing sensations
- Moderate to severe pain
- Onset aggravated by routine physical activity
- At least one of the following: nausea, vomiting and sensitivity to light and sound.
Symptoms are broken down into four stages:
Pro-drome
24 to 48 hours before a migraine, many experience:
- Frequent yawning
- Unexplained neck stiffness
- Unexplained food cravings
- Constipation
- Changes in mood, including extreme highs or lows
- Increased urination
- Increased thirst
Aura
Aura is not experienced by all migraine sufferers, and may occur before and during headaches. Auras are acute symptoms that usually progress over several minutes and then last between 20 to 60 minutes.
Auras are an indication of the nervous system and may cause disturbances to a person’s vision, sensory experiences, motor skills and speech.
Other characteristics of migraine aura include:
- Visual phenomena, such as seeing bright flashes of light, various shapes and zig-zag vision
- Temporary vision loss
- “Pins and needles” sensations in arms or legs
- Uncontrollable movements, including jerking or twitching
- Difficulty speaking
- Facial numbness or weakness
- Numbness or weakness in one side of the body
- Hearing noises or music.
- Limb weakness
Attack
Migraines typically last between four to 72 hours, and may include:
- Sensitivity to light, sound, as well as smells and touch
- Throbbing or pulsing pain
- Blurred vision
- Lightheadedness or fainting
- Nausea and vomiting
- Pain on one or both sides of head
Post-drome
After a migraine attack, some people feel exhausted, while others may be euphoric. Additionally, a one may also experience:
- Emotional or cognitive disorientation
- Moodiness
- Dizziness
- Weakness
- Light and sound sensitivity
Risk Factors & Possible Causes
Age, genetic predisposition and hormonal changes are all possible causes of headaches.
Tests to Diagnosis Chronic Migraines
A migraine diagnosis is determined by a neurologist and is based on a combination of family history, medical history, symptoms and a physical and neurological examination.
Doctors may recommend additional tests in order to rule out other possible causes for headache pain, including:
- Blood tests
- Magnetic resonance imaging (MRI)
- Computerized tomography (CT) scan
- Spinal tap
Treatment Options
Oral pain relievers, such as over-the-counter medications and prescription pain killers are the most common treatment options. However, Botox and beta blockers have proven effective in treating chronic migraines.
Prevention
There are a variety of nontraditional migraine prevention therapies and nutritional and supplemental approaches. Acupuncture, biofeedback, massage and electrical stimulation of the occipital nerve may be helpful. Supplements that may also be helpful are magnesium, riboflavin (vitamin B-2), and coenzyme Q10. Cheeses, caffeine, monosodium glutamate (MSG), nitrates, or aspartame are also considered to be migraine triggers that a migraine sufferer may want to avoid.