Migraines are a severe compilation of neurological symptoms that cause debilitating headaches in over 37 million Americans each year. The condition can be classified as chronic migraine syndrome when 15 or more headaches per month are experienced – eight or more of which being migrainous in nature over a three month period. Chronic migraine syndrome accounts for nearly 14 of the 37 million sufferers.
Who Gets Migraines?
Migraines impact 18% of women and 6% of men in the U.S. The condition tends to present most intensely after puberty, between the ages of 15 and 55 and severity begins to taper off with age. Migraines may also affect equal percentages of male and female children under the age of 12.
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Four out of five migraine sufferers have a family history of the condition. If one parent has been diagnosed with migraines, their child has a 50% likelihood of also developing the condition. If both parents experience migraines, the odds jump to 75%. Even if a relative has migraines, the child still has a 20% chance of developing the condition.
Chronic Migraine Symptoms
Not all chronic migraine sufferers will experience every symptom associated with the condition, however, it is not uncommon to experience a number of symptoms at once, including:
- Intense throbbing pain on once side of the head
- Intense throbbing pain on both sides of the head (1/3 of sufferers)
- Pain that shifts from one side of the head to the other
- Pain that affects the front of the head or seems to impact the entire head
- Pain that is mild, moderate, severe or debilitating
- Dizziness
- Nausea and vomiting
- Extreme sensitivity to light, sound, touch or smell
- Visual disturbances (auras)
- Pain lasting 4 to 72 hours
- Tingling or numbness in the face or extremities
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Migraine Theories
The exact cause of chronic migraine syndrome is unknown, however, research has uncovered a number of theories that may explain the source of the problem. A few of the most widely accepted explanations include:
1. Migraine Cascade
One theory describes migraine sufferers as having over-excited nerve cells in their brain. These cells can be triggered by specific stimuli or can become over-excited for no reason at all. When over-excitement occurs, blood vessels in the brain become inflamed, which may explain the searing, throbbing pain associated with a migraine attack.
2. Serotonin Levels
Serotonin is a neurotransmitter that controls the dilation of blood vessels when the body responds to injury. Studies have found evidence that migraine sufferers frequently have low levels of serotonin in their brain, hence the prescription of tricyclic antidepressants, which increase serotonin levels and have been shown to reduce migraine frequency. Low serotonin levels may cause improper pain processing in the brain, which can contribute to a migraine attack.
3. Hormones
Female migraine sufferers make up 70% of total migraineurs and some experts believe this may be because migraines are directly linked to estrogen. During a female’s menstrual cycle, estrogen levels dramatically drop, contributing to biochemical changes in the production, release and regulation of prostaglandin, a fatty acid that contributes to muscle contractions, blood pressure, inflammation and body temperature. The biochemical changes cause blood vessel inflammation that induces migraine pain.
Migraine Triggers
Many factors can activate the onset of a migraine attack. These factors are called migraine triggers and may include:
- Stress, anxiety or depression
- Food preservatives
- Caffeine
- Barometric changes
- Menstrual cycles
- Muscle tension
- Excessive fatigue
- Abrupt changes in sleep patterns
- Unstable eating pattern
Migraine Treatments
Because the exact cause of migraine pain is unknown, there is no singular “fix-all” treatment for the condition. Sufferers often experiment with a variety of medications and therapies before finding one or a combination of a few that works to reduce pain and frequency of attacks. Possible treatments include:
1. Over-the-Counter Medication
Over the counter remedies do not require a prescription and are comprised of pain relieving anti-inflammatory agents. Ibuprofen and Naproxen are the most commonly suggested types of over-the-counter drugs for migraine pain; however, it is not recommended these drugs be taken more than three days per week.
2. Anti-Nauseants
Severe nausea is a common symptom of migraines and prescription strength medications may be administered to combat queasiness and vomiting.
3. Preventative
Preventative medications aim to do just that – prevent an attack from occurring. Those who experience at least one migraine per week usually take them daily. Only four types of preventative medications have been approved by the FDA, including:
- Inderal (beta blocker)
- Blocadren (beta blocker)
- Depakote (anticonvulsant)
- Topamax (neuronal stabilizer)
4. Abortive
Abortive medication is used as soon as the first warning signs of an attack present to constrict blood vessels and prevent the progression of the migraine episode. The most commonly prescribed drugs in this class of treatment include triptans (Imitrex, Maxalt, Zomig, Amerge, Axert, etc.) or a triptan/non-steroidal anti-inflammatory (NSAID) compound (Treximet).
Abortive meds can be pricy and that’s why we wrote this: What Do I Do When I Can’t Pay for My Migraine Medication?
5. Rescue
If abortive medication fails to resolve an attack, rescue medication may be taken to help mask pain symptoms. Commonly prescribed rescue medications include:
- Vicodin
- Percocet,
- Tylenol #3
- Ultram
- Toradol
- Demerol injections
- Soma
- Skelaxin
- Zanaflex
6. Other
Injectable blocks that target the occipital nerves in the head may also be administered to interfere with the delivery of pain signals to the brain. Neurostimulation has also been found to have a similar affect and may be administered by wearing a device (Cefaly device) across the forehead or by implanting a neurostimulation device below the surface of the skin. Neurostimulation implantation is a minimally invasive, semi-permanent procedure with few side effects for qualifying patients. Natural supplements like feverfew, magnesium and CoQ10 have also been shown to reduce migraine frequency and severity by targeting specific bodily deficiencies and restoring balance.
Sadly, almost half of all migraine sufferers are never diagnosed and many choose not to seek medical attention. If you suffer from any of the abovementioned symptoms, It’s important to schedule an appointment with your physician to discuss the type of pain and symptoms you are experiencing. With a correct diagnosis and guidance, symptoms and pain can be better managed and quality of life can be restored.
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