Migraines are headaches that are typically characterized as vascular headaches. In addition, they can be preceded by disturbances in vision such as loss in side or peripheral vision, flashes of light, and abnormalities in smell, which are known as auras. Other symptoms that may present themselves at the time that auras present themselves are numbness, tingling and weakness in the legs or arms, speech disturbances, confusion and perceptual disturbances.
Pain of migraines is typically felt as a throbbing, one-sided head pain that sometimes spreads to the entire head. In addition, pain is sometimes accompanied by nausea, vomiting, light sensitivity and is made worse by physical activity. Also, patients often complain of feeling cold, weak and might appear pale. Less common migraine symptoms include redness and tearing in one eye, nasal congestion and runny nose. Migraine headaches are more common in women, as they are sometimes tied to the menstrual cycle. It is thought that the hormone estrogen plays an important role in the development of migraines. Migraines that occur during the menstrual cycle are typically more severe, are not preceded by auras and last longer.
Migraine suffers often report that they experienced their first migraine headache as children. Since these types of headaches are usually exacerbated by fluctuations in hormones, they are worse during the reproductive years and decline as menopause approaches. As women near menopause, their levels of circulating estrogen declines, thereby decreasing hormonally fueled migraines. Also, when women undergo ovary removal they sometimes notice that their migraines decrease. Again, this is due to the fact that their estrogen levels have decreased. The ovaries produce significant amounts of estrogen and when the ovaries are surgically removed, estrogen production is diminished.
Treatment for migraines include over-the-counter medications such as anti-inflammatory drugs and analgesics such as acetaminophen and prescription medications such as ergotamine and triptans. Physicians might prescribe barbiturates and opioid based medications when a patient cannot tolerate side effects from triptan medications or ergotamine. These side effects include nausea, vomiting, palpitations and anxiety. Although very effective in treating migraine pain, the side effects can be worse than the migraine attack itself. Other treatments for the symptoms of migraines include anti-nausea medication. Many times the nausea that accompanies migraines is debilitating, so the physician may recommend drugs that control nausea and vomiting. A typical side effect of anti-nausea medication is drowsiness, which in this case, can be beneficial to the patient because it affords them much needed sleep and rest.
If these treatment options fail to bring resolution to the symptoms of migraine headaches, further evaluation may be needed. Although rare, symptoms of migraine headache can be indicative of more serious medical conditions such as a brain tumor or neurological condition. In addition, diagnostic tests such as an MRI or CAT scan might be useful in ruling out other causes of severe headache. If migraine pain and resultant symptoms come on suddenly, especially if the patient has no prior history of migraines, a lumbar puncture, or spinal tap may be warranted, as these symptoms might indicate meningitis, and will need immediate medical intervention.