What are migraine headaches?
Migraines are painful, sometimes disabling headaches that are often accompanied by nausea, vomiting, and sensitivity to light, noise, and smell. These throbbing headaches usually occur on only one side of the head, although the pain can shift from one side of the head to the other, or can occur on both sides at the same time.
What causes migraines?
Migraines run in families, and a genetic link has been identified. 1 However, it is not entirely clear why some people get migraines and others do not. While the cause of migraines is not well understood, it seems to involve widening and narrowing of the blood vessels in the brain, which triggers changes in brain chemicals, inflammation, and pain. 1 What are the symptoms?
Migraine headache symptoms vary and may occur with or without a warning sign called an aura. People who get an aura, which usually begins within 30 minutes before the headache starts, may see spots, wavy lines, or flashing lights. Some people have numbness or a "pins-and-needles" sensation in their hands, arms, or face during the aura. However, most people do not have an aura before they get a migraine headache. Common symptoms of migraine include a throbbing headache on one side of your head, along with nausea, vomiting, and sensitivity to light, noise, or smells. Physical activity can make your headache worse. Without treatment, your migraine headache may last anywhere from 4 to 72 hours. The pain and other symptoms that are associated with a severe migraine headache attack can be disabling.
How are migraines diagnosed?
Your doctor will diagnose a migraine by asking you questions about your health and lifestyle and by examining you. There are no lab tests that can confirm a diagnosis. Migraines can be difficult to diagnose because symptoms resemble those of other headache conditions. For example, many people have been diagnosed with sinus headaches when they actually have migraines. As a result, migraines are underdiagnosed and undertreated.
Your doctor may use the International Headache Society's criteria to diagnose migraines. You may be diagnosed if you experience 5 or more headache attacks without an aura (or 2 attacks with an aura) that last from 4 to 72 hours without treatment and are accompanied by symptoms of nausea, vomiting, or sensitivity to light and noise. 2 Your doctor will check your symptoms and decide whether you need to have tests to rule out other conditions that might be causing your headaches.
How are they treated?
There are many different treatments for migraines. Often doctors recommend trying a nonsteroidal anti-inflammatory drug (NSAID) first, such as aspirin or ibuprofen. NSAIDs have fewer side effects than migraine drugs. You may also try to reduce the number of migraines you experience by identifying and avoiding triggers that lead to migraines. If NSAIDs do not effectively treat your migraines, your doctor may suggest prescription drugs that treat or prevent migraines:
- Certain headache drugs known as triptans (such as Imitrex, Amerge, and Axert) are often used to treat a migraine as it is starting.
- Preventive headache drugs such as propranolol (for example, Inderal), divalproex (Depakote), or tricyclic antidepressants (amitriptyline or nortriptyline) are used to prevent migraines in some people who get them regularly.
Nontraditional treatments, such as acupuncture or the herb feverfew, may be added to drug treatment to help reduce headache pain or the number of migraines you experience, although more research is needed to confirm whether these alternative therapies actually work. 3, 4 Can migraines be prevented?
You may be able to reduce frequent migraines by avoiding triggers, such as certain foods, stress, and changes in your daily routine, although it is not clear how or why these events lead to migraines. Some common triggers of migraines include:
- Consuming certain substances such as chocolate, monosodium glutamate (MSG), red wine, and caffeine.
- Getting too much or not enough sleep.
- Fasting or skipping meals.
- Changes in the weather or barometric pressure.
- Stress or intense emotions.
- Strong odors or cigarette smoke.
- Bright lights or reflected sunlight.
Your doctor may also prescribe drugs to help prevent migraine headaches. | 
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