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Migraine Headaches

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What Are Migraines?

Almost everyone gets headaches. You might feel pain in your temples or at the back of your head from a tension headache after a busy day. Most regular headaches produce a dull pain around the front, top, and sides of your head, almost like someone stretched a rubber band around it.

A migraine is different. Doctors define it as a recurrent headache that causes other symptoms. The pain is often throbbing and can happen on one or both sides of the head. People with migraines often feel dizzy or sick to their stomachs. They may be sensitive to light, noise, or smells.

Migraines can be disabling, and teens with migraines often need to skip school, sports, work, or other activities until they feel better.

Who Gets Migraines?

If you have migraines, you're not alone. Up to 10% of U.S. teens and young adults get migraines. And after age 12, during and after puberty, migraines affect girls twice as often as boys.

Experts believe that the likelihood of getting migraines is inherited. If one of your parents gets migraines, you have a greater chance of having them than someone who doesn't have that family history.

What Causes Migraines?

The exact cause of migraines isn't known. Scientists think that they happen because some neurons (nerves in the brain) stop working properly and send the wrong signals. This may affect the nerve system that regulates pain.

Whatever the cause, experts do agree that different things trigger (set off) migraines in people who have them. Eating particular foods can bring on a migraine in some people. Others find that not getting enough sleep causes them.

Common migraine triggers include:

  • stress
  • menstruation (periods)
  • skipping meals
  • dehydration
  • too much caffeine (more than 200 mg a day, such as the amount of caffeine in energy drinks)
  • some foods (alcohol, cheese, citrus fruits, pizza, chocolate, ice cream, lunch meats and hot dogs, nitrites, aspartame, and MSG)
  • sudden changes in sleep patterns
  • changes in hormone levels
  • smoking
  • weather changes

What Happens During a Migraine?

Most migraines last from 30 minutes to 6 hours; some can last a couple of days.

Every migraine begins differently. Some people just don't feel right. Light, smell, or sound may bother them or make them feel worse. Sometimes, if they try to continue with their usual routine after the migraine starts, they may become nauseated and vomit. Often the pain begins only on one side of the head. Trying to do physical activities can make the pain worse.

Some people get auras, a kind of warning that a migraine is on the way. The most common auras include blurred vision and seeing spots, colored balls, jagged lines, or bright or flashing lights or smelling a certain odor. The auras may only be seen in one eye. An aura usually starts about 10 to 30 minutes before the start of a migraine.

Some people have a migraine premonition hours to days prior to the actual headache. This is a bit different from auras, and may cause cravings for different foods, thirst, irritability, or feelings of intense energy.

Some people with migraines also have muscle weakness, lose their sense of coordination, stumble, or even have trouble talking either just before or while they have a headache.

How Are Migraines Diagnosed?

Your doctor may ask you to keep a headache diary to help figure out what triggers your headaches. The information you record will help the doctor figure out the best treatment.

Sometimes, doctors may order blood tests or imaging tests, such as a CAT scan or MRI of the brain, to rule out medical problems that might cause a person's migraines.

How Are Migraines Treated?

Migraine headaches and their triggers can vary a lot between sufferers. So how doctors treat them depends on the type of migraine a person gets.

Treatment may involve lifestyle changes — like changing your sleep patterns or dietary habits, or avoiding things that trigger your migraines. Your doctor may also prescribe pain relief medicine or medicines that help with nausea and vomiting. Some people need preventive medicines that are taken every day to reduce the number and severity of the migraines.

Some doctors teach a technique called biofeedback to their patients with migraines. This technique helps a person learn to relax and use the brain to gain control over certain body functions (like heart rate and muscle stress) that cause tension and pain. If a migraine begins slowly, many people can use biofeedback to remain calm and stop the attack.

Some studies show that alternative methods such as acupuncture and the use of certain herbs can help some people. But it's important to ask your health care provider about alternative medicines before trying them for yourself. This is especially true of herbal treatments because they can interfere with more traditional methods of treatment.

Can Migraines Be Prevented?

Not all migraines can be prevented. But learning what triggers your migraines and trying to avoid them can help. Take a break from activities that might start a migraine, such as using the computer for a long time. If you know that certain foods are triggers, skip them. Some people find that cutting back on caffeine or drinking a lot of water can help prevent migraines.

Make a plan for all the things you have to do — especially during stressful times like final exams — so you don't feel overwhelmed when things pile up. Regular exercise also can reduce stress and make you feel better.

If your doctor has prescribed medicine, always have a dose on hand. Then, if you feel a migraine coming, take your medicine. It also can help to lie down in a quiet, dark room until the pain starts to go away.

Because migraines are so different for different people, keeping a headache diary can help you learn what triggers your migraines. The more you understand about your headaches, the better prepared you can be to fight them.

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Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.

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