Sufferers can have 'aura' to warn of migraine

Q: How is a migraine different from a headache?

A: Almost everyone experiences headaches occasionally. Most headaches are mild enough that they don’t significantly hamper an individual’s lifestyle or impair the ability to perform the tasks that we usually carry out in a typical day. Migraines can have accompanying nausea and vomiting, as well as difficulty in thinking clearly. Migraines can also have associated warning signs of an impending migraine headache, known as the “aura.” This aura can be non-painful and will often include visual experiences, such as flashing lights or colors. Migraine headaches are often accompanied by a painful sensitivity to light, known as photophobia, as well as sensitivity to loud noise, known as phonophobia. Milder variants of headache do not have these accompanying sensitivities.

Q: Are there different types of migraines?

A: There are several different types of migraines, which are classified by the International Headache Society (IHS). These include migraines without aura, which is the most common variant of migraine headache. These headaches are typically accompanied with nausea, vomiting, photophobia or phonophobia, as mentioned above. Migraines with aura are the second most common variant of migraine headache. Basilar-type migraines are migraine headaches that are accompanied by brainstem dysfunction during the headache, which can cause difficulty in speaking as well as dizziness. More severe episodes of basilar-type migraines can lead to possible stroke, although this is rare. There are also abdominal migraines that principally affect children and may not feature a headache at all, but abdominal symptoms, such as a dull abdominal pain, with associated loss of appetite, nausea/vomiting and possible moodiness. Menstrual migraines affect about 21 million women in the United States. Menstrual migraines often occur around the timing of the menstrual period and can be more severe than the typical migraine, with more associated nausea and vomiting. Menstrual migraines are often treated with the same medications used to treat other migraine headaches.

Q: What triggers migraines?

A: Migraines can be triggered by a variety of causes, some obvious and some not so obvious. Keeping a daily diary of your routine, including a log of your eating, sleeping and exercise habits, can be helpful in recognizing the factors that contribute to your headaches. Some common triggers of migraines include light, including bright sunlight, flickering lights, fluorescent lights and the light from a computer screen; menstrual cycles and associated hormonal fluctuation; certain foods, particularly red wine, diet soda, chocolate and aged cheeses; fatigue; and changes in the weather.

Q: Who is at risk?

A: Migraines can affect everyone, but there are differences in prevalence of migraine associated with age and gender. During childhood, boys and girls suffer equally. About 5 percent of all children will suffer from a migraine disorder. After puberty, there is an increased incidence of migraine in women, compared to men. Up to 15 percent of adult men will suffer from a migraine headache, while up to 35 percent of adult women will experience a migraine. Individuals with epilepsy are twice as likely to complain of migraine headaches as the rest of the population not affected by seizure disorder.

Q: Can migraines lead to more serious conditions?

A: There is a significant relationship between migraine headaches and potential increased incidence of cardiovascular disease, such as stroke and heart disease. There is a two- to three-time increased risk for stroke in young adult migraine sufferers, particularly in women who use a hormonally based form of contraception.

Q: When is it necessary to see a doctor?

A: You should seek medical advice when you have new, persistent headache pain and you are over the age of 50. Additionally, if you experience a headache that starts abruptly and is very severe, the so-called “thunderclap” headache, you should promptly seek help. A headache after a head injury, especially if not improving, should be evaluated by a medical professional. Any headache with accompanying worrisome neurologic symptoms, such as difficulty speaking, double vision, weakness and confusion, should also be assessed by a health-care provider.

Q: What do you know about a type of treatment called biofeedback?

A: Biofeedback is a method of treatment for migraine headaches that doesn’t require the use of medications. It is a method of learned relaxation to use your thoughts to control your body. Using specialized equipment that can measure markers of relaxation, such as hand temperature, individuals can control blood pressure, muscle tension and brain activity. It can be very helpful in reducing the frequency of migraine headaches and can decrease the severity of a migraine, but requires significant practice to implement it.