Despite years of research cause is still unknown

What is a migraine?

Migraine headaches can be extremely painful and debilitating – just ask anyone who has ever experienced one. Characterized by intense throbbing head pain, symptoms typically include pain on one side of the head accompanied by nausea and sensitivity activity, bright light or loud noises. Most migraines last from four to 12 hours, although they can be as short as a few hours or last a few days. Twenty-five percent of migraine sufferers experience aura, which cause visual disturbances such as wavy lines, dots or flashing lights and blind spots.

Despite years of research, the cause of this type of headache is still unknown. Today, many believe migraines are the result of a neurobiological disorder, which basically means they originate deep inside the brain. Changes in brain chemicals stimulate electrical activity, causing the vessels and nerves surrounding the brain to swell and cause intense pain.

Who Has Migraines?

Approximately 28 million Americans suffer from migraines each year, 70 percent of whom are women. Attacks can be set off by certain activities, foods, smells or emotions. Some are more likely to have migraines when they are under stress, while others suffer when the stress is relieved.

While the exact cause is unknown, evidence strongly suggests that the brain chemical serotonin is involved. For women, there appears to be a hormonal link with serotonin and estrogen. A majority of women with migraines suffer attacks near their menstrual cycle. Many believe the sharp drop in estrogen levels causes serotonin to react with brain chemistry, thus triggering an episode.

Migraines tend to strike people between the ages of 15 and 45 years old. They also appear to be hereditary. For example, if both parents have migraines, there is a 75 percent chance that their children will, too. If only one parent gets migraines, that percentage falls to 50 percent.

Diagnosis

If you suffer from regular migraines or have a family history of migraines, your doctor will likely diagnose the condition on the basis of your medical history and a physical exam. There is no test to diagnose migraines. If, however, your headaches are unusual, severe or sudden, your doctor may want to run tests to rule out other possible causes. The most likely tests would include computerized tomography or magnetic resonance imaging.

Computerized tomography provides a cross-sectional view of your brain and helps diagnose tumors, infections and other possible medical problems that may be causing your headaches. MRIs produce very detailed cross-sectional views of your brain and help diagnose tumors, strokes, aneurysms, neurological diseases and other brain abnormalities. An MRI can also be used to examine the blood vessels that supply the brain.

Migraine pain management has improved dramatically in the last decade. If you’ve seen a doctor in the past and had no success, it’s time to make another appointment. Although there’s still no cure, medications can help reduce the frequency of migraines and stop the pain once it has started. The right medicines combined with self-help remedies and changes in lifestyle may make a tremendous difference for you.

When to see a doctor

You should see a doctor if you have any symptoms that could indicate a serious, underlying medical problem. These include:

• Migraines that get worse over time;

• New migraines in a person over age 40;

• Severe headaches that start suddenly;

• Headaches with unusual symptoms such as passing out, loss of vision, or difficulty walking or speaking;

• Migraines that start after a head injury;

• Migraines that always occur on the same side of the head;

• Migraines in a person with certain medical problems including high blood pressure, cancer or AIDS;

• Migraines in a person with a family history of brain aneurysms.

In addition, you may want to see your health care professional if you have headaches that do not get better with over-the-counter medications; severe headaches that interrupt work or the enjoyment of daily activities; or daily headaches.

Dr. Kevin McKeighen is a board-certified family practitioner with special interests in hypertension, diabetes and migraine headaches. He practices at Enumclaw Medical Center, part of Franciscan Medical Group.