DUBOIS — As anyone who has experienced a migraine knows, it is much more than a bad headache. It can be a debilitating condition, making daily activities almost impossible and can sometimes leave you bedridden for hours or even days. Fortunately, there are lifestyle changes and treatments that can help manage your symptoms.
A migraine is a type of headache with severe throbbing or pulsating pain that usually affects one side of the head. Other symptoms may include nausea, vomiting and increased sensitivity to light, noise and odors.
Researchers are not sure what exactly causes migraines, but it may be the result of nerve-controlled inflammation of the dura, which is the membrane between the brain and the skull. Chemical changes in your brain and genetic factors may also play a part. Migraines can be triggered by a drop in estrogen levels (pre-menstruation), alcohol use, stress, cold weather fronts and sleep deprivation.
There are four phases of a migraine, although not everyone will experience all four phases and others may experience the phases simultaneously. The first stage, called prodrome, usually occurs up to 24 hours before the attack and might include symptoms such as mood changes, trouble sleeping and difficulty concentrating. The second stage, called aura, may not be experienced by everyone. This phase usually occurs between five and 60 minutes before the attack, during which time you may feel muscle weakness, vision changes and ringing in your ears.
The third stage is the actual headache, which can come with vomiting, severe pain and increased sensitivity to stimuli. This can last anywhere from several hours to several days. Finally, during the postdrome stage patients can experience fatigue, neck stiffness and trouble focusing. This stage can last up to 48 hours after the attack.
Migraine medicine and treatment options depend on the type and frequency of headaches you are experiencing. Some patients may benefit from lifestyle changes that minimize or eliminate the triggers of their migraines, such as establishing regular sleep hours, eating consistent meals, exercising regularly and managing stress. Other patients may be able to control their pain with over-the-counter medications. However, patients who consistently use over-the-counter medications for migraines can experience rebound headaches.
You might be wondering, “When is it time to see a neurologist for migraines?” It may be time to consider an appointment if you have a headache that lasts for more than two days, a headache that comes on suddenly and causes changes in your vision, a headache with pain that is made worse with straining, or a headache that is inhibiting your daily activities.
There are two types of treatment a neurologist can prescribe, acute treatment and preventive treatment.
“Acute migraine treatment is administered when the migraine is present,” said James Pacelli, MD, a neurologist with Penn Highlands Neurology.
“Acute treatment can address the pain, side effects like nausea or the underlying triggers. A range of pills, nerve blockers and infusion therapy may be recommended by your provider.”
Preventive migraine medication has advanced considerably in the last few years, according to Pacelli. Treatment now can include infusion therapy, injectable monoclonal antibodies, nerve blocks and Botox injections.
Everyone experiences migraines differently, and while each migraine is temporary, it is a lifelong condition. Your healthcare provider can help you manage the symptoms so that they are less intense and not as long. If you have been experiencing migraines and your current treatment plan is not working, talk to your provider.
Penn Highlands Neurology provides care to patients suffering from disorders of the brain and nervous system, including migraines as well as Parkinson’s, Alzheimer’s, stroke, MS, brain injuries, sleep disorders and much more. For more information, visit www.phhealthcare.org/headaches.
