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Migraines: A Concierge Doctor’s Guide To Types, Causes, Symptoms, And Treatments

Migraines are a debilitating condition that affects many people, but with the right understanding and proper management, they can be controlled. Recognizing the types of migraines and knowing the triggers, such as certain foods or stress, are essential steps in prevention. If you are struggling with frequent or severe migraines, getting medical advice and exploring different treatment options, including lifestyle changes and medications, can significantly help improve your quality of life.

What is a Migraine?

Have you ever wondered why some headaches feel much worse than others?

Migraines are not just regular headaches; they are a neurological condition that causes intense, throbbing pain, often on one side of the head. Unlike typical headaches, migraines can last for hours or even days and are often accompanied by symptoms like nausea, sensitivity to light, and visual disturbances. Understanding the difference between migraines and regular headaches is important in order to treat them properly.

woman having a migraine

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What Are The Types of Migraines?

Common migraines

Common migraines, also known as migraines without aura, are the most frequent type of migraine. They are characterized by a throbbing or pulsing pain on one side of the head, often accompanied by nausea, vomiting, and sensitivity to light and sound. Unlike migraines with aura, these migraines do not include visual disturbances or other neurological symptoms before the headache begins. The pain can last from a few hours to several days, significantly impacting daily activities.

Migraines with aura

Migraines with aura are a specific type of migraine that includes sensory disturbances before the headache begins. These disturbances, known as auras, can involve visual changes like seeing flashing lights, zigzag patterns, or blind spots. Some people may also experience tingling in the face or hands, difficulty speaking, or a feeling of weakness. Migraines with aura usually progress to the typical migraine symptoms of throbbing head pain, nausea, and sensitivity to light and sound.

Chronic migraines

Chronic migraines are defined as headaches that occur on 15 or more days each month, with at least eight of those days involving migraine symptoms. This condition can be particularly debilitating, as it negatively impacts quality of life and daily functioning. Over time, the frequent occurrence of migraines can lead to increased sensitivity to pain and other long-term effects, making it important to get proper medical treatment.

Ocular migraines

A rare type of migraine that primarily affects vision, ocular migraines cause temporary vision loss or blindness in one eye, usually lasting less than an hour. This migraine type is often accompanied by a headache, but not always. The exact cause of ocular migraines is not fully understood, but they are believed to be related to changes in blood flow to the eye or visual cortex. Anyone experiencing these symptoms should consult a healthcare provider to rule out other serious conditions.

Vestibular migraines

Vestibular migraines are characterized by dizziness, vertigo, and balance problems, in addition to the typical migraine symptoms of head pain, nausea, and sensitivity to light and sound. These migraines are often triggered by certain movements, changes in head position, or visual stimuli like bright lights or patterns. Vestibular migraines can be particularly challenging because they affect coordination and balance, making daily activities more difficult.

Hemiplegic migraines

Hemiplegic migraines are a severe yet rare type of migraine that causes temporary paralysis or weakness on one side of the body, similar to a stroke. This paralysis is usually accompanied by other migraine symptoms, including a harsh headache, visual disturbances, and difficulty speaking. Hemiplegic migraines can be frightening and require immediate medical attention to rule out other serious conditions like a stroke.

Menstrual migraines

Migraines that are linked to hormonal changes in the body, especially the drop in estrogen levels that occurs before or during menstruation, are referred to as menstrual migraines. These migraines typically occur in the days leading up to or during a woman’s period and can be more intense than regular migraines.

Cluster migraines

Cluster migraines, also known as cluster headaches, are a type of migraine that occurs in cyclical patterns or clusters. These migraines are characterized by severe, burning pain around one eye or one side of the head, and they often occur at the same time each day. A cluster period can last weeks or even months, followed by a period of remission.

* Use the swipe feature to learn about the various types of migraines

What Are The Causes of Migraines?

There are many potential causes of migraines. One or a combination of these factors may contribute to the type and frequency of symptoms.

Genetic Factors

Genetics play a significant role in the development of migraines. If migraines run in your family, you are more likely to experience them yourself. Certain genetic mutations can make individuals more susceptible to triggers that cause migraines.

Hormonal Changes

Hormonal fluctuations, particularly in women, are a common trigger for migraines.1 What causes migraines in females often relates to changes in estrogen levels, especially during menstruation, pregnancy, or menopause. These hormonal shifts can make women more prone to migraines at specific times.

Stress and Anxiety

When you are feeling stressed, your body releases chemicals that can cause blood vessel changes, leading to migraines. Chronic stress can also lead to more frequent and severe migraines, making stress management an important part of migraine prevention.

Dietary Factors

Certain foods and drinks can influence migraines in susceptible individuals. Common foods that may cause migraines include aged cheeses, processed meats, chocolate, and alcohol. Caffeine and food additives like MSG can also be culprits. Avoiding these dietary choices  can help reduce the frequency of migraines.

Sensory Triggers

Bright lights, loud noises, and strong smells are common sensory triggers that can bring on a migraine. These triggers can result in overstimulation of the brain, leading to the onset of a migraine. Minimizing exposure to these stimuli, such as wearing sunglasses or limiting your exposure to strong odors, can help prevent migraines.

Sleep Patterns

Irregular sleep patterns, whether due to receiving too much or too little sleep, may also be a significant trigger for migraines.2 Maintaining a consistent sleep schedule is important because disruptions in your natural sleep cycle can increase your vulnerability to migraines.

Physical Exertion

Intense physical activity or sudden bursts of strenuous exercise can trigger migraines in some people.3 This is often due to changes in blood flow and pressure during exertion. Recognizing what causes migraines during physical activity can help you modify your exercise routine to prevent these painful episodes.

What Are The Symptoms of Migraines?

Common Symptoms

Migraine symptoms can vary but typically include a severe, throbbing headache on one side of the head, often accompanied by nausea, vomiting, and sensitivity to light and sound. Some may also experience visual disturbances, such as flashing lights or blind spots. The pain can last anywhere from a few hours to several days.

Symptoms by Migraine Type

Different types of migraines are associated with specific symptoms. For example, migraines with aura involve visual or sensory disturbances before the headache begins, while vestibular migraines include dizziness and balance issues. Ocular migraines primarily affect vision, causing temporary blindness in one eye. Hemiplegic migraines can cause temporary paralysis or weakness on one side of the body.

Warning Signs (Aura)

Before a migraine fully develops, some people experience warning signs known as aura. Individuals suffering from a migraine with aura might see flashing lights, zigzag patterns, or have blind spots in your vision. Other signs include tingling in the hands or face, difficulty speaking, or a feeling of weakness. These symptoms typically appear 30 minutes to an hour before the headache begins, serving as an early warning that a migraine is coming.

When to See a Doctor

You should see a doctor if your migraines become frequent, severe, or if they suddenly change in pattern. Also, if you experience symptoms like sudden, intense headaches, confusion, vision loss, or difficulty speaking, seek medical help immediately. These could be signs of a more serious condition. Understanding what are migraines caused by and getting a proper diagnosis is essential for effective treatment and management.

How To Diagnose Migraines?

Medical History

A thorough medical history is essential to properly diagnose a migraine. Your healthcare provider will ask about the frequency, duration, and intensity of your headaches, as well as any associated symptoms like nausea or sensitivity to light. They will also inquire about family history, triggers, and any medications you are taking to help in identifying patterns and ruling out other conditions, making it an essential step in the diagnostic process.

Physical Examination

During a physical examination, your doctor will check for neurological signs that could indicate other causes of your headaches. These checks may include testing your reflexes, muscle strength, and sensory responses. The exam helps to rule out more serious conditions like tumors or strokes and ensures that the headaches are indeed migraines.

Telemedicine

Telemedicine offers a convenient way to discuss your symptoms and medical history with a healthcare provider from the comfort of your home. This option can be especially beneficial  for initial consultations, where you can receive guidance on whether further in-person testing is necessary.

Diagnostic Tests

To confirm a migraine diagnosis, doctors may need to order additional tests. These might include MRI or CT scans to rule out other conditions, and sometimes an EEG if seizures are suspected.

Blood tests can also help identify underlying issues. While these tests are not always necessary, they are valuable tools in diagnosing migraines accurately and ensuring appropriate treatment.

Potential Treatments for Migraines

There is no one-size-fits-all for migraine treatment. One or a combination of the treatments below may help manage symptoms and provide relief.

Medications

Comprehensive migraine treatment often involves a combination of over-the-counter (OTC) and prescription medications.

Common OTC options include ibuprofen and acetaminophen, which can relieve mild to moderate pain. For more severe migraines, prescription medications like triptans or topamax may be recommended to reduce the frequency and intensity of your migraines.

Preventive medications, such as amitriptyline or nortriptyline, can be prescribed to lower the frequency of migraines.4 Also, Myers Cocktail IV Therapy offers a blend of vitamins and minerals delivered directly into the bloodstream, providing relief and potentially preventing future migraines.

Non-Pharmacological Treatments

Non-pharmacological treatments focus on lifestyle adjustments to manage migraines. Implementing lifestyle changes like maintaining a regular sleep pattern, a balanced diet, and getting adequate hydration can help reduce the frequency of migraines. Paying close attention to diet and nutrition is very important because certain foods may trigger migraines.

Stress management techniques, including meditation or yoga, can also play a significant role. Incorporating regular sessions of mild exercise into your routine is another good strategy to prevent migraines by promoting overall health and reducing stress levels.

Alternative Therapies

There are a wealth of traditional treatments options that can offer additional relief for those with migraines. Acupuncture has been shown to reduce the frequency and severity of migraines in some individuals. Biofeedback helps patients learn how to control physiological functions like muscle tension and heart rate, which can trigger migraines.

Herbal supplements, such as magnesium for migraines and feverfew, are often used to prevent or alleviate migraine symptoms. While there are still ongoing studies being conducted on their effectiveness, these natural approaches may be effective, especially when combined with other treatments.

Surgical Options

For chronic migraine sufferers, surgical options may provide long-term relief. Botox for migraines involves injecting small amounts of botulinum toxin into specific areas of the head and neck, reducing the frequency and severity of migraines by blocking pain signals.

How To Prevent Migraines

Implementing positive lifestyle modifications can significantly reduce the frequency of migraines. Regular exercise, maintaining a consistent sleep schedule, and sticking to a daily routine are essential steps. Exercise promotes overall health and reduces stress, while proper sleep helps prevent migraines by ensuring your body is well-rested. Establishing a routine that includes these elements can be a powerful way to manage and prevent migraines.

Dietary Adjustments

The specific foods you choose to eat can also play a key role in preventing migraines. Identifying and avoiding foods that trigger migraines is crucial. Common triggers include aged cheeses, processed meats, and foods containing MSG. By eliminating these items from your diet, you can reduce the likelihood of migraine attacks. Incorporating a balanced diet rich in nutrients is also beneficial for overall health and migraine prevention.

Stress Reduction Techniques

Anxiety and stress are significant causes of migraines, so learning stress reduction techniques is vital. Practices such as deep breathing exercises, meditation, and yoga can help you manage stress levels. Regularly incorporating these techniques into your routine can help prevent migraines by keeping stress under control. Understanding what helps with migraines in terms of stress management is key to reducing their frequency and severity.

Regular Sleep Patterns

Maintaining regular sleep patterns is essential in the prevention of migraines. Irregular sleep, regardless of if you get too much or not enough, can bring about migraines. Establishing a consistent bedtime and wake-up time helps regulate your body’s internal clock and reduces the risk of migraines. Prioritizing good sleep hygiene is one of the most effective ways to prevent migraines and improve overall well-being.

Final Words

Migraines are more than just headaches; they are a complex neurological condition that requires careful management. Understanding the different types of migraines, their causes, and effective treatment options is crucial for managing the condition. If you experience persistent or worsening symptoms, it’s important to seek medical advice. With the right approach, including lifestyle adjustments, medications, and stress management, you can live a fulfilling life despite migraines. Don’t hesitate to reach out to a healthcare provider to find the best strategies for your specific needs.

FAQs About Migraines

How do I stop my migraine?

Start by taking over-the-counter pain relief like ibuprofen or acetaminophen at the first sign of symptoms. Rest in a dark, quiet room, and apply a cold compress to your forehead. Staying hydrated and using relaxation techniques can also help. If symptoms persist, consult a healthcare provider for further treatment options.

What are migraines caused by?

Migraines are caused by a combination of genetic, environmental, and neurological factors. Common triggers include stress, hormonal changes, certain foods, and sensory stimuli like bright lights or loud sounds. Understanding your personal triggers can help you manage and prevent migraines more effectively.

What to do when a migraine starts?

When a migraine begins, take your prescribed medication or an over-the-counter pain reliever immediately. Find a quiet, dark place to rest, and try to relax. Applying a cold compress to your head and drinking water can help alleviate symptoms. If the pain worsens or doesn’t improve, seek medical advice.

How do you cope with migraines?

Coping with migraines involves a combination of medication, lifestyle adjustments, and stress management techniques. Identifying and avoiding triggers, maintaining a regular sleep schedule, and practicing relaxation exercises like yoga or meditation can all help. Staying proactive in your approach to managing migraines is key to reducing their impact on your life.

[1] Reddy N, Desai MN, Schoenbrunner A, Schneeberger S, Janis JE. The complex relationship between estrogen and migraines: a scoping review. Syst Rev. 2021 Mar 10;10(1):72. doi: 10.1186/s13643-021-01618-4. PMID: 33691790; PMCID: PMC7948327.

[2] Tiseo C, Vacca A, Felbush A, Filimonova T, Gai A, Glazyrina T, Hubalek IA, Marchenko Y, Overeem LH, Piroso S, Tkachev A, Martelletti P, Sacco S; European Headache Federation School of Advanced Studies (EHF-SAS). Migraine and sleep disorders: a systematic review. J Headache Pain. 2020 Oct 27;21(1):126. doi: 10.1186/s10194-020-01192-5. PMID: 33109076; PMCID: PMC7590682.

[3] Amin FM, Aristeidou S, Baraldi C, Czapinska-Ciepiela EK, Ariadni DD, Di Lenola D, Fenech C, Kampouris K, Karagiorgis G, Braschinsky M, Linde M; European Headache Federation School of Advanced Studies (EHF-SAS). The association between migraine and physical exercise. J Headache Pain. 2018 Sep 10;19(1):83. doi: 10.1186/s10194-018-0902-y. PMID: 30203180; PMCID: PMC6134860.

[4] Gooriah R, Nimeri R, Ahmed F. Evidence-Based Treatments for Adults with Migraine. Pain Res Treat. 2015;2015:629382. doi: 10.1155/2015/629382. Epub 2015 Dec 29. PMID: 26839703; PMCID: PMC4709728.



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