JUSTIN C.K. DAVIS, M.D.: Hi. My name is Dr. Justin Davis, and today I would like to describe to you briefly about migraine headaches. Now, a migraine headache is a kind of headache but it is a particular kind of headache that sometimes it is referred to as a neurologic headache, because it occurs in the brain due to a spasming or an instability of the blood vessels of the brain which then cause other symptoms. Now there are other types of headaches such as a tension headache or a cluster headache, or perhaps a headache that is caused to some other reason, and these are very different kinds of headaches and have different treatments and different symptoms than a migraine. Migraines are fairly common almost everyone knows somebody that suffered from a migraine at least once and unfortunately, those that do suffer from migraines tend to do so repeatedly over a course of their lifetime. Migraines are a little bit more common in women than in men for some reason. Up to 17% of women in the United States will suffer from migraines, only about 6% of men suffer from migraines, but those that do suffer from migraines will all tell you the same thing: They are excruciating, unbearable and really negatively affect their life in many ways if not controlled properly. Some of the symptoms of migraines are as follows: First of all, some people, but not all people, may have what is called an aura. An aura is some kind of signal that the headache is about to occur before it actually does. For some people, this may be a tingling of lights or a tingling sensation in their arms or legs. Other people may get a certain sound that they hear or a certain taste. Why do they get this? We do not know exactly but because some migraine is a neurologic headache in the brain, it can cause a variety of symptoms. Most people that have migraines will have one common symptom, however, and that is excruciating pain. Although even that is not always true, there are some atypical migraines that will cause other unusual symptoms rather than pain such as a narrowing of vision, maybe dizziness, maybe a tingling sensation in a part of the body but this is more uncommon. Again, the most common feature of a migraine is excruciating pain perhaps that maybe accompanied by not wanting to move at all, not being able to be exposed to light, light sensitivity is what that is called or photosensitivity, and a number of other potential symptoms maybe associated with the migraine
aside from pain. So how exactly do you treat a migraine? Well, first of all we divide treatments into two different categories, there is preventive treatment and there is abortive treatment. Abortive treatment simply refers to the term when you are trying to get rid of the headache once it is there. So we have a number of different means to try to prevent the headache some of those are simply avoiding triggers. Sometimes people know that there may be something that makes them more likely to have headaches; this could be caffeine, maybe chocolate or other certain foods or red wines, or there maybe certain kind of activities or stressful situations or not getting enough sleep that may trigger it. Whatever it is, it is important to try to recognize what these triggers may be in an individual so that you are more likely to be able to avoid getting migraines. Also, many women may get more migraines around their menstrual cycle. So while you cannot avoid your menstrual cycle until you go into menopause, there may be certain treatments around that that will be helpful in avoiding having a migraine. The other kind of treatment, which is the abortive therapy or getting rid of a migraine once you have it, there are a number of different medicines that are used to do this. Some of the categories of these medicines will include drugs called triptans and there is a number of this. There are also neurologic medicines that sometimes are used for seizures but seem to have a helpful effect upon migraines as well. Also other medicine such as antidepressants, some kind of vascular medicines that would typically be used to lower blood pressure can also be used, and there are even some medicines such as Botox injections that for some reason we are finding more evidence that perhaps these even help with migraines. But keep in mind, there is a number of different medications to help with this and not everyone works for every person so it is very important to work with your doctor or perhaps a neurologist that can help you find just the right way to prevent a migraine and to cure your migraine if it is present. So, what should you do if you suspect that you are having migraines? Migraines will typically begin to first occur in childhood or adolescence so they are not always and so usually you have known for a long time, but when it first occurs it can be very scary and because the symptoms of migraines can be so varied, it is important to let somebody know right away so that they can assess the problem and let you know that it really is a migraine and
not something else. So if you think that you may be experiencing migraines or you are having some of the symptoms that I described that could be associated with migraines, it is important to let a physician know because if you do have migraines then there are many different treatments to treat the migraine or prevent the migraine but sometimes these symptoms can be something else and they need to also be evaluated properly and then treated.
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