By Christie Aschwanden
CONSUMER HEALTH INTERACTIVE

Note: This article has been localised for an Irish audience.

People get migraine headaches when blood vessels in the head expand, touching nearby pain receptors. Researchers aren't sure what causes these arteries to misbehave, but they think fluctuations in levels of neurotransmitters -- which regulate the perception of pain -- may be to blame. Other possible triggers include the hormonal changes that accompany menstrual periods (migraines are twice as common in women), oral contraceptives, changes in sleep patterns, changes in weather, bright or flashing lights, VDUs, and some foods - particularly chocolate, red wine and aged cheese. Your genes may also predispose you to getting migraines, and age seems to play a role as well. Most people who get migraines have their first attack before age 30, and migraines often go away after age 50.

About 10 to 30 minutes before they get a migraine, most people begin to get irritable or restless or nauseated, or lose their appetite. Others experience visual changes called auras (neurological symptoms that can include vision loss, the appearance of shimmering borders around objects, or zigzag patterns); you might see flashing lights or colours as well. In rare cases, an aura can mimic a stroke, causing weakness, numbness, or difficulty speaking. Once the headache begins, you'll probably notice these symptoms:

•Mild to severe pulsing or throbbing pain, usually on one side of the head, that lasts from several hours to several days

•Worse pain if you move around or look at bright light or hear loud noise

•Interference with daily activities and perhaps nausea or vomiting

Over-the-counter pain relievers, such as aspirin and other analgesics, can be helpful. But for frequent migraines, prescription drugs are probably your best bet, particularly a class of drugs called triptans, which can stop a migraine in its tracks if taken at the first sign of symptoms. There are two triptans now available in Ireland, namely sumatriptan (Imigran) and zolmitriptan (Zomig). These are in tablet form, and are available on prescription only. Some people have also found relief from acupuncture, relaxation exercises, yoga, and herbal remedies like feverfew, though no good studies support their use.

Not always. But you can lessen your chances of getting a migraine:

•Try taking over-the-counter pain relievers when you first notice symptoms.

•Eat regular meals. When you skip a meal, your blood sugar levels crash, which can trigger a migraine.

•Track your migraines in a diary that includes when you got the migraine, where you were when it came on, and what you ate and drank that day. Over time, the diary will help you recognise and avoid your individual triggers.

•If you're on birth control pills and your migraines strike just before your period each month, some doctors may recommend a lower dose pill to even out your hormonal ups and downs, but this isn't always effective.

•Some prescription drugs (including beta blockers, some antidepressants, calcium channel blockers, and anticonvulsants) are now used to prevent migraines in people who get frequent migraine attacks. Consult your doctor to find out whether any of these preventive treatments are right for you.

•if your headaches interfere with daily life

•if your headaches get stronger and more frequent

•if your headaches last more than 24 hours or recur two or three times per week

•if you also have numbness, blurred vision, memory loss, or dizziness

•if you get a headache after hitting your head

•if exercise brings on the headache

•if your headache is accompanied by a fever of more than 38 centigrade (100 farenheit) degrees, you find it painful to bend your head forward, or light hurts your eyes

•if the headache is accompanied by nausea, vomiting, or drowsiness

Migraine Association of Ireland.

Tel. 01 8724137/8724157

http://www.migraine.ie

e-mail: info@migraine.ie

This article has been revised by Vhihealthe for its audience and may contain, among other things, information or medical practices that are unique to Ireland. Neither Consumer Health Interactive nor the original author make any warranty as to the accuracy of the article as revised, and assume no responsibility for modified content.

First published November 21, 2000

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