Headache Syndromes, including Migraine

Almost everyone has had a regular headache, but did you know that sometimes, headaches can serve as warning signals of more serious disorders? 

Headaches fall into two categories:

Primary Headaches

Primary headaches are the most common types by far. They include:

  • Muscle contraction (tension headaches, which may involve the tensing of the face and neck muscles)
  • Vascular  
    • Migraines (described in more detail below)
    • Cluster headaches, which cause repeated episodes of intense pain
    • Headaches caused by high blood pressure

Secondary Headaches

Secondary headaches are rarer and more serious than primary headaches.

They may be caused by underlying diseases or other conditions ranging from brain tumors, to aneurysms, to inflammatory diseases, to problems with the spinal fluid

If a headache is of a new or unusual type to you, or is the worst pain you’ve ever felt, or comes with other symptoms like blurry vision or stomach problems, seek medical help immediately.

What makes it a migraine?

Migraine headaches are usually characterized by severe pain on one or both sides of the head, an upset stomach, and, at times, disturbed vision. Some other features of migraine can include:

  • Number of attacks (at least 5, lasting 4-72 hours if untreated)
  • Nausea and/or vomiting
  • Sensitivity to both light and sound
  • Preceded by an “aura,” visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision
  • Recurring attacks triggered by a number of different factors, including stress, anxiety, hormonal changes, bright or flashing lights, lack of food or sleep, and dietary substances

Migraine is three times more common in women than in men. Migraine in some women may relate to changes in hormone levels during their menstrual cycles. Scientists used to believe that migraines were linked to the dilation and constriction of blood vessels in the head. Now, however, investigators think that migraine has a genetic cause.

How are migraines treated?

Although migraines can’t be cured, they can be treated. There are two approaches:

Prevention of migraine attacks

  • Medications—drugs originally developed for epilepsy, depression, or high blood pressure have been shown to be extremely effective. So has botulinum toxin A
  • Behavioral changes—stress management, exercise, relaxation techniques, biofeedback mechanisms, may help. Making a log of personal triggers can also provide useful information for trigger-avoiding lifestyle changes. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle.

Symptom relief (acute treatments) during attacks

Medicines like sumatriptan, ergotamine, and analgesics are used. The sooner these treatments are administered, the more effective they are.

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