Migraine Headache

A migraine headache feels like throbbing, stabbing or pulsating, normally on one side of the head.  It normally lasts hours to days.  It is often associated with  nausea and sensitivity to light or sound.  Sometimes, it occurs with a warning symptom called an aura.  This may be a visual sensation of colored lights or shapes interfering with what you normally see.

Migraines may occur after eating certain foods.  These may be foods like soup, salad dressing, beer, wine, chocolate, cheese, smoked or cured meats, or nuts.  Foods that are rich in monosodium glutamate (MSG) also tend to promote migraines.  Doctors ask patients with migraines to keep a diary of the foods they eat to find these triggers.  Migraines are also associated with poor sleep and psychological stress.

Sometimes migraine headaches can be stopped by certain medications.  These include simple remedies (aspirin, ibuprofen, acetaminophen), triptan medicines (sumatriptan, rizatriptan, eletriptan, rizatriptan, etc.), and others (indomethacin, ketorolac, midrin).  These medicines work best at the onset of the headache, especially within the first 20-30 minutes.

When migraine headaches occur frequently, such as more than 2 days per week, preventive treatment may help.  The most commonly used preventive treatments are vitamin B2, magnesium supplements, propranolol, amitriptyline, topiramate and valproic acid.  These are used every day, whether there is a headache or not.  For some people, injections with botulinum toxin every 3 months are helpful.