Migraine Symptoms

Migraine headaches usually present as one-sided throbbing head pain, along with symptoms such as nausea, vomiting, or sensitivity to light and sound. Migraine is very common and rated as the third most common reason for disability in both men and women younger than 50 years of age.^[1]

There are two major types of migraine: with or without an aura. Between 25-30% of people with migraine will experience auras, which are neurological symptoms (such as visual disturbances) that occur before, during, or after the migraine itself.^[1] Migraine can be debilitating and disruptive to a person’s life. However, the symptoms are transient, and do not result in permanent physical disability. That said, migraine is associated with a 2-3 fold increase in risk of various types of stroke. This is why it is especially important not to self-diagnose and to really figure out if you may have migraine or not.

Usually, a headache with additional symptoms of sensitivity to light and sound, nausea, and worsening with physical activity is most suggestive of a migraine. A migraine with aura involves reversible neurological symptoms that can be visual or sensory (e.g.: flashing lights, zig-zag lines, foggy vision).^[2]

In patients with acute migraine, first line treatments usually include two classes of medicines: nonsteroidal anti-inflammatory drugs (NSAIDS) and triptans. Examples of NSAIDS are ibuprofen and naproxen, and examples of triptans are sumatriptan and rizatriptan.^[3].

When these treatments are not enough to treat the migraine or when migraines still occur too often, preventative treatments may be prescribed.^[4]. These can include antiseizure, blood pressure,and antidepressant medications. Consult with your health care provider about what treatments are right for you.

Many supplements have been studied for migraine prevention and some seem to have some benefit. Some examples include riboflavin (vitamin B2), magnesium, coenzyme Q10, butterbur, melatonin.^[5]

Certain foods such as cheese, chocolate and wine are thought to trigger migraine in some people. However, food-elimination diets have yielded mixed results for reducing migraine frequency. Specific dietary modifications such as the ketogenic diet, the DASH diet, low-fat diet have been studied for migraine prevention, but it is unclear if they help.^[6]

Many non-medical treatments have been studied for preventing migraine by reducing stress. Some of these treatments include meditation, mindfulness, biofeedback, cognitive behavioral therapy (CBT), yoga, and hypnosis.^[5]

Migraine triggers differ from person to person. Daily headache journals are recommended to be better able to identify specific triggers. Some commonly identified triggers include alcohol, caffeine, fatigue, menstruation, certain foods (e.g.: cheese or chocolate), missed meals, smoke, stress, and weather changes.^[4]