Migraine headaches are not your typical types of headaches. It is more painful than a typical headache, and it is usually accompanied by an extreme sensitivity to lights and sounds along with nausea and vomiting. It affects 18% of women and 9% of men. The pain from a migraine can last for hours, and sometimes days. The symptoms can be so severe that it can be disabling, making it difficult or impossible to get through the day. Your doctor will want to consider other causes of headache such as tension headache, cluster headache, and sinus headache. This article will discuss the various phases of a migraine headache. It will discuss how migraines are diagnosed and when you should go to the emergency room if you are suffering from a severe headache.
What is a Migraine Headache?
The actual cause of migraine headaches is not known. Most doctors believe that they are caused by genetics as well as environment. It is also believed that chemical imbalances (headache triggers) in the brain can cause migraines. Migraines progress through four stages. Each stage has its own set of symptoms.
This is the first stage of migraine symptoms, and it usually occurs a day or two before a migraine starts. Some of the symptoms include mood changes, going from depression to euphoria. It can also cause constipation, neck stiffness, frequent yawning, food cravings, and increased urination and thirst. Patients may experience allodynia, which is non-noxious stimuli perceived as painful.
This is the second stage, and some people don’t experience it at all. Those who do will have the symptoms before or during a migraine. Visual auras are the most common. The symptoms occur in the nervous system, and they can cause flashes of light or wavy vision. In severe cases, the auras can affect touching sensations, speech, and motor skills. Some people complain that they feel as though someone is touching them or they get weak. Some migraine sufferers even complain of hearing noises or music or uncontrollable jerking movements.
The attack is the headache itself. It can last for 4 to 72 hours, based on the person. The symptoms of the attack can cause a throbbing or pulsing pain on both sides of the head, visual disturbances, lightheadedness, nausea, and vomiting. Some people even faint during the attack phase.
This is the final phase of a migraine. It occurs when a headache is over. It can make the person feel very drained. Most people experience these symptoms for 24 hours. Some of the post-drome symptoms include confusion, dizziness, moodiness, weakness, and sensitivity to light.
Quick Care or ER?
Some people go for years, and their migraines go untreated and undiagnosed. If a person has a history of headaches, they should see their doctor. There are certain situations where a person should visit a quick care clinic or an emergency room as soon as possible.
The following symptoms warrant an immediate visit to the ER.
- severe head pain that feels like a thunderclap
- a headache with a fever
- mental confusion
- a stiff neck
- trouble speaking.
If a person has a headache after a head injury, it is likely not a migraine, and they should go to the hospital immediately. Finally, if a person has a headache that gets worse after coughing or a sudden movement or if they have a new headache pain and they are over 50 years old, they should seek a doctor’s help as soon as possible.
Diagnosing Migraine Headaches
The diagnosis of migraine headache is made clinically. The patient may see a neurologist to diagnose a specific type of migraine headache. They will use the patient’s family history, medical history, symptoms, and a neurological examination to diagnose a headache. The doctor will also order a few tests for a new onset of a migraine.
The blood test will show the doctor if there is an infection in the patient’s brain or spinal cord, if there are toxins in the system or if they have any blood pressure problems.
The MRI can detect tumors, a stroke, and infection, bleeding in the brain, and other brain conditions.
The CT scan will detect the same thing that the MRI would. The test that is used would be up to the doctor.
The doctor might order a spinal tap if they suspect bleeding in the brain, and infection, or another underlying problem.
What is the Treatment for a Migraine?
When a person is suffering from a migraine, they can take pain-relieving medication. The most common medications used as a treatment of migraine are non-steroidal such as Advil, Motrin IB, aspirin, and Ketorolac (Toradol). It is best to sit in a dark room until the medication has a chance to take effect. Another first-line class of medications includes anti-dopaminergic which treats both headache and nausea. Examples include metoclopramide (Reglan) and prochlorperazine (Compazine). Both medication doses are given IV. The doctor could also prescribe triptans, which make the blood vessels constrict, blocking the pain pathways in the brain. Examples of triptans include Imitrex, Maxalt, and Zomig. Ergots are less effective than triptans. However, they are very effective for people who suffer from migraine pain for over 48 hours. If a person is unable to take triptans or ergots, they could be given opioid medications. Since these are narcotics, they can be habit-forming. Thus, it should not be a first-line therapy. The doctor could also prescribe steroids prednisone or dexamethasone, which can be used with other medications to improve pain relief.
Some people choose alternative treatments, such as acupuncture, massage therapy, herbs, vitamins, and minerals.
If a person suffers from at least four migraine headaches per month, the doctor will prescribe medications to keep the headaches from coming on. The same is true if the headaches last for over 12 hours and if pain medications don’t help. These medications include cardiovascular drugs, antidepressants, anti-seizure drugs, and Botox. Preventative medications can reduce the frequency, severity, and the length of time a migraine lasts. It can take a few weeks for the symptoms to approve with these medications.
How Long Will a Person Have Migraines
Migraine headaches tend to be chronic. They can start during the teen years and last throughout the person’s life. In the acute setting, even with the aforementioned treatment, 2/3 will have a headache within 24 hours of leaving the ER.
Migraine headaches can be very painful and they can last a long period of time. If you consider that you may be suffering from chronic migraine headaches, you should see a doctor to have the chronic headaches diagnosed. It may be helpful to keep a “headache diary” so that your doctor can see the causes of a flare-up. Along those same lines, with this information, your doctor may be able to prevent headaches. The sooner the condition is diagnosed, the sooner you can start getting the necessary treatments to treat a migraine and to keep it a headache from coming on at all.
I hope this helps