A migraine is more than just a headache.
The Migraine Research Foundation categorizes migraine as a neurological disease “with extremely incapacitating neurological symptoms.”
Migraines can get severe to the point where light or noise bothers a person and they begin to feel nauseous, explained Mary Sadler, FNP-C, with Trinity Health Neurology. “They can’t participate in activities they enjoy and work can become difficult. They usually have to shut out the world by going into a dark room and in the quiet, away from everything.”
According to the Migraine Research Foundation, migraine affects 39 million men, women, and children in the United States, and one billion worldwide.
“People let it go so long that it gets out of control by the time I see them,” Sadler said. “Many tell me they think it is normal to always have a headache or others tell me they have been told they have sinus infections for years, but when you look at the imaging of the sinuses, there is not any disease. It starts debilitating their life. They can’t go to work. They can’t function. It isn’t until then that they seek treatment, sometimes after years and years of having them.”
Diagnosis
Migraines can progress through four stages: prodrome, aura, headache, and post-drome, Mayo Clinic said on their website.
During prodrome, which can happen one or two days before a migraine, subtle changes, such as constipation, mood changes, food cravings, neck stiffness, increased thirst and urination, or frequent yawning may be noticed. “Usually, people don’t always recognize it,” Sadler said. “You have a prodrome, where you might not feel so well. Your mind doesn’t think as clearly. Then, it will progress to ‘the headache is coming.’”
Next is aura, which are symptoms of the nervous system. “Sometimes, auras can also be touching sensations (sensory), movement (motor), or speech (verbal) disturbances,” the Mayo Clinic website said. (Sadler noted that sometimes migraines do not have aura.)
Examples of migraine aura include: visual phenomena, such as seeing various shapes, bright spots, or flashes of light; vision loss; pins and needles sensations in an arm or leg; weakness or numbness in the face or one side of the body; difficulty speaking; hearing noises or music; uncontrollable jerking; or other movements.
Then there is the actual headache, which could last anywhere from four to 72 hours, if untreated.
During a migraine, a person may experience pain on one or both sides of the head; pain that feels throbbing or pulsing; sensitivity to light, sounds, and sometimes smells and touch; nausea and vomiting; blurred vision; or lightheadedness, sometimes followed by fainting.
After the headache, a person would be in the final, postdrome stage. For about 24 hours following the headache, a person may feel confusion, moodiness, dizziness, weakness, or sensitivity to light and sound.
Treatment
Initially, if a person suspects they have migraine rather than a headache, they should see their primary care provider. Depending on how often the headaches are, the primary care provider may be able to treat migraine. “Some are very confident on how to treat it,” Sadler said. “If they feel overwhelmed by the symptoms, they would refer.”
“Prevention medicines, ranging from blood pressure medications to seizure medications to anti-depressants, work on the chemicals of our brain, the nerves, inflammation, and many other factors,” Sadler said. “These medications are taken regularly to prevent getting a migraine, and there are medications to treat at the onset to make it go away.”
According to Sadler, the basics, such as exercise and a proper diet, can also help with migraines. “I know we preach it all the time, but prevention is the key to most medical problems, including migraine,” she said. “You want to prevent bad things.”
It is important to work on managing what triggers migraines. Reducing stress, “which is hard,” can also help, as stress can be a trigger for about 80 percent of migraines. Addressing anxiety, depression, and not sleeping well can also help.
Trinity Health Neurology includes Mary Sadler, FNP-C; Rosina Medel, MD; and Bahram Nico, MD. Their office is located at Health Center – East, 20 Burdick Expy W, Suite 303. For appointments or consultations, please call 701-857-5421.