Mark W. McFarland, DO
Everyone knows what a headache is but say the word migraine… we conjure up vague images of someone with pounding head pain, lying in a dark room with a cool cloth over their eyes, trying to lie still so the accompanying nausea doesn’t overtake them. If you’ve never had a migraine headache, consider yourself lucky, as they are unlike any typical headache you’ve ever had. In this series of articles, I will discuss what causes a migraine, what the symptoms are, how they are diagnosed and treated.
At this time, there is no definitive cause for migraines, but some studies indicate a genetic link may be a factor. About 12% of American are affected with migraines and women get them most often. Migraines may be more likely in persons who suffer with depression, sleep disorders, anxiety, bi-polar disorders, and epilepsy. These headaches tend to be more common in the morning and after busy weeks at work. There are many triggers for migraines and each person may have only one or any combination of them. The most often seen triggers are listed as follows, but this list is not all inclusive:
- Hormonal Changes in Women
- Stress/Anxiety
- Loud noises
- Bright or flashing lights
- Strong or unpleasant odors
- Too much or too little sleep
- Sudden changes in the weather
- A variety of foods and beverages
Migraine headaches are different than regular headaches in that they have four distinct phases. A person does not have to have every phase each time they suffer a migraine, but these phases are part of the migraine headache cycle and differentiate them from a run-of-the-mill headache.
Phase I is called the Prodome Phase and it occurs up to 24 hours before the headache begins. The signs and symptoms are weird and include increased urination, food cravings, mood changes, uncontrollable yawning, and fluid retention. Researchers have not been able to explain these symptoms.
Phase II is called Aura Phase and those who experience it see flashing or bright lights and/or zig zag lines and may feel like they are being grabbed or touched. This can happen before or during the actual headache phase.
Phase III is called Headache because this is when the throbbing or pulsing head pain starts, typically on one side of the head. Occasionally, a migraine will not involve head pain, but will include nausea and vomiting, sensitivity to light, sound, and smells. Most people also find movement of any kind causes worsened pain during this phase.
Phase IV is called Postdrome, after the headache has passed. The person will feel physically weak, extremely tired, and even confused for up to a day, after the migraine has ended.
In my next installment, I’ll cover the diagnosis and treatment of migraine headaches. That article will be posted soon.