Migraines and headache awareness

Migraine attacks are, for those who suffer from them, significant and painful experiences. Migraines usually occur on one side of the head presenting with severe throbbing and pain, often accompanied with nausea, and sensitivity to light, sounds, smells and taste. Some migraines can last for hours or even days and many times, the pain is disabling, requiring the affected person to rest in a darkened, quiet room until they recover.

Migraines can onset at any time of life and many times they progress through four stages — the prodrome, aura, headache and post-drome. Not everyone always experiences all four stages every time.

The prodrome stage may begin one or two days before the onset of the migraine. It may be subtle and oftentimes missed. Symptoms of an oncoming migraine may include: constipation, mood changes, food cravings, stiff neck, increased thirst and urination and frequent yawning.

The aura may occur before or during the migraine; however, most people experience migraines without aura. The auras are usually visual disturbances such as flashes of light, blind spots or wavy zigzagged vision abnormalities. Auras can also involve muscle weakness, or sensory disturbances that start gradually and build up, lasting up to an hour before the actual migraine attack. There can be a feeling of pins and needles in an arm or leg, or hearing music or other sounds, and difficulty speaking or finding the right word.

The migraine attack usually lasts from four to 72 hours if left untreated. Some people get migraines frequently and for others it is a rare occurrence. This leads to the difficulty in recognizing what is occurring. During a migraine attack, a person may feel pain on one side or both sides of the head. The pain may be very severe and be pulsating or throbbing. They may have sensitivity to light, sounds, smell, touch and taste. They may experience nausea and vomiting, have blurred vision and be lightheaded.

The post-drome phase occurs after the migraine attack is over. The person may feel drained and up to 24 hours afterwards may feel confusion, moodiness, dizziness, weakness and have sensitivity to light and sound.

Migraine causes are not well understood, although the environment and genetics seem to both play a role in their onset. It is know that the serotonin levels drop during migraine attacks and this may cause the trigeminal nerve to release neuropeptides that travel to the meninges and result in migraine pain. The role of serotonin and other neuro- transmitters are the subject of study in migraine research.

There are a number of known migraine triggers, including hormonal changes in women, certain foods, food additives, alcohol, caffeine, stress, sensory stimuli, changes in sleep patterns, intense physical exertion, weather changes, and certain medications such as oral contraceptives or vasodilators.

Fluctuations in estrogen appears to trigger migraines in women, so that some experience the headaches immediately before or during their periods or during pregnancy or menopause. Hormone replacement therapy can also have a worsening effect on the occurrence of migraines and for others it can help alleviate the problem.

Aged cheeses, salty foods and processed foods with aspartame and monosodium glutamate appear to trigger migraines in many susceptible people. Sometimes skipping a meal or fasting can bring on an attack as well. Wine with sulphites and highly caffeinated drinks can cause migraines. Strong smells such as perfumes, paint thinner, gasoline and secondhand smoke are known triggers as well.

Risk factors that make an individual more prone to migraines include a family history of migraines, being a woman (three times more likely to have migraine attacks) and age. Migraines tend to occur most often in the 30-year-old age bracket.

Migraines are serious in and of themselves and lead to debilitating pain and discomfort. However, a person who presents with an abrupt severe headache should see a doctor immediately, as should an individual who has a headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness and trouble speaking.

Medical advice should be sought if a headache occurs after a head injury or if a headache gets worse after coughing, exertion or sudden movement. A medical practitioner should be consulted if a person is over the age of 50 and has a new type of headache pain.


Jane Riley is a certified personal trainer, adviser and behavior change specialist. She can be reached at janerileyfitness@gmail.com or (808) 212-8119 and www.janerileyfitness.com


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