Migraine Headaches: Triggers and Treatments

by Celeste E. Williams

Can't find those tax records and it's April 14th? Late for a new job interview and the State Trooper pulls you over? The daily stresses of living can cause the muscles around the head and neck to contract, resulting in a tension headache; the most common type of headache. But can you actually experience a migraine headache and not know it?

If your head pain is moderate to severe, lasts 4-72 hours, is throbbing, often on one side of your head, worsens with exercise or movement, is sensitive to light, sound, odor, or associated with an upset stomach, then you may very well have a migraine headache. Some people have even reported experiencing an aura before the onset of this type of headache. Auras can last 5-30 minutes and may be characterized by waves of flashing lights, temporary loss of vision or double vision, and numbness on one side of the body.

Anyone at any age can suffer migraines, but it is more commonly seen in young women. The exact cause of migraines is unknown. One theory is that migraine sufferers have nervous systems that are sensitive to sudden changes in the environment or within their own bodies. During a migraine episode, the changes in brain activity cause blood vessels and nerves around the brain to become inflamed. Therapy is designed to reduce this inflammation and quiet sensitive nerve pathways and nerve endings to calm the brain down.

What can possibly trigger migraine episodes?

• *Diet. Skipping meals or consuming foods that may have Monosodium glutamate (MSG), nitrites/nitrates, or tyramine.
  • MSG FOODS:
    1. Gelatins
    2. Snack foods (potato chips, corn chips, dry roasted peanuts)
    3. Breaded foods
    4. Cheese dips
    5. Soups Seasonings
    6. Salad dressings
    7. Canned meats
    8. Soy sauce
    9. Frozen dinners
  • NITRATE FOODS:
    1. Luncheon meats (pastrami, liverwurst, ham)
    2. Hot dogs
    3. Smoked foods
    4. Bacon
  • TYRAMINE:
    1. Usually found in aged cheeses.
• Drinking large amounts of alcohol (especially red wine).
• *Too much or too little sleep
• *Environmental changes such as outdoor temperature, computer screens, high altitude, glaring or fluorescent lights, or strong odors.
• *Hormonal changes such as in menstrual cycles or pregnancy.

Although there is no cure for migraines, treatment is available. Medication that can help with migraines is essentially in three categories.

1. Pain relievers. These include over-the-counter medicines like aspirin or Tylenol. These sometimes come in combination with antihistamines, decongestants, and caffeine. Prescription painkillers include narcotics and non-steroidal anti-inflammatory drugs.

2. Specific drugs used to stop migraine attack. These include ergot alkaloids (ergotamine and dihydroergotomine), triptans (sumatriptan, zolmitriptan, naratriptan, rizatriptan).

3. Drugs for other illnesses that can also prevent the onset of migraines. These include antidepressants, hypertension/heart medicines such as beta-blockers and calcium channel blockers, and anticonvulsants.

Obviously, once you are taking these medicines you are working closely with your physician, but ultimately, good control of frequency and severity will come from you. So keep observing and identifying what triggers your migraine. Consider these healthy choices to a migraine-free lifestyle.

• Adjust your sleep schedule. Consistency may be the key. Go to sleep and wake up at the same time even on weekends, holidays and vacations.
• Manage stress in life by learning relaxation techniques. Let go of things out of your control. Consider regular exercise and meditation, which can decrease migraine pain.

© 2001 Celeste E. Williams

Celeste E. Williams, M.D., is a board certified OB/GYN. Dr. Williams is a fellow of the American Board of OB/GYN.