Mind & Body
Migraine Management
2/1/2020 1:00:00 PM
Migrane Management

Sensitivity to light. Loss of appetite. A dull headache that grows into a throbbing pain. Blurred vision. Nausea. Dizziness. Those who experience migraines are all too familiar with these uncomfortable symptoms. 


And there are many who have them. The American Migraine Foundation estimates that more than 36 million Americans deal with them, and women are three times more likely to have them than men. Of those who get migraines, they begin having them between ages 10 and 40. Migraines can last between four and 72 hours. 

The symptoms of a headache and a migraine can be similar, but a migraine will be more severe.  Those with migraines report moderate-to-severe headaches that are usually on one side of the head. Other symptoms such as nausea and vomiting frequently occur. To help differentiate a migraine from a headache, it’s helpful to keep a diary such as the time of onset, any triggers, duration and any other symptoms.  


The International Headache Society recommends the 5, 4, 3, 2, 1 method to diagnose migraines without aura. This stands for:

5 or more attacks with a duration of 4 hours to 3 days.

At least 2 of the following qualities: occurring on one side of the head, a pulsating quality, moderate-to-severe pain, and aggravation by routine physical activity.

At lease 1 additional symptom, such as nausea, vomiting, sensitivity to light, or sensitivity to sound. 


"Migraines can be caused by a variety of triggers, but imbalances in certain brain chemicals may play a role,” explains Nirmala Tumarada, MS, MD, neurologist and neuromuscular medicine specialist with Imperial Health. "If someone in your family tends to get migraine headaches, you’re more likely to get them than someone without a family history. In fact, for those who inherit the tendency to have migraines, they can also inherit the same triggers that cause the migraines, such as bright lights, fatigue, weather changes, stress and hormonal changes.”


Other triggers include:

Certain foods. Salty, processed foods and aged cheeses like blue cheese. Also, the artificial sweetener aspartame, and the flavor enhancer monosodium glutamate (MSG.)

Skipping meals, due to a drop in blood sugar.

Alcohol, especially wines, and caffeine, including caffeinated sodas. 

Changes in sleep patterns. Too much or too little sleep, as well as jet lag. Exertion, especially intense workouts. Activity is still encouraged, but at a moderate pace.


The two main types of migraines are those with aura and those without. Auras act as a warning, indicating a headache will soon develop. The effects of a migraine aura include:

Confusing thoughts

Perception of strange, sparkling, or flashing lights

Blind spots in the vision

Difficulty speaking

Stiffness in the shoulders, neck or limbs


Migraines without aura are far more common, which means no sensory disturbances occur leading up to a migraine. Between 70 and 90 percent of migraines occur without an aura.


There are two approaches for migraine treatment: treating the symptoms when they occur, and preventative medications taken daily to reduce the intensity or frequency of symptoms.


Medications aimed at the symptoms of migraines are best taken when the migraine is developing and not at its peak. Over the counter medications, such as naproxen, ibuprofen and acetaminophen have been proven to help reduce the painful symptoms associated with migraines. 


"Many medications can have side effects and finding the one that works best is usually a trial and error process. You and your physician should work together to find the most effective medication with the most tolerable side effects, or hopefully, no significant side effects,” says Dr. Tumarada. "It generally takes between four and 12 weeks to know if a migraine medication is effective.”


To date, four medications are approved by the Food and Drug Administration for the prevention of migraines, but considerable research continues to find more options.


Migraine preventative medications may not completely prevent all migraine symptoms, but they tend to reduce the frequency and severity of them. 


"Because migraines are associated with nerve receptors in the brain, the severity, length, and frequency of migraines can change over time, as the physiology of the body changes. The use of a preventative medication may need to be adjusted from time to time,” she explains. "In addition to medications, stress-relieving techniques such as yoga, aromatherapy, journaling, and relaxation practices have been proven effective.”

Identifying and avoiding triggers is one of the most effective ways to manage migraines. It often takes diligence and time, but it’s well worth it when the debilitating symptoms can be decreased or avoided.


For a consultation about migraines or other neurological conditions, call Dr. Tumarada’s office at (337) 312-8730.



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