Migraine
Overview
A migraine is a type of headache that causes intense, throbbing pain, often on one side of the head. It can be accompanied by symptoms like nausea, sensitivity to light and sound, and visual changes known as aura. The most common type is migraine without aura, which occurs without warning signs. Migraine with aura involves visual disturbances or other sensory symptoms before the headache starts.
Our approach
A migraine is a neurological condition characterized by intense, throbbing headaches that can last from a few hours to several days. Migraines are often accompanied by other symptoms, such as nausea, vomiting, and sensitivity to light and sound. They can significantly affect daily functioning and quality of life. The exact cause of migraines is not fully understood, but they are believed to involve changes in brain activity, blood flow, and nerve signaling, often influenced by genetic and environmental factors.
Symptoms
Symptoms of a migraine can vary in intensity and may include:
- Headache: Often on one side of the head, characterized by a throbbing or pulsating sensation.
- Aura (in some cases): Visual disturbances (flashing lights, blind spots), tingling in the face or hands, or difficulty speaking, which may occur before or during the headache phase.
- Nausea and Vomiting: Accompanying the headache, sometimes making it difficult to keep food or liquids down.
- Sensitivity to Light, Sound, or Smell: Worsening of headache symptoms with exposure to bright lights, loud noises, or strong odors.
- Fatigue or Weakness: Feeling tired or lacking energy, especially after the headache phase ends.
- Dizziness or Lightheadedness: A feeling of unsteadiness, which can occur before or during a migraine.
- Neck Pain or Stiffness: Tension or discomfort in the neck or upper back region.
Diagnosis
Healthcare professionals diagnose migraines based on a combination of evaluations:
- Medical History: Discussing the nature of headaches, including frequency, duration, location, and accompanying symptoms, as well as any family history of migraines.
- Physical and Neurological Examination: Assessing for signs of other conditions that may cause headaches.
- Diagnostic Criteria: Using guidelines such as the International Classification of Headache Disorders (ICHD) to differentiate migraines from other types of headaches, requiring a history of at least five headache episodes with specific characteristics.
- Imaging Tests (if needed):
- Magnetic Resonance Imaging (MRI): To rule out other causes of headaches, such as tumors or structural abnormalities.
- Computed Tomography (CT) Scan: May be used in emergency situations to check for serious underlying conditions.
Complications
Untreated or severe migraines can lead to complications, including:
- Chronic Migraine: Headaches occurring 15 or more days per month for at least three months.
- Medication Overuse Headache: Resulting from frequent use of acute migraine medications.
- Status Migrainosus: Severe migraine attacks lasting more than 72 hours, requiring medical intervention.
- Stroke Risk: Migraines, especially with aura, may be associated with a slightly increased risk of stroke.
- Depression and Anxiety: Higher prevalence of mood disorders in individuals with chronic migraines.
A multidisciplinary approach involving neurologists, pain specialists, and lifestyle interventions is often needed to manage migraines effectively and improve quality of life.
Providers for Migraine
View All ProvidersLocations for Migraine
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Katie Hageboeck Children's Cancer Research Fund Clinic (formerly Journey Clinic)-
Katie Hageboeck Children's Cancer Research Fund Clinic (formerly Journey Clinic)
M Health Fairview Pediatric Specialty Clinic - Explorer
M Health Fairview Neurology Clinic - Maplewood
M Health Fairview Pediatric Specialty Clinic - Discovery
M Health Fairview Clinics and Surgery Center - Minneapolis
M Health Fairview Maternal Fetal Medicine Center Minneapolis
M Health Fairview Neurology Clinic - Woodbury
M Health Fairview Clinics and Surgery Center - Maple Grove
Treatments for Migraine
Treatment for migraines aims to relieve symptoms during an attack and prevent future episodes. Approaches include:
- Acute (Abortive) Treatments:
- Over-the-Counter Pain Relievers: Such as acetaminophen, ibuprofen, or aspirin, for mild migraines.
- Triptans: Prescription medications (e.g., sumatriptan, rizatriptan) that block pain pathways in the brain to treat moderate to severe migraines.
- Ergotamines: Drugs such as dihydroergotamine, used to relieve pain by constricting blood vessels.
- Anti-Nausea Medications: For managing symptoms like nausea and vomiting (e.g., metoclopramide, ondansetron).
- CGRP Inhibitors: Newer treatments that target calcitonin gene-related peptide (CGRP) pathways involved in migraine pain (e.g., ubrogepant, rimegepant).
- Preventive Treatments: For individuals with frequent or severe migraines:
- Beta-Blockers: Medications such as propranolol, which can help reduce migraine frequency.
- Antidepressants: Such as amitriptyline, used to prevent migraines by affecting serotonin levels in the brain.
- Anticonvulsants: Drugs like topiramate, which can help reduce migraine occurrence.
- CGRP Monoclonal Antibodies: Monthly or quarterly injections (e.g., erenumab, fremanezumab) that prevent migraines by blocking CGRP activity.
- Botox Injections: Used in chronic migraine cases to reduce headache frequency.
- Lifestyle Modifications:
- Regular Sleep Schedule: Going to bed and waking up at the same time each day to improve sleep quality.
- Dietary Changes: Avoiding known triggers such as alcohol, caffeine, processed foods, or foods containing additives like monosodium glutamate (MSG).
- Regular Physical Activity: Engaging in moderate exercise, such as walking, swimming, or yoga.
- Stress Management: Practicing relaxation techniques such as meditation, deep breathing, or progressive muscle relaxation.
- Alternative and Complementary Therapies:
- Acupuncture: May help reduce the frequency and severity of migraines in some individuals.
- Herbal Supplements: Feverfew or butterbur may be considered, but should be used under medical supervision.
- Magnesium and Riboflavin (Vitamin B2) Supplements: May be beneficial in reducing migraine frequency.