We all experience headaches from time to time, and they usually pass fairly quickly. For people who experience migraines, however, the situation can be very different. In addition to severe headaches, migraines may be accompanied by other symptoms and tend to recur. So, what is the difference between a migraine and an ordinary headache? What can help relieve a migraine, and how can future attacks be prevented?
A migraine is a type of headache that may be accompanied by additional symptoms. It is relatively common, with an estimated 12% of the population experiencing migraines. Women are more likely to experience migraines than men, and genetics also appear to play a role, as migraines often affect several members of the same family.
Migraines can be divided into two main types, based on the symptoms accompanying the headache - or, more precisely, when those symptoms occur:
The main symptom of a migraine is, of course, a headache. The pain is often relatively mild at the beginning of an attack and gradually becomes more intense over a short period or several hours. Toward the end of the attack, the pain usually subsides gradually. A migraine attack may last anywhere from a few hours to two or three days.
Migraine pain is often described as throbbing or pulsating and may be accompanied by nausea and vomiting. The location of the pain also varies between different types of headache. In migraines, the pain is often concentrated in a particular area - for example, on the left side of the head only, in the forehead, or “behind the eyes”.
Pain may sometimes be felt in the temples, on either side of the head. However, this is less typical of migraine and may be caused by other conditions, such as a problem with the jaw joint.
Many people also experience sensitivity to light, known as photophobia, and sensitivity to sound, known as phonophobia, during a migraine attack. Resting in a quiet, dark room may therefore help relieve the symptoms.
Approximately one-quarter of people who experience migraines have what is known as an aura before the headache begins. People experiencing an aura may see flashes of light, zigzag lines, or spots. An aura may also involve other sensations, such as tingling in the lips or fingers, weakness, and more.
These symptoms usually appear several minutes to an hour before the headache begins and tend to disappear around the time the headache starts.
An ocular, or retinal, migraine is a rarer subtype of migraine characterized by changes in vision. The symptoms usually appear suddenly rather than gradually and affect only one eye.
Common symptoms include the temporary loss of vision, or loss of vision in part of the visual field, together with other migraine symptoms. These may include a severe headache concentrated in a particular area, such as the forehead or temples, sensitivity to sound, and more.
It is important to note that if you experience a sudden change in vision, such as loss of vision, for the first time, you should seek an immediate examination by an ophthalmologist. Several conditions other than ocular migraine may cause these symptoms, and some require urgent treatment.
The approach to migraine treatment depends, among other factors, on the frequency and severity of the symptoms. Treatment can be divided into medication taken during an attack and ongoing preventive treatment intended to reduce the likelihood of future attacks.
Once a migraine headache reaches its peak intensity, it may be more difficult to bring the pain under control. Treatment should therefore be started as early as possible.
People who experience migraine with aura can use the aura symptoms as a signal to take their migraine medication. If you do not experience an aura, it is advisable to take medication as soon as the pain begins. Many people describe feeling pressure in the head at the onset of an attack.
There are also certain treatments that should be avoided. Excessive use of pain relievers, for example, can itself lead to headaches. If you experience migraines regularly, it is advisable to consult a physician to receive more appropriate treatment.
Opioid pain relievers should also generally be avoided. In addition to the other risks associated with these medications, they may contribute to the development of further headaches.
If migraine attacks recur frequently, preventive treatment will usually be recommended. Several types of preventive treatment are available. The most appropriate treatment, or combination of treatments, may vary from person to person, depending on factors such as other medical conditions, the nature of the pain, and more.
Several medications have been shown to be effective in preventing migraines. However, it may be necessary to try more than one treatment before finding the most effective option. Most of these medications were originally developed to treat other conditions but have also been found to help prevent migraines.
Medications used to prevent migraines include beta blockers such as propranolol and metoprolol, other blood-pressure-lowering medications, anti-seizure medications such as valproic acid and topiramate, and antidepressants such as amitriptyline.
Research into new migraine treatments is ongoing. Newer options include medications known as CGRP antagonists, which target processes involved in migraine pain. These treatments are intended for patients whose symptoms have not improved sufficiently with standard medications.
One of the more surprising treatments for migraine is the injection of botulinum toxin type A, commonly known as Botox. Botox temporarily paralyzes the muscles in the injected area, which is why it is also used in cosmetic treatments.
Injecting Botox into specific areas has been shown to help prevent migraines. However, it is not effective for every type of migraine, and medication will usually be used as the initial treatment.
Changing certain everyday habits may help prevent migraines:
In addition to lifestyle changes and avoiding known triggers, some people report improvement after using complementary treatments. These may include acupuncture, massage, cognitive behavioral therapy (CBT), and other approaches.
Research has also examined several “natural” products as potential migraine treatments, including feverfew, butterbur root, coenzyme Q10, and magnesium.
Some of these products have not demonstrated clear effectiveness in treating migraines. Others have shown a certain degree of benefit but have not yet been studied in a sufficiently large number of patients, as is customary before a treatment can be considered proven and effective.
For this reason, the current recommendation is to begin with treatments that are supported by scientific evidence, such as those described above.
Several factors have been reported to contribute to the onset of a migraine attack. Many people find that emotional stress can trigger a migraine, as can fatigue, lack of sleep, prolonged hunger, exposure to certain smells or products, and even the use of certain medications.
Alcohol consumption may also trigger a migraine. In addition, many women notice changes in their migraine patterns at different stages of their menstrual cycle.
If you experience migraines regularly, it is advisable to keep a headache diary for one month. Record each headache, including its location and intensity, when it began, what you were doing beforehand, and whether it responded to a particular medication.
This information may help you identify factors that trigger your migraines so that you can avoid them whenever possible.
Some women who experience migraines notice no change during pregnancy. However, most experience an improvement in their migraine attacks while pregnant. It is thought that hormonal changes during pregnancy are responsible for the reduction in migraine frequency.
A small minority of women experience migraines for the first time during pregnancy. If you are pregnant or have recently given birth and develop a new type of headache, particularly if you did not previously experience migraines, you should consult a physician to determine the cause.
It is important to remember that some migraine treatments, both those used during an attack and preventive treatments, are not suitable for use during pregnancy. If you take regular migraine medication and are planning a pregnancy, or if you are currently pregnant, consult your physician about the appropriate treatment.
Certain symptoms are considered “red flags.” This means that they may indicate a condition more serious than an ordinary headache or migraine.
If you experience any of the following symptoms, particularly if they appear suddenly, seek medical attention as soon as possible:
If you are unsure whether you need to visit an urgent care center or emergency room, you can consult Leumit’s Medical Advice Hotline 24 hours a day.
Call Leumit Customer Service at 1-700-507507 or *507, and select the “Medical Advice Hotline” option from the telephone menu.
Recent studies have found a link between diet and migraine. Their findings suggest that diet may influence a person’s susceptibility to migraine and that many people with the condition have dietary triggers that may contribute to the onset of an attack. Research indicates that a carefully planned, personalized diet may be an effective strategy for managing various types of headache, including migraine.
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