Tame painful migraines

December 01, 2010 By Letterio Asciuto, M.D.

Are you one of the more than 29 million people who cope with debilitating migraine headaches? If you often find yourself huddled in your dark bedroom, waiting for the incessant throbbing in your head to go away, the answer may be “yes.”

Inside a migraine
A migraine is no ordinary headache. It is usually a one-sided headache described as a pulsating sensation in your temple or behind one of your eyes and accompanied by nausea and/or vomiting, or sensitivity to light and sound. The headache may not go away for hours (most common) or even days. Most migraineurs, about 75 percent, have three or fewer attacks per month; 10 percent have four to five episodes; and the remaining 15 percent have five or more. Migraines are three times more common in women than in men and although the prevalence varies with age, it is highest between ages 30-50.
Your healthcare provider can diagnose your condition based on an exam and your symptoms: where your pain is, how often you have the headaches, how long they last, when they occur, whether there are coexisting symptoms and if there's a family history of migraine.
If you're diagnosed with migraines, your healthcare provider may take a two-pronged approach: preventative – helping prevent the headaches from occurring, if severity and frequency dictate; and abortive – treating the pain and symptoms when they do occur.

Preventing the pain
You can help ward off a painful attack by:
• Avoiding or limiting dietary triggers. Common culprits include red wine, nitrate-rich foods such as deli meat and hot dogs, foods that contain monosodium glutamate (MSG) such as broths and fast foods, the artificial sweetener aspartame and tyramine, a chemical found in foods such as aged cheese and soy products.
• Relaxation. Try acupuncture, meditation and relaxing physical activity, such as tai chi.
• Getting plenty of sleep. Get up and go to bed at the same time every day.
• Eating regularly. Don't skip meals.
• Exercising regularly. Aim for a minimum of three days a week.
• Taking your medicine. Your healthcare provider can prescribe medications normally used to treat conditions such as epilepsy and depression that can help prevent attacks. Hormone therapy may help some women.
• Asking about alternatives. Biofeedback is a technique that teaches you how to monitor and control your body's responses to stress which, in turn, can lower your heart rate and ease muscle tension.
If you feel an attack coming on, over-the-counter medications such as aspirin or nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen may relieve mild pain. Your provider may also prescribe triptans, drugs that balance chemicals in the brain, or ergot derivatives, which also work on brain chemicals.

What is ocular migraine?
The term “ocular migraine” is sometimes used to describe migraines with aura — those temporary vision changes such as zigzagging patterns, flashing lights and blind spots — that come before or during a migraine. While these migraines can interfere with tasks such as reading, they're not considered serious. Only about 30 percent of migraine patients ever experience aura.
The term can also be used to describe retinal migraines, repeated episodes of temporary reduced vision or blindness in one eye that also occur before or during a migraine. In some cases, this may signal a more serious condition, so make sure to see your healthcare provider if you experience them.

Dr. Letterio Asciuto is a member of The Hospital of Central Connecticut (HCC) medical staff.