Migraine - All In Your Head

Pain from migraine headaches is typically
located on only one side of the head, behind the eye

The damage caused by headaches is eye-popping. About 45 million Americans suffer them regularly, and about half of the sufferers find the pain severe and sometimes disabling. The result: lost time from work, play, the day-to-day stuff of life. Count­ ing only the 30 million who suffer migraine headaches-one of the 150 described categories of headaches-American vic­ tims lose 157 million work days each year.

All In Your Head

Victims often describe the pain as throbbing or pound­ing. Other related symptoms include sensitivity to light, sound, and odor. Some expe­rience nausea, abdominal pain, or vomiting, and some sufferers report seeing auras or streaks of light shortly before the pain begins. Young victims may also complain of blurred vision, fever, dizziness, and upset stomach. A few children get migraines about once a month accompanied by vomiting; such headaches are sometimes referred to as abdominal migraines. About 5 percent of children younger than 15 report having had migraines, compared with 15 percent who experienced tension headaches.

Anatomy Of Migraine

Headaches occur when nerve cells that are pain sensitive, for reasons that are still not clearly understood, begin sending pain signals to the brain . These nociceptor cells often act in response to stress, tension, hormonal changes, or the dilation of blood vessels. Migraines are particularly devastating because of their severity and recurrence . They begin with impulses in hyperactive nerve cells. These impulses tell blood vessels in the head to constrict, and then to dilate. The process releases sero­ tonin, prostaglandins, and other chemicals that inflame nerve cells surrounding the blood vessels in the brain. Specifically targeted are the trigeminal cra­ nial nerve and its connections to the upper spinal cord and brain stem. The result: pain. Researchers long believed migraines arose from the narrowing and expanding of blood vessels on the surface of the brain; now, the most com­ mon theory traces migraines to hereditary abnormalities of the brain itself.

Triggers

Emotional stress, anxiety, changes in weather, depression, lights, loud noises, alterations in sleep routines, and foods and beverages have been identified as migraine triggers . Stress causes the release of so-called fight or flight hormones, which can prompt changes in blood vessels that bring on headaches. Chemicals in foods and food additives also are commonly linked to the onset of migraines. These include choco­ late, aged cheese, red wine, yeast, monosodium glutamate, wheat, tea, meat containing sodium nitrates, coffee, oranges, milk, and corn syrup.

Genetics Matter

Family genetics tell the tale:

When one parent suffers migraines, his or her child has a 25 to 50 percent chance of befalling the same fate, but when both parents are victims, their child's risk rises to 70 percent.

Then there's the genetics of the two sexes. Boys who suffer from migraines tend to outgrow them by the time they get to high school. Girls, however, are more likely to see their migraines become more frequent after they enter puberty because of body changes related to female hormones. Teenage girls are three times more likely than teenage boys to suffer migraines

Prevention

Eliminating or reducing severe stress and the intake of risky foods may help stop migraines from returning. In addition, physicians may prescribe regular doses of antidepressants, anti-seizure medi­ cine, and cardiovascular drugs to ward off migraines. Migraines that are mild may respond to nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibupro­fen or naproxen sodium. Stronger migraines may respond to drugs containing acetaminophen, aspi­ rin, caffeine, or triptans, which mimic the neurotransmitter sero­ tonin . Even when taken under a physician's care, these drugs can have unpleasant side effects. Doctors often advise patients to stop taking them as soon as possible.

Treatment

Biofeedback also has shown prom­ ise for some sufferers as a treat­ ment, and particularly as an early response to the onset of a migraine. A headache sufferer who has learned biofeedback techniques monitors vital body signals and then attempts to control them through "mind over matter." Biofeedback methods often help reduce stress or anxiety; among headache suf­ ferers, a common technique aims to alter the pulse or raise the tem­ perature of one or both hands, diverting blood there and helping restore circulatory balance to the head. However, some researchers believe biofeedback works bet­ ter with other forms of headaches than with migraines. Showing new promise in lowering the pain and frequency of migraines, according to a study in the journal Headache is a mix of yoga, relaxation techniques, and breathing exercises.

Research

The link between body chemistry and migraines was underscored by a study associating migraines with depression. The study conducted by the Henry Ford Health System, found that compared with people who are free from headaches, migraine sufferers are five times more likely to develop major depression. Likewise, people who began the study suffering from depression were three times as likely to develop migraines as those who weren't depressed. Researchers concluded that the two disorders are biologically related, perhaps through hormones or neurochemistry. If one disease exists, they say, doctors should be on the lookout for the other.