Migraine Diagnosis, Preventions & Treatment

Migraine DiagnosisHeadache, Migraine

Your physician will enquire about your medical history and symptoms. Keeping a diary of your symptoms and any triggers you’ve identified may be helpful. Put down:

  • What symptoms do you have, including where it hurts
  • How often do you have them
  • How long do they last
  • Other family members who have migraine
  • All the medicines and supplements you take, even over-the-counter ones
  • Other medicines you remember taking in the past

Your doctor may order tests to rule out other things that could cause your symptoms, including:

  • Blood tests
  • Imaging tests like MRI or CT scans
  • Electroencephalogram (EEG)

When to Call Your Doctor

  • See your doctor any time a headache doesn’t go away or comes back.
  • See a doctor right away or go to the emergency room if you have a headache with a stiff neck, fever, vomiting, numbness or weakness in the limbs, or trouble speaking.

 

Migraine Treatment and Home Remedies

There’s no cure for migraine headaches. However many drugs can treat or even prevent them. Common migraine treatments include:

  • Pain relief. Many over-the-counter (OTC) medications are effective. Acetaminophen, aspirin, caffeine, and ibuprofen comprise most of the components. Never administer aspirin to anyone younger than 19 due to the possibility of Reye’s syndrome. OTC pain relievers should be used with caution as they may exacerbate headaches. They can cause rebound headaches or make you reliant if you use them excessively. Talk to your doctor about prescription medications that might work better if you take any OTC painkillers more than twice a week. They might recommend triptans and the more recent titans and gepants as prescription medications that could effectively relieve your migraine headache. If these are appropriate for you, your doctor can let you know.
  • Nausea medicine. Your doctor can prescribe medication if you get nausea with your migraine.
  • Triptans. These drugs balance the chemicals in your brain. You might get a pill to swallow, tablets you dissolve on your tongue, a nasal spray, or a shot. Examples include almotriptan (Axert), eletriptan (Relpax), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig).
  • Ergotamine (Cafergot, Ergomar, Migergot). This also works on the chemicals in your brain.
  • Lasmiditan (Reyvow). This drug eases pain, nausea, and sensitivity to light or sound.
  • CGRP receptor antagonists. Your doctor might give you rimegepant (Nurtec) or ubrogepant (Ubrelvy) if other treatments don’t help.
  • Preventive medicines. Your doctor could advise them if other treatments are unsuccessful, you get frequent headaches or have four or more migraine days per month. You take them frequently to lessen the severity or frequency of your headaches. They include medications for seizures, blood pressure medications (such as beta-blockers and calcium channel blockers), a few antidepressants, and Botox injections. Atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) are CGRP antagonists that can also stop migraines from occurring.
  • Single-pulse transcranial magnetic stimulation (sTMS). You place this device on the back of your head at the start of a migraine with aura. It sends a pulse of magnetic energy to part of your brain, which may stop or reduce pain.
  • Neuromodulation devices. Other devices can affect the vagus nerve and the trigeminal nerve to give relief from or prevent migraines.

Home remedies

You may ease migraine symptoms by:

  • Resting with your eyes closed in a dark, quiet room
  • Putting a cool compress or ice pack on your forehead
  • Drinking plenty of liquids

Complementary and alternative treatments

Some people get relief with therapies they use in addition to or instead of traditional medical treatment. These are called complementary or alternative treatments. For migraine, they include:

  • Biofeedback

    This helps you take note of stressful situations that could trigger symptoms. If the headache begins slowly, biofeedback can stop the attack before it becomes full-blown.

  • Cognitive behavioral therapy (CBT)

    A specialist can teach you how actions and thoughts affect how you sense pain.

  • Supplements

    Research has found that some vitamins, minerals, and herbs can prevent or treat migraines. These include riboflavin, coenzyme Q10, and melatonin. Butterbur may head off migraines, but it can also affect your liver enzymes.

  • Bodywork

Physical treatments like chiropractic, massage, acupressure, acupuncture, and craniosacral              therapy might ease headache symptoms.

Talk to your doctor before trying any complementary or alternative treatments.

Migraine Prevention

Try these steps to prevent symptoms:

  • Identify and avoid triggers. Keep track of your symptom patterns in a diary so you can figure out what’s causing them.
  • Manage stress. Relaxation techniques like meditation, yoga, and mindful breathing can help.
  • Eat on a regular schedule.
  • Drink lots of fluids.
  • Get plenty of rest.
  • Get regular moderate exercise.
  • Ask your doctor about preventive medicines if you get migraines around your period or if lifestyle changes don’t help.

Some modern gadgets can also stop migraines. Cefaly is a device that resembles a headband and delivers electrical pulses to your forehead skin. Your trigeminal nerve is impacted, and migraine headaches are associated with it. Cefaly is used for 20 minutes once every day. You’ll get a tingling or massaging sensation when it’s on. A stimulator called gammaCore uses a moderate electrical pulse to treat pain and ward off migraines by reaching the vagus nerve fibers in your neck.

SOURCES:

  • National Headache Foundation: “Migraine.”
  • Annals of Neurology: “Familial risk of migraine: A populationbased study.
  • Daroff, R. Bradley’s Neurology in Clinical Practice, 6th edition,Saunders, 2012.
  • Medical Clinics of North America, March 2009.
  • Medscape: “Migraine Headache.”
  • American Migraine Foundation: “What Is Chronic Migraine?” “What Type of Headache Do You Have?” “Silent Migraine: A Guide,”  “Identifying and Treating Migraine.”
  • MedlinePlus: “Migraine.”
  • American Academy of Family Physicians: “Migraines.”
  • Mayo Clinic: “Migraine.”
  • The Migraine Trust: “Menstrual migraine.”
  • Johns Hopkins Medicine: “Vestibular Migraine.”
  • Yale Medicine: “Abdominal Migraine: Symptoms, Diagnosis & Treatment.”
  • S. Department of Health and Human Services Office on Women’s Health: “Migraine.”
  • Cleveland Clinic: “Migraine Headaches.”
  • UpToDate: “Acute treatment of migraine in adults,” “Preventive treatment of migraine in adults.”
  • National Organization for Rare Disorders: “Hemiplegic Migraine.”
  • Stroke Association: “Migraine and stroke.”
  • Journal of Headache and Pain: “Shift from high-frequency to low-frequency episodic migraine in patients treated with Galcanezumab: results from two global randomized clinical trials.”
  • BMC Neurology: “Global assessment of migraine severity measure: preliminary evidence of construct validity.”
  • Medline Plus: “Migraine.”
  • Gov: “Migraine Fact Sheet.”
  • UpToDate: “Pathophysiology, clinical manifestations, and diagnosis of migraine in adults,” “Acute Treatment of Migraine in Adults.”
  • The Migraine Trust: “Hemiplegic Migraine.”
  • Mayo Clinic: “Migraine Aura.”
  • American Migraine Foundation:  “What Is Chronic Migraine?” “Silent Migraine: A Guide,” “What Type of Headache Do You Have?” “Abdominal Migraine.”
  • Cleveland Clinic: “A Migraine Without Pain? Yes, It Can Happen, and It’s Called an Ocular Migraine.”
  • Yale Medicine: “Abdominal Migraine: Symptoms, Diagnosis & Treatment.”
  • Cephalalgia: “Abdominal migraine.”
  • Journal of Headache and Pain: “Shift from high-frequency to low-frequency episodic migraine in patients treated with Galcanezumab: results from two global randomized clinical trials.”

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