Migraine Headaches


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The term migraine refers to a class of headaches sharing certain characteristic symptoms. Headache pain usually occurs in the forehead or temples, oftenon one side only and typically accompanied by nausea and a preference for adarkened room. Headache attacks last for several hours, up to a day or more.They are usually separated by completely pain-free intervals. In some cases,headache pain is accompanied by a visual (or occasionally nonvisual)disturbance known as an aura. Migraines are classified as migraine with auraand migraine without aura. Migraines can be set off by a variety of triggers, including fatigue, stress, hormonal changes, and foods such as alcoholic beverages, chocolate, peanuts, and avocados. When people with migraine headaches first consult a physician, they are generally advised to identify such triggers, and avoid them if possible. However, migraines quite frequently occur with no obvious avoidable triggering factor.The underlying cause of migraine headaches has been a subject of continuing controversy for over a century. Opinion has swung back and forth between two primary beliefs: that migraines are related to epileptic seizures and originate in the nervous tissue of the brain; or that blood vessels in the skull cause headache pain when they dilate or contract (so-called vascular headaches). Most likely, several factors are involved, and more than one stimulus can light the fuse that leads to a full-blown migraine attack.Conventional treatment of acute migraines has lately been revolutionized by drugs in the triptan family. These medications can completely abort a migraine headache in many individuals. They work by imitating the action of serotonin on blood vessels, causing them to contract. However, while they are dramatically effective for the majority of people with migraines, a substantial minority do not respond, for reasons that are unclear.People interested in prevention of migraines have a great variety of options, including ergot drugs, antidepressants, beta-blockers, calcium channel blockers, and antiseizure medications. Picking the best one is mostly a matter of trial and error. Most but not all people can find some medication that will work.

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