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  • April 16, 2014

Migraines: All in Your Head - Ladue News: Health-wellness

Migraines: All in Your Head

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Posted: Thursday, November 7, 2013 12:00 pm | Updated: 2:44 pm, Thu Nov 7, 2013.

The National Institutes of Health estimates that about 12 percent of the American population suffer from migraine headaches, which are marked by throbbing or pulsing pain, often on one side of the head, sensitivity to light and sound, and possible nausea. And if you’re female, you’re two to three times more likely to experience a migraine.

“It’s not known why so many people get migraines," says Dr. Jo Bonner, a neurologist with Mercy Clinic Headache Center. “There is a genetic predisposition. And with hormonal changes in their teens, women become more likely to have migraines. Overall, 18 percent of women and 6 percent of men have migraines. The percentage for women ages 20 to 40 is higher.”

In fact, hormones seem to play a significant role in migraines. “Fluctuating levels of estrogen are particularly important,” notes Dr. Rachel Darken, a neurologist with Washington University Physicians. “Examples can most clearly be seen with menstrual migraines, which involve estrogen withdrawal, and perimenopausal migraine exacerbations.”

Aside from the role of hormones and genetics, exactly what causes migraines is not clear. “It was thought that a migraine was linked to the opening and narrowing of blood vessels in the head. However, it has been proven that people with migraines have what we consider to be ‘hyperexcitable brains,’ ” says Dr. Frasat Chaudhry, a neurologist at the Orthwein Brain and Spine Center at St. Luke's Hospital. Abnormalities involving neurotransmitters and other brain chemicals also are thought to play a part.

Regardless of cause, migraine sufferers simply want relief. Treatment strategies vary, depending on the migraine’s severity—from mildly annoying to debilitating—and individual circumstances. Anything from relaxation techniques and over-the-counter pain relievers to powerful prescription drugs may be needed. If migraines are a frequent problem, preventive treatments are available, including prescription medications initially indicated for seizure, depression and high blood pressure.

“There is evidence that some supplements can act as migraine preventives, including butterbur, magnesium and vitamin B2,” Darken says. “Additionally, lifestyle is very important: Regular exercise, good sleep hygiene, a balanced diet, smoking cessation and weight control can all help to gain control over migraines. Stress is a big trigger for many people, so better stress-management skills can be helpful.”

Darken adds that certain foods can be ‘migraine triggers’ for some people, so they should be avoided. Among the more common food-based migraine triggers are alcohol, aged cheese, caffeine, citrus and food additives, such as MSG.

Another type of treatment, approved by the Food and Drug Administration in 2010, involves Botox injections for control of chronic migraines. The Botox is given at intervals of about 12 weeks as multiple injections around the head and neck, to try to dull future headache symptoms, the FDA says in a statement.

“An individual should see a physician about migraines if they are having them at an increased frequency, the headache has changed in its characteristics, and over-the-counter medications are not working,” Chaudhry says. “Patients also should not be having more than one to two migraines per month. The key to knowing if someone needs to see a physician is if ibuprofen or naproxen quits working to relieve the migraines or the person is taking excessive amounts of the medications.”

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