Migraine is a neurological syndrome that can cause headache. It is a common condition which affects women more frequently than is does men. A typical migraine headache is
one sided and pulsating, lasting 4 to 72 hours. Accompanying complaints are nausea and
vomiting, and a heightened sensitivity to bright lights and noise. Although the exact cause of migraine remains unknown, the most widespread theory is that it is a disorder of
the serotonergic control system. Genetic factors may also contribute. Fluctuating hormone levels show a relation to migraine in several ways: three quarters of adult migraine patients are female while migraine affects approximately equal numbers of boys
and girls before puberty, and migraine is known to disappear during pregnancy in a substantial number of sufferers.
The treatment of migraine begins with simple pain killers for headache and anti-emetics
for nausea, and avoidance of triggers if present. Specific anti-migraine drugs can be used
to treat migraine. If the condition is severe and frequent enough, preventative drugs might be considered. Patients themselves often start off with acetaminophen, aspirin, ibuprofen or other simple analgesics that are useful for tension headaches. It is one of doctors’ practical diagnoses of migraine head pain when patients say typical OTC drugs “won’t
touch it”. Anti-emetics by mouth may help relieve symptoms of nausea and help prevent
vomiting which can diminish the effectiveness of orally taken analgesia.
If over the counter medications do not work, the next step for many doctors is to prescribe Fioricet of Fiorinal, which is a combination of butalbital (a barbiturate) and
aspirin with caffeine. While the risk of addiction is low, butalbital can be habit-forming
if used daily. Narcotic pain killers (for example, codeine, morphine, or other opiates)
provide variable relief, but their side effects include the possibility of causing rebound
headaches or analgesic overuse headache.
Preventive treatment of migraines can be an important component of migraine management. Such treatment can take many forms, including everything from taking certain drugs or nutritional supplements, to lifestyle alterations such as increased exercise and avoidance of migraine triggers. The goals of preventive therapy are to reduce the
frequency, painfulness and duration of migraines.
Preventive medication has to be taken on a daily basis, usually for a few weeks, before the effectiveness can be determined. Supervision by a neurologist is advisable.