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Q: I can’t seem to shake these headaches lately.á I’m a 32-year-old professional woman. I’ve been having these serious, throbbing headaches for a year and a half now.á I didn’t realize how bad they felt when my mom would talk about them.á But it’s affecting every part of my life, even my love life.áá Please help, MsNOT2NITE Dr. Dave: MsNOT2NITE, Many people feel your pain.á It sounds like you may have developed migraine headaches.á Migraines can be treated, but first it’s important to make sure that nothing else is causing your headaches. Migraines cause varying degrees of throbbing pain, typically on one side of the head or, less commonly, frontal pain.á It is common for migraine attacks to start in the early morning, but they can occur at any time and can also wake people from sleep.á Migraine pain is usually gradual in onset with subsequent resolution, but sometimes only after hours or days of discomfort.á In this way, migraines can be quite debilitating. Migraine attacks are about 3 times more common in women, where up to 17% of women and 6% of men are affected each year. It is, however, most common in people between the ages of 30 to 39, where the percentages reach as high as 24% in women and 7% in men. Migraines also tend to run in families. People who suffer from migraines report one of more of 3 general phases of the headaches: áááááááá 1. Premonitory symptoms: can precede a migraine attack by several hours or days. These symptoms include fatigue, concentration difficulty, neck stiffness, sensitivity to light or sound, nausea and/or blurred vision. áááááááá 2. Aura* [awr-uh]: is a complex of progressive neurologic symptoms that occur before the onset of migraine headache or accompanies migraine headache but subsequently resolve. á áááááááááááááá 1.á Visual disturbances (most common, including halluciantions) áááááááááááááá 2.á Sensory symptoms (second most common,áá includes numbness and tingling of the lips, loweráá face, and fingers).á Something called cutaneous allodynia can make even simple touching a painful experience for people with migraine. áááááááááááááá 3.áá Muscle weakness áááááááááááááá 4.áá Speech disturbances áááááááá 3. Migraine: rapid head movements, sneezing, straining, or physical exercise can worsen headaches. Many report unusual or extreme sensitivity to light (photophobia) or sound (phonophobia), causing many to seek relief by lying down in a dark, quiet room. *About 80% of migraine cases occur without aura. Triggers have been identified in migraine sufferers.á Approximately 75% reported at least one trigger of acute migraine attacks. One study listed the following top 5 triggers: ááá * Emotional stress (80%) ááá * Hormones in women (65%-so-called menstrual migraines) ááá * Not eating (57%) ááá * Weather (53%) ááá * Sleep disturbances (50%) Accumulating reports identify obesity as a factor that predisposes people to more frequent and more severe migraines. NOTE: In a patient with the recent onset of headaches, brain tumors and glaucoma should be carefully evaluated by thorough neurologic and ophthalmologic examination.á Only your doctor can do this. Migraine Treatment The cause of migraines is now believed to be inflammation surrounding a major nerve of the face—called the trigeminal nerve.á Because of this, some of the treatments are non-steroidal anti-inflammatory (NSAIDs) medications, like ibuprofen and naproxen as well as painkillers, like Tylenol.á In other cases, anti-nausea medicines are used alone or in combination and provide some with considerable relief. When these fail or lose effectiveness, the use of migraine-specific medicines—triptans and ergotamines—can be very effective in patients with more severe migraines when used in combination with analgesics.á Talk about these with your doctor. It is important not to overuse these medications. Migraine researchers and doctors now know that an ‘overuse syndrome’ can ensue and severely worsen the symptoms and response of migraines.á It is imperative that migraine sufferers talk to their doctors in detail about the treatment strategies available and which are right. Copyright 2010 Chicago Defender Dave Montgomery, MD, PhD is Senior Fellow in Cardiology at Northwestern University and a sought after Speaker and Health Coach.á http://davemontgomerymd.com

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