Migraines cannot be cured, but they can be managed through effective treatment. Each person suffering from migraines (called a migraineur) has their own triggers (events, chemicals or circumstances that immediately precede an attack). Because each migraineur has his or her own triggers, there is no one best migraine treatment for everyone. The best migraine treatment is the one suited to a migraineur’s particular circumstances.
You Need to Go to the Hospital If
According to Migraines For Dummies (Diane Stafford and Jennifer Shoquist, MD; 2003), there are two reasons why someone with migraines may need to be treated in the emergency room. The first is any head pain that lasts over 72 hours straight should be considered an emergency, because it may be the sign of a life-threatening medical condition such as a stroke.
Any person over the age of 50 that experiences a migraine for the very first time should also be hospitalized because this may be the sign of a stroke.
There is no one definitive medical test for migraines, so it may take a while before you get a definitive diagnosis. According to the Mayo Clinic, the migraineur’s personal health history, any other symptoms and family history are taken into account in order to determine a diagnosis. The doctor or neurologist may need to run tests to eliminate other causes.
Migraines can also be the symptom of a more serious medical condition. For examples, migraines occur in severe medical conditions such a brain aneurysm (where a blood vessel swells and bursts), glaucoma (a buildup of fluid in the eyes) or a stroke.
There are two types of medication for migraine treatment – painkillers to take after an attack begins and daily medications to prevent attacks. Painkillers include over the counter non-steroidal anti-inflammatory drugs (NSAIDs) like acetaminophen; triptans such as Imitrex (sumatriptan) and, if all else fails, narcotics like codeine.
Daily preventative medications include antidepressants like Prozac (fluoxetine), anti-seizure medications like Depakote (divalproex sodium) and high blood pressure medications like the calcium-channel blocker verapamil.
MAGNUM, the National Migraine Association, encourages all migraineurs to keep a journal or diary about their attacks. This should quickly list how long the attack was, what happened right before the attack, how much sleep the person had, what foods were eaten before an attack and, for women, what time of the menstrual cycle they are at. These migraine diaries can be kept in a notebook or templates can be downloaded for free from the National Headache Society.
Over time, this can help a migraineur recognize their personal triggers and therefore avoid them. They may also learn to recognize when the body is giving out warning signs that an attack is immanent so the migraineur can take medication before the pain hits.
It is unknown exactly why people get migraines, but the prevailing theory is that a drop in the neurotransmitter serotonin begins a series of chemical events in the brain that results in a migraine. Serotonin is also thought to be a major culprit in some other chronic ailments like clinical depression and epilepsy.
According to the American Headache Society, other chronic medical conditions like epilepsy and clinical depression may affect migraines. This is one reason why anti-depressants and anti-seizure medications are often prescribed off-label for migraine prevention. Unless the other chronic illness is addressed, the migraineur may continue to suffer from attacks.
“Diagnosing and Managing Migraine Headache.” Loretta L. Meuller, DO. “The Journal of the American Osteopath Association.” Nov. 2007.
The Mayo Clinic. Migraine