FAQs on Migraines Headaches from a Phoenix Migraine Specialist

A migraine headache is an intense throbbing, pulsing, or aching pain in one region of the head. This type of headache is often accompanied by nausea, vomiting, and sensitivity to sound and light.

When do migraine headaches start?

Migraine headaches often start during childhood, adolescence, or early adulthood. Migraine attacks can last anywhere from several hours to days.

What is the prodrome stage of migraine headache?

One or two days before a migraine comes on, you may notice slight subtle changes that alert you of an onset. The prodrome stage consists of neck stiffness, irritability, depression, hyperactivity, and uncontrollable yawning.

What is the aura stage of a migraine headache?

An aura can occur before or during a migraine headache. Auras are nervous system symptoms that are a type of visual disturbance, such as seeing flashes of light. Aura can also be movement or touch related, as well as speech disturbances. Each of these symptoms begins gradually and lasts for around 30-60 minutes.

What is a migraine attack?

A migraine can last for up to 72 hours, if left untreated, but this varies from person-to-person. An attack is when the severe pain comes and stays. During an attack, the pain can be on one side of the head, or on both sides. In addition, the pain is a pulsating quality. Other symptoms include blurred vision, lightheadedness, and dizziness.

What is the postdrome phase of migraine?

After the headache pain is gone, the fourth and final stage is known as postdrome. During this time, the patient feels fatigued and tired. However, some patients report feeling mildly euphoric during the postdromal phase.

What causes a migraine headache?

Experts believe that one of the contributing factors to migraine headaches is an imbalance in brain chemicals. Serotonin is a chemical that regulates pain in the nervous system. When serotonin levels drop during a migraine attack, it possibly causes the trigeminal system to release neuropeptides, which are substances that travel to your brain’s outer meninges.

What brings on a migraine attack?

Migraine headaches are often triggered by situations, substance, or environmental stimuli known as “triggers.” These include:

Hormonal changes – For women, fluctuations in estrogen will trigger a headache. Women with a history of migraines often experience migraines before or during their periods.

Foods and beverages – Salty foods, processed meats, and aged cheese can bring on a migraine. Skipping meals will also produce a migraine. Food additives, such as aspartame, wine, and caffeine-high drinks will produce headaches.

Stress – Emotional and physical stress is known to produce a headache.

Sensory stimuli – This includes bright lights, sun glare, and loud sounds, as well as paint thinner, secondhand smoke, and perfume.

Changes in the weather – This is due to barometric pressure, excessive heat, and cold temperatures.

What are the risk factors for migraine headache?

Family history – This type of headache tends to run in families.

Sex – Women are three times more likely to suffer from this type of headache.

Pregnancy – Being pregnant is a risk factor for migraines.

What is the treatment of migraine headache?

The pain specialist may use a combination of therapies to treat your migraine headaches. Options include:

Abortive agents – To stop a migraine attack, the doctor can prescribe triptans, such as Imitrex, Zomig, and Maxalt.

Preventive medications – Antidepressants are used for prevention, such as amitriptyline and nortriptyline. In addition selective serotonin reuptake inhibitors (SSRIs) (Zoloft, Prozac, and Paxil) and norepinephrine reuptake inhibitors (SNRIs) (Cymbalta and Effexor) are used to raise levels of brain chemicals.

Radiofrequency denervation – The doctor can use radiofrequency energy to destroy a portion of the nerve root and disrupt pain signal transmission. A needle is inserted between the cervical vertebrae using x-ray guidance. In a recent clinical study, this procedure had a 75% efficacy rate.

Botox – The neurotoxin botulinum toxin type A is used for preventing migraines. To paralyze and block acetylcholine release from the nerve cells, the doctor uses a tiny needle to make several injections along the temples, forehead, back of neck, and jaw. A recent study found that Botox was effective for reducing the symptoms of migraine headache, as well as the severity of the pain.

Acupuncture – This procedure involves inserting fine needles into the back of the neck. Based on studies, this stimulates the release of endorphins (feel-good chemicals) from the brain and into circulation. In a large research study, acupuncture was found to be better than placebo for the treatment of headaches.

Sphenopalatine ganglion block (SPB) – This involves injecting the sphenopalatine ganglion nerves with a long-acting anesthetic. The procedure involves numbing a nostril, and inserting a catheter through to reach the targeted nerves. In a recent randomized clinical trial, participants had a mild decrease in migraine headache pain after the SPB.

Radiofrequency denervation – If the SPB works with an anesthetic, the doctor may decide to use radiofrequency energy to destroy the nerves or a portion of the root. One clinical study showed that this procedure had a 75% success rate.