Migraines

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Migraines

Referring to a migraine as a headache is like saying the Grand Canyon is a large hole. While a run-of-the-mill headache can make your head spin, migraines can make you feel like Linda Blair in The Exorcist. Besides intense head pain, there's often nausea and vomiting as well.

The onset of a migraine is not like the creeping-in head pain of the "classic" tension headache. About 20 minutes before the war between your ears, a migraine can cause flashes of light, blind spots, dazzling zigzag lines, dizziness and numbness on one side of the body. You may feel thirsty or crave sweets, feel elated and energetic or drowsy and depressed. There's also hypersentivity to light and sound.

Heredity plays a role, and women are twice as likely as men to suffer migraines. These mega-headaches usually start around puberty and tend to dwindle after age 45. (But for some reason, they rarely occur during pregnancy.) Although the exact cause of migraines is unknown, evidence suggests that these one-sided headaches (they don't affect the entire skull) have something to do with the blood vessels in your head. Triggers also include certain foods, stress, light and even perfumes or other odors.

Your doctor may prescribe ergotamine for these hard-to-handle headaches, but that drug can produce distressing symptoms of its own. Luckily, the experts say, there are other ways to control migraines.

Sleep it off. "Generally, the best treatment for a migraine is to sleep," says Glen Solomon, M.D., a headache specialist at the Cleveland Clinic Foundation in Cleveland and associate professor of medicine at Ohio State University in Columbus. "Relief comes from falling asleep--even if it's for a short time." Dr. Solomon warns, however, that napping can trigger other types of headaches. So if you're susceptible to other headaches besides migraines, the best policy is to get on a regular sleeping schedule rather than taking catnaps.

Say no to NutraSweet. The popular artificial sweetener isn't so sweet to migraineurs: Aspartame (sold commercially as NutraSweet) can trigger migraines or make them worse. "Various studies have implicated NutraSweet but not other artificial sweeteners," says Fred Sheftell, M.D., director of the New England Center for Headache in Stanford, Connecticut, and coauthor of Headache Relief. "There's no question, medically, that many people prone to migraines or headaches will do better if they eliminate NutraSweet."

Take time to relax--literally. "Most migraines occur on weekends or while people are on vacation, and I think it may have to do with a reduction of stress," says Dr. Solomon. "When the body's stressed, it produces adrenaline--and adrenaline protects blood vessels against migraines. When you relax and don't have this adrenaline protection, you're more prone to an attack. You need to ease into relaxation, make it more of a gradual transition than just going full blast until 5:00 P.M. Friday and then suddenly stopping everything. I suggest practicing some sort of relaxation technique to slowly unwind--exercise, listening to music, whatever helps you relax--rather than just leaving work Friday afternoon and hitting the bar."

Munch on magnesium. Research by K. Michael Welch, M.D., a neurologist at Henry Ford Health Sciences Center in Detroit, suggests that most migraine sufferers may have a shortage of magnesium in their brains. "Magnesium is a muscle relaxer, and it can help those with migraines," explains Allan Magaziner, D.O., a Cherry Hill, New Jersey, family practitioner who specializes in nutritional therapy and preventive medicine. Good sources of this mineral include dark green, leafy vegetables, fruits and nuts.

When to See the Doctor A headache hurts. A migraine can feel even worse. But for either ache, it's unlikely you'll need emergency medical care. However, you should call the doctor immediately if your headache is accompanied by convulsions, fever, severe mental confusion or a drop in alertness. Other signals that you should see the doctor include a sharp pain in the ear or an acute pain in any point around your face or head. And if you have a headache following a severe head injury, don't hesitate to call the doctor or emergency room. You should also see a doctor if regular headaches become much more severe. Finally, if you have a child who frequently complains of a recurring headache, be sure to consult a pediatrician.

Watch what you eat. About 10 to 15 percent of people plagued by migraines are food-sensitive, which means that consuming some foods or drinks can trigger a severe migraine, says Dr. Solomon. "There are certain foods that we know are triggers--chocolate, red wine and other items containing the animo acid tyramine. Also, foods cooked with MSG (monosodium glutamate) can trigger attacks. I tell my patients to eat what they want but to note if they get headaches after eating certain foods. If they do, stay away from those foods." (For a complete list of tyramine-rich foods, see "Foods That Bring Pain" on the opposite page.)

Take an aspirin every other day. A landmark Physician's Health Study found that aspirin reduced the risk of heart attack. Less publicized was the finding that aspirin is also very beneficial for alleviating migraines. In the 22,000-person study, migraine-prone participants who took a 325-milligram aspirin tablet every other day cut their attacks by 20 percent. "Even a daily dose of aspirin seems to help prevent migraines," says Seymour Diamond, M.D., executive director of the National Headache Foundation and director of the Diamond Headache Clinic in Chicago. But check with your doctor before you start an aspirin-a-day program, and never give aspirin to children because of the risk of Reye's syndrome.

Ice your head. You have a 50-50 chance of getting some pain relief within three minutes of applying a soft, cold ice pack wrapped in a towel to your head, says Lawrence Robbins, M.D., an assistant professor of neurology at Rush Medical College and the University of Illinois College of Medicine, both in Chicago, who also has his own headache clinic in Northbrook, Illinois. That's because ice constricts blood vessels, returning them to normal size.

Be aerobically inclined. Doctors have long known that exercise is a great way to reduce the stress that often triggers migraines in some people. But now there's research suggesting that cardiovascular fitness may also help lessen migraines--no matter what the cause. Research psychologists at Carleton University in Ottawa, Ontario, report that the severity of migraines decreases as cardiovascular fitness increases. "Regular exercise is a great idea for anyone who has migraines," agrees Dr. Diamond. But he warns: Exercise during an attack can make it worse.

Foods That Bring Pain Certain foods are known to trigger migraines in some people. Leading culprits include: Alcohol (especially red and fortified wines). Foods containing tyramine (an amino acid)--chocolate, aged cheeses, organ meats, vinegar, ketchup, salad dressings, sour cream, yogurt and yeast extracts. Foods containing MSG (monosodium glutamate). Other offenders--citrus fruits, onions, dairy products, pickled herring, deli meats, hot dogs, lima/fava beans and seafood.

Relax--as often as possible. Whether you just "imagine" yourself on a beach or actually go to one, practicing a regular activity that helps you unwind, relax and manage stress is essential for preventing migraines, say all our experts. Try to find some time every day for activities such as listening to music, reading or practicing yoga.

Don't pop the Pill. If you're a migraine-prone woman who takes birth control pills, you might want to consider discontinuing them. One in three women with migraines has increased attacks when she takes oral contraceptives.

Try feverfew. Fevers are fewer after taking this white-flowered plant, and so are migraine headaches. Research conducted at University Hospital in Nottingham, England, has shown that people who take feverfew get fewer and less intense migraines. You can grow feverfew, a common herb, or check your local health food store for supplements or powders. Note: Don't take feverfew if you're pregnant. And if you experience swollen lips, dulled taste buds or a sore mouth and tongue after trying the herb, be sure to stop taking it.