Headache, or migraine? Knowing the differences and getting treatment Many people get headaches from time to time - those stress-induced tension headaches that may feel as though there is a band tightening around your head. However, some people suffer from migraines, which are different from regular headaches. They are different not only in symptom but in their root cause. In fact, they are essentially opposites. While regular headaches are caused by a narrowing of the cranial blood vessels, migraines are caused by those same blood vessels dilating or expanding. Approximately 32 million Americans are living with migraine disease, which is a serious health and disability problem. Many of those afflicted are women, and those who get them can be disabled by them. In addition, severe and prolonged migraines may lead to stroke. Symptoms of migraine include nausea, vomiting, sensitivity to light and sound, difficulty with speech, and severe head pain that may be concentrated on one side. Migraine pain may be throbbing and aggravated by certain head movements. Auras, or the appearance of spots of light, are also associated with migraine, and sufferers may know that a migraine is coming upon the presence of these light spots. It is possible that one migraine attack can last for hours, days, or even weeks. Treatments help to manage the pain and symptoms associated with migraine, but there is no known cure. It is difficult for migraine sufferers to find a treatment that is wholly effective and will not diminish its effects over time. During a migraine, inflammation of the tissue surrounding the brain makes the pain worse. Therefore, medicines often prescribed to treat headaches may not work, or may make the migraine worse if they dilate the blood vessels even more. "If you feel a migraine coming on, take your medication immediately," Michael Sher, M.D., board certified in internal medicine on staff with Kimball Medical Center said. "This can potentially reduce the severity and duration of the episode. Waiting until the pain has been going on for a few hours before taking pain medication means there is less likelihood that the migraine will abate." Additionally, lifestyle and behavior changes must also be incorporated into the headache treatment plan. A migraine can be induced by both controllable and uncontrollable triggers. "Uncontrollable triggers would include weather patterns and menstrual cycles," explains Dr. Sher. "Controllable triggers include stress, bright light, sleep disturbances, and anything you intake, such as food or alcohol, aspartame, nicotine or caffeine. The triggers cause the cranial blood vessels to open up, which triggers nerve endings in the brain to release neurotransmitters, such as serotonin." You may know you are going to have a migraine before the headache starts. Warning signs of classic migraines include auras, nausea, vomiting, and sensitivity to noise, light, or smells. You may also feel as though you are looking through a tunnel, or your body may feel prickly, hot or weak. These warning signs occur about 15 to 30 minutes before the onset of the migraine. Another type of migraine, called common migraine, has different warning signs. With this type of headache, you may feel tired, depressed, restless, or talkative for two or three days before the headache starts. Migraine treatments There are many different medications for migraine, including serotonin receptor agonists, or triptans. These medications can offer substantial relief from the acute migraine attack. Ergot medications such as dihydroergotamine mesylate and ergotamine tartrate can also relieve the acute pain of migraine. However, all medications can have potential side effects and overuse of any pain medication can result in a worsening of headache symptoms. Nonsteroidal anti-inflammatory medications (NSAIDS) can be quite effective in the treatment and prevention of menstrual migraine if dosed correctly. Standard prophylactic medications include many of the anti-convulsant medications such as divalproex sodium, carbamazepine and topiramate. Antidepressants or beta blockers can also be very effective in preventing headache recurrence. It is important to note that some medications may not be safe for women who are pregnant or who are trying to become pregnant and the choice of therapy should be discussed with your doctor. Migraines and children Migraine headaches occur not only in adults, but in children and teenagers as well. In fact, migraines in teenagers are common, disabling, and substantially under treated. The frequency of migraine headaches among adolescent sufferers increases over time. The child may start out with a few headaches each month, but a few years later may be up to 10 to 15 per month. Parents of children with frequent headaches should seek help from their doctors. "We're seeing more and more overweight children and teens getting more migraines than their thinner counterparts," notes Dr. Sher. "Migraines are disabling to young kids, who may miss a number of school days and other activities. It's important that kids with frequent headaches are seen by a doctor." Though the connection is not fully understood, the increased severity of migraine in overweight or obese children mirrors the same phenomenon in adults. In children, there is also a relationship to behavioral health issues. Research has shown that when the headache pain is treated adequately, the emotional and behavior problems may abate. Super sensitive nerves Recent research has added another interesting piece into the migraine puzzle. During migraine, a chain reaction may occur that activates nerve cells in the spinal cord. It's as if these cells get stuck in the "on" position, and the result is that the sufferer has super sensitivity to the slightest sensation. This sensitivity is played out in sometimes strange ways, with patients claiming to feel pain from their glasses or even their own hair. They may also experience painful sensitivity to touch and/or temperature in specific areas of their skin. The nerves become so sensitive that even the pulse of blood in their brains causes pain, which leads to the "throbbing" sensation often felt during migraines. Dr. Sher emphasizes the importance of reporting unusual symptoms to their doctor. "Tell your doctor about what you experience during your headache, no matter how strange it may seem," he pressed. "It can be just about anything - numbness, hallucinations, strange smells, tastes, or inability to form sentences. These are neurological symptoms that occur with migraine but not other kinds of headaches, so it's important that your doctor know about them." To reducing the pain of migraine: + Lie down in a dark, quiet room with your eyes closed. + Put a cold compress or rag over your forehead or splash cold water on your face. + Massage your scalp using a lot of pressure, and put pressure on your temples. It is also important to take note of what was happening earlier that day that may have triggered the migraine. Seek care immediately: + If you have a headache that gets worse or lasts more than 24 hours despite treatment. + If you develop a high temperature. + If you faint or develop weakness, numbness, double-vision, difficulty with speech, or neck pain or stiffness.