A migraine is a primary headache disorder that produces recurring head pain and other symptoms. It differs from an ordinary headache, and it develops on its own rather than from another medical condition. Most people feel a moderate to severe throbbing sensation on one or both sides of the head, and episodes can last hours or days. Chronic migraine has a specific definition that helps distinguish it from other migraine patterns.
Recognizing Migraine Symptoms
Migraine symptoms set the disorder apart from tension and other headaches. The pain is usually throbbing, and it arrives alongside neurological and physical effects. Some people experience an aura before or during an attack. This sensory symptom includes flashes of light, ringing in the ears, or tingling on the face, and for a small group, an aura is the primary symptom. Reported symptoms include:
- Throbbing head pain
- Difficulty concentrating
- Changes in speech
- Fatigue
- Nausea and vomiting
Identifying Common Migraine Triggers
The exact cause of migraine remains unclear. Genetic and environmental factors appear to contribute, and triggers vary from person to person. A headache journal supports this process, and keeping one allows a person to connect specific exposures to later attacks.
Known triggers include hormones, stress, alcohol, caffeine, and overstimulation from strong smells, loud sounds, or flashing lights. Sleep patterns matter too. Too little or too much sleep can provoke episodes, and weather changes and certain foods, such as chocolate, aged cheese, and processed items, also serve as triggers.
Comparing Acute and Preventive Treatment
Treatment plans reflect how frequent and severe the attacks are. Acute treatment reduces pain once an attack begins, and preventive treatment works to stop attacks from starting. Frequent use of acute medications can lead to medication overuse headache, while preventive strategies reduce the frequency, severity, and duration of attacks.
Preventive approaches divide into two methods. Monotherapy uses a single medication adjusted gradually to its beneficial dose, while polytherapy combines two or more drugs from different classes at lower doses. Polytherapy combines medications that complement each other, and providers monitor treatment to manage potential side effects and interactions.
Reviewing Preventive Migraine Medications
Several medication classes prevent migraine. Blood pressure medications serve as long-standing options, and propranolol and timolol hold Food and Drug Administration approval for this use. Anti-seizure medications also work as preventive options. Topiramate and divalproex sodium both carry FDA approval, though these medications have restrictions for women who are pregnant or who may become pregnant.
Antidepressants such as amitriptyline and venlafaxine also serve as preventive options. CGRP therapies target a protein involved in migraine pain, and these treatments have fewer side effects than some traditional medications. Supplements including riboflavin, magnesium, coenzyme Q10, and feverfew show varying levels of effectiveness, while neuromodulation devices use electrical currents or magnets to affect brain activity.
OnabotulinumtoxinA received FDA approval in 2010 for chronic migraine, which is defined as 15 or more headache days per month. Clinicians administer injections around the head and neck every 12 weeks, and preventive medications can take two to three months to reduce attack frequency. Tracking symptoms during that period provides information about treatment response.
Consult a Headache Specialist Today
Preventive migraine treatment involves discussion between a patient and a provider. Symptoms, health conditions, and past medications inform that discussion, and the provider uses this information to develop a treatment plan. A specialist can evaluate migraine patterns and discuss preventive options, which vary based on the individual’s needs.
