David Lee Gordon, MD – OU Health Chair of Neurology in Oklahoma City – says the most important feature in diagnosing a headache as a migraine headache is the previous occurrence of similar, intermittent headaches, since migraine is a genetic condition that causes recurrent, transient symptoms throughout one’s life.
“Migraine is also the likely diagnosis if the headache is associated with classic migraine visual ‘aura’ (moving spots, dots, zigzag or wavy lines, or lights), classic migraine sensory ‘aura’ (tingling traveling up or down one side of the body), sensory ‘phobias’ (light intolerance, noise intolerance, smell intolerance and motion sickness), or lower abdominal symptoms – especially cramping pain and diarrhea,” says Gordon. However, he adds that while nausea and vomiting are common with migraine attacks, these symptoms can also occur with other types of headaches.
Migraine is a complex sensory processing disorder, says Abeera Ali, MD, a neurologist with INTEGRIS Baptist Medical Center in Oklahoma City. And women are three to four times more likely than men to suffer from migraine headaches. Common triggers include dehydration, sleep deprivation and emotional stress.
“Some people can identify environmental triggers like changes in barometric pressure (before storms) and certain smells and foods that bring about migraine, but that varies from person to person,” says Ali.
It may surprise you to know that you could be experiencing migraine and not know it.
“Nearly all recurrent, ‘regular’ headaches, ‘tension’ headaches, and ‘sinus’ headaches (migraine causes sinus congestion) are actually migraine headaches,” says Gordon. “Infantile colic and irritable bowel syndrome are actually due to abdominal migraine. Recurrent vertigo (the sensation that the world is moving or spinning) is more commonly due to migraine than ear problems. Recurrent chest pain with normal heart, lung, and stomach tests is most often due to migraine.”
He says migraine can even mimic stroke by causing difficulty speaking or weakness on one side of the body, and that most migraine attacks are associated with either an increase or decrease in blood pressure caused by the migraine itself.
“This leads some folks to mistakenly think their headache or other symptoms are due to high blood pressure. High blood pressure may cause chronic diseases, but actually causes no symptoms,” says Gordon, adding that migraine can also cause fainting due to decreased blood pressure.
Within the past several years, there have been important advancements in the treatment of migraine, the most significant being calcitonin gene-related peptide (CGRP) inhibitors, says Gordon.
“CGRP is a chemical released in the brain during a migraine attack that, among other things, turns on pain nerves in the head, causing a migraine headache,” he says. “We now have four injectable medications that target either CGRP or the CGRP receptor on pain nerves and prevent migraine attacks if taken on a regular basis.”
In addition, he says there are many other effective medications for both migraine prevention therapy and migraine stopper therapy.
Ali shares the reminder that migraine is not just a headache but a condition that can be very disabling. According to the Migraine Research Foundation, migraine is the sixth most disabling illness in the world.
“If you believe you are suffering from migraine headaches, please see a doctor,” she says. “You need a treatment plan tailored to your needs. There are things that can be done to stop a migraine in its tracks and make migraine less frequent and severe.”
