Migraine Headache Causes

Migraine Headache Causes

Migraine
A Migraine is not just a bad headache. It is considerably worse. Some people get
migraine without any headache at all. The research to date seems to indicate that a
migraine headache is a neurological disease based on an inherited genetic abnormality.
A cause of migraine symptoms is usually called a "trigger". A trigger is what begins the
chain reaction, usually leading to migraine headaches. If you have heard much about
migraine, you may have heard about various things that happen to the body - serotonin
levels, changes in blood vessels - a variety of things happen that cause terrible symptoms,
such as nausea and headache.
Causes
Sinus headache
Headache causes, types and treatments can get confusing. Migraine is often
misdiagnosed as sinus headache, for example. A sinus headache from sinusitis happens
when you get an infection and your sinuses become inflamed. You usually have other
symptoms such as congestion, fever and fatigue.
Cluster headache
Clusters are another type of headache that may not always be a headache. Rarer than
migraine, and more painful, clusters usually attack mostly men. The cause of clusters is
also somewhat of a mystery. Now research, however, is giving us some facts that may
crack the cluster code and provide relief. Cluster headaches may be related to the
sinuses, the nervous system, and serotonin.
Other headache causes and treatments
There are many more reasons why you may have a headache, and different symptoms. Do
you get a headache after you exercise? Are your headaches caused by allergies? What
about an ice cream headache, a thunderclap headache, or getting a headache along with a
bloody nose? Information on these headaches and more can be found on this page about
your type of headache.
Once you identify the cause of the problem its time to
move on to Migraine Therapy
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Causes of Migraine Headaches
Persons with mild and un common migraine headaches that do not cause disability may require only
OTC analgesics. Individuals who experience several moderate or severe migraine headaches per
month or whose headaches do not respond readily to medications should avoid triggers and consider
modifications of their life-style. Life-style modifications for migraine headache sufferers include:
Sleep and waking up at the same time each day.
* Exercise daily. Make a commitment to exercise even when out on vacationor during busy periods at
work. Exercise can improve the quality of sleep and reduce the frequency and severity of migraine
headaches. Build up your exercise level gradually. Over exertion, especially for persons who is out of
shape, can lead to migraine headaches.
Do not miss meals, and avoiding prolonged fasting.
Try to Limit stress through regular exercise and relaxation techniques.
Try to Limit caffeine consumption to less than two caffeine-containing beverages a day.
Do not bright or flashing lights and wearing sunglasses if sunlight is a trigger.
Identify and do not eat foods that trigger headaches by keeping a headache and food diary. Review
the diary with your doctor. It is impractical to adopt a diet that avoids all known migraine triggers,
however, it is reasonable to avoid foods that consistently trigger migraine headaches.
What ar prophylactic medicines especially
for migraine headaches?
Prophylactic medications are medications taken daily to reduce the frequency and duration of migraine
headaches. They are not taken once a headache has begun. There are several types of prophylactic
medications: beta blockers, calcium-channel blockers, tricyclic antidepressants, antiserotonin agents
and anticonvulsants. Medications with the longest history of use are propranolol (Inderal), a beta
blocker, and amitriptyline (Elavil), an antidepressant. When deciding a prophylactic medication for a
patient the doctor must take into account the drug side effects, drug-drug interactions, and co-existing
conditions such as diabetes, heart disease, and high blood pressure.
What are Beta blockers
A Beta-blockers are a class of drugs that block the effects of beta-adrenergic substances such as
adrenaline (epinephrine). By blocking the effects of adrenaline, beta-blockers relieve stress on the
heart by slowing the rate at which the heart beats. Beta blockers are used to treat high blood
pressure, angina, certain types or tremors, stage fright, and abnormally fast heart beats (palpitations).
They also have become important drugs for improving survival after heart attacks. Beta-blockers have
been used for many years to prevent migraine headaches.
It is not known how beta-blockers prevent severe migraine headaches. It may be by decreasing
prostaglandin production, though it also may be through their effect on serotonin or a direct effect on
arteries. The beta-blockers used in preventing migraine headaches include propranolol (Inderal),
atenolol (Tenormin), metoprolol (Lopressor, Lopressor LA, Toprol XL), and timolol (Blocadren).
Beta-blockers are well-tolerated. They can aggravate breathing difficulties in patients with asthma,
chronic bronchitis, or emphysema. In patients who already have slow heart rates (bradycardias) and
heart block (defects in electrical conduction within the heart), beta-blockers can cause dangerously
slow heartbeats. Beta-blockers can aggravate symptoms of heart failure. Some side effects include
drowsiness, diarrhea, constipation, fatigue, decrease in endurance, insomnia, nausea, depression,
dreaming, memory loss, impotence.
Tricyclic anti depressants for Migraines
Tricyclic antidepressants (TCAs) prevent bad migraine headaches by altering the neurotransmitters,
norepinephrine and serotonin, that the nerves of the brain use to communicate with one another. The
tricyclic antidepressants that have been used in preventing migraine headaches include amitriptyline
(Elavil), nortriptyline (Pamelor, Aventyl), doxepin (Sinequan), imipramine (Tofranil), and protriptyline.
The commonly encountered side effects associated with TCAs are fast heart rate, blurred vision,
difficulty urinating, dry mouth, constipation, weight gain or loss, and low blood pressure when standing.
TCAs should not be used with drugs that prevent monoamine oxidase such as isocarboxazid (Marplan),
phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane), since high fever,
convulsions and even death may occur. TCAs are used with caution in patients with seizures, since
they can increase the risk of seizures. TCAs also are used with caution in patients that have
enlargement of the prostate because they can make urination difficult. TCAs can cause elevated
pressure in the eyes of some patients with glaucoma. TCAs can cause excessive sedation when used
with other medications that slow the brain's processes, such as alcohol, barbiturates, narcotics, and
benzodiazepines, e.g. Ativan, diazepam (Valium), temazepam oxazepam (Serax), clonazepam
(Klonopin), zolpidem (Ambien). Epinephrine should not be used with amitriptyline, since the
combination can possible cause uncommonly high blood pressure
Anti serotonin medications
Methysergide prevents severe migraine headaches by constricting blood vessels and reducing
inflammation of the blood vessels. Methylergonovine arerelated chemically to methysergide and has a
similar mechanism of action. They are not widely used because of their side effects. The most serious
side effect of methysergide is retroperitoneal fibrosis (scarring of tissue around the ureters that carry
urine from the kidneys to the bladder). Retroperitoneal fibrosis, though rare, can block the ureters and
can cause backup of urine into the kidneys. Backup of urine into the kidneys can cause back and flank
(the side of the body between the ribs and hips) pain and ultimately can lead to kidney failure.
Methysergide also has been reported to cause scarring around the lungs that can lead to severe chest
pain, and shortness of breath.
Calcium channel blockers
A Calcium channel blocker (CCBs) are a class of drugs that block the entry of calcium into the muscle
cells of the heart and the arteries. By blocking the entry of all calcium, CCBs reduce contraction of the
heart muscle, decrease heart rate, and lower blood pressure. CCBs are used for treating high blood
pressure, angina, and abnormal heart rhythms (e.g., atrial fibrillation). CCBs also appear to block a
chemical within nerves, called serotonin, and have been used occasionally to prevent migraine
headaches. The CCBs used in preventing migraine headaches are diltiazem (Cardizem, Dilacor, Tiazac),
verapamil (Calan, Verelan, Isoptin), and nimodipine.
The most common side effects of CCBs are constipation, nausea, headache, rash, edema (swelling of
the legs with fluid), low blood pressure, drowsiness, and dizziness. When diltiazem or verapamil are
given to individuals with heart failure, symptoms of heart failure may worsen because these drugs
reduce the ability of the heart to pump blood. Verapamil and diltiazem may reduce the elimination &
increase the blood levels of carbamazepine (Tegretol), simvastatin (Zocor), atorvastatin (Lipitor), and
lovastatin (Mevacor). This can lead to toxicity from these drugs.
Anticonvulsants
Anticonvulsants (antiseizure medications) also have been used to prevent migraine headaches.
Examples of anticonvulsants that have been used are valproic acid, phenobarbital, gabapentin, and
topiramate. It is not known how anticonvulsants work to prevent migraine headaches.
Who you should consider prophylactic medications to hopefully prevent migraine headaches?
Not all migraine persons need prophylactic medications; individuals with mild or infrequent headaches
that respond readily to abortive medications do not need prophylactic medications. Individuals who
should consider prophylactic medications are those who:
1. Require medications for migraine headaches more frequently than twice weekly.
2. Have two or more migraine headaches a month that do not respond readily to abortive medications.
3. Have migraine headaches that are interfering substantially with their quality of life and work.
4. Cannot take abortive medications because of heart disease, stroke, or pregnancy, or cannot
tolerate abortive medications because of side effects.
How effective is prophylactic medications?
Prophylactic medications can reduce the frequency and time of migraine headaches but cannot be
expected to eliminate migraine headaches completely. The success rate of most prophylactic
medications is approximately 50%. Success in preventing migraine headaches is defined as more than a
50% reduction in the frequency of headaches. Prophylactic medications usually are started at a low
dose that is increased slowly in order to minimize side effects. Individuals may not notice a reduction in
the frequency and duration of their headaches for 2-3 months after begining treatment.