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Headache Journal. American Headache Society News Stay up to date on the latest research and developments in the field of headache medicine. Nov 20 Nov 21 Jan 16 Mar 27 Making a Difference in Headache Medicine The American Headache Society works alongside physicians, health care providers and advocates to improve the lives of those living with migraine and other diseases that cause severe head pain. Why Headache Medicine?

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American Migraine Foundation. Click Here to Continue. The pain of a migraine headache probably relates to spasm or irritability of blood vessels in the brain, which are sensitive to pain unlike the brain tissue itself, which does not have pain receptors. Beyond these hypotheses, however, the exact mechanism that triggers a migraine remains unknown.

Diagnosing and Managing Migraine Headache | The Journal of the American Osteopathic Association

It is often possible to identify certain risk factors that increase the chance of having migraines. Overall, migraines are more common in women than in men.


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Many individuals can identify specific triggers for their migraines. These triggers include fatigue, skipping a meal, caffeine withdrawal, stress, and certain foods including red wine, chocolate, or aged cheese. For many patients with isolated visual migraines, however, the events can be very infrequent and no definite trigger can be determined.

An isolated visual migraine, without headache, typically does not require any acute treatment, since the visual symptoms resolve on their own fairly quickly. The first few times someone experiences a visual migraine it usually causes a lot of anxiety. Once someone has become familiar with the symptoms of a visual migraine, new episodes no longer cause the same level of anxiety.

It can be helpful to try to rest during the episode. Patients in whom the visual symptoms are accompanied by a severe headache often benefit from additional therapies.

The American Headache Society

Some patients find naproxen i. Triptans are specially designed to work on receptors on blood vessels and brain cells in order to halt a migraine at an early stage. Although there are a number of different triptans, made by several different pharmaceutical companies, each of these is approximately equally effective. Triptans are often taken orally, but also come as injections and nasal sprays.

These medicines are generally not considered safe in patients with a history of strokes, heart attacks, or other vascular diseases. Many patients with isolated visual migraines, without severe headaches, have relatively infrequent episodes that do not require specific preventive treatments.

If a patient is aware of the particular triggers that seem to bring on an episode, then those triggers can be avoided. In patients where the pattern of migraines includes frequent, severe headaches, it is very reasonable to consider additional preventive treatments.

The main goal for any of these strategies is to reduce the overall frequency and severity of the headaches.

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For example, it would be considered successful if a preventive treatment helped reduce the number of severe headaches from 8 per month to per month. There are numerous medications that can be used as a preventive treatment for migraine. One medication that is used commonly, particularly because it has no side effects, is vitamin B2 riboflavin.

Tell Me a Story: Headache Center Helps Teens Manage Migraines

One common side effect of riboflavin is that the urine turns bright yellow. Other herbal medications used to reduce migraine headaches include petasites butterbur and feverfew. The other medications used as preventive treatments frequently cause side effects, but starting with a low dose and then increasing very slowly is usually a helpful strategy.

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Some commonly tried medications include amitryptiline, gabapentin, and topiramate. Less commonly, medications such as propranolol or valproic acid are used.


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For some patients, botulinum injections in the forehead and scalp can help reduce headaches.