Migraines are caused by abnormal brain activity and involve intense headache pain, though the exact triggers are unclear. A migraine involves four stages - a prodrome phase with subtle symptoms 1-2 days before, an aura phase with sensory disturbances right before, the attack with severe headache pain and other symptoms, and a postdrome hangover phase after. While there is no single test to diagnose migraines, keeping a symptom journal and ruling out other causes with medical tests can help doctors make a diagnosis. Treatment involves preventative daily medications and acute pain relievers during attacks, though overuse can cause rebound headaches. Common triggers include hormonal changes, foods, smells, lights and stress. Managing triggers and lifestyle factors

2. Alissa Caron
Migraines: The Mystery
Revealed (Or Not…)

3. Alissa Caron
March 26, 2012

5. WHAT IS A MIGRAINE, AND WHY DOES IT
HAPPEN?
!! A migraine is caused by abnormal brain activity.
!! However, the exact sequence of events leading to
a migraine remains unclear:
!! Doctors think that attacks begin in the brain and then
spreads via nerve signals to affect other pathways
throughout the body.
!! The headache itself causes intense pain (normally
on one side of the head) that lasts from 4 hours to
3 days.
!! Migraine headaches often begin to affect people in
childhood, adolescence, or early adulthood.

7. 4 STAGES OF A MIGRAINE HEADACHE
Prodrome:
1-2 days before migraine:
subtle changes including depression,
irritability, hyperactivity, constipation,
diarrhea, food cravings, neck stiffness

8. 4 STAGES OF A MIGRAINE HEADACHE
Aura:
Visual or sensory disturbances 10-15
minutes before migraine:
blurred vision, bright spots, loss of vision, pins
and needles in arms and/or legs, speech
problems

9. 4 STAGES OF A MIGRAINE HEADACHE
Attack:
pulsating pain on one side of the head
sensitivity to light, sound, and/or smells
nausea and vomiting
blurred vision
diarrhea
lightheadedness, fainting
numbness, tingling
chills
sweating
increased urination
problems concentrating or speaking the right words

10. 4 STAGES OF A MIGRAINE HEADACHE
Postdrome, aka migraine
hangover:
After the attack, you will feel
drained, and these symptoms may
linger:
Lack of clear thinking, weariness (need for
sleep), neck pain

11. WHAT IT FEELS LIKE TO ME…

12. IN CASE YOU THINK YOU HAVE MIGRAINES…
!! Migraines normally continue undiagnosed and
untreated. If you regularly experience the signs
and symptoms, start to keep a journal of your
attacks and visit your doctor…
!! If you have typical migraine symptoms and/or
family history, your doctor can diagnose migraines
based on your medical history.
!! In addition, the following tests can be done to rule
out critical causes for pain:
Blood Work and Urinalysis
Computerized tomography (CT) scan
Magnetic resonance imaging (MRI)
Spinal tap

13. “DIAGNOSIS OF EXCLUSION”
!! The bottom line of diagnosis is that…
There is NO specific test that can be performed
to prove that your headache is actually a
migraine. Tough luck!
!! Current scientific understanding is limited.

14. MIGRAINE TREATMENT
!! Preventive
medications: taken regularly (often daily), to
reduce the severity or frequency of migraines.
!! Beta blockers (Inderal) , calcium channel blockers (Calan)
!! Tricyclic antidepressants (amitriptyline)
!! Anti-seizure drugs (Topamax)
!! Pain-relieving
medications: acute or abortive treatment,
taken during migraine attacks, designed to stop
symptoms that have already begun.
!! Modest pain relievers (ibuprofen, acetaminophen)
!! Triptans (Relpax, Imitrex, Zomig): most effective
!! Ergot (ergotamine + caffeine): less effective

15. COMPLICATIONS FROM TREATMENT
!! Rebound headaches: medications taken often and/or
in high doses can start to cause additional
headaches
!! Abdominal pain, bleeding, ulcers from high doses of
certain pain relievers (ex/ ibuprofen)
!! Life-threatening
serotonin syndrome if taking
certain migraine medicines (triptans, ex/ Zomig,
Imitrex) and selective serotonin reuptake inhibitors
(SSRIs) or serotonin-norepinephrine reuptake
inhibitors (SNRIs) anti-depressants simultaneously

16. THE MYSTERY OF MIGRAINES: WHO GETS
THEM AND WHY?
!! Family history: Some sources claim that 90% of
people with migraines have a family history of migraine
attacks.
!! Age:!Migraine can begin at any age, though most
people experience their first migraine during their
teenage years.
!! Gender: Women are three times more likely to have
migraines than men. During childhood, headaches tend
to affect boys more than girls, but by adolescence, more
girls are affected.
!! Hormonal changes: Women may experience
migraines just before or after their period. During
pregnancy, attacks may be more intense during the first
trimester but should occur less frequently during the
rest of the pregnancy.

17. COMMON TRIGGERS
!! Alcohol
!! Stress
!! Loud noise
!! Bright lights
!! Smoking or exposure to smoke
!! Certain strong perfumes and odors
!! Caffeine withdrawal
!! Changes in sleep patterns
!! Physical stress or intense exercise
!! Missed meals
!! Dehydration
!! Changes in women’s hormone level due to menstrual
cycle or birth control
!! And….

18. …AND FOOD! WHO KNEW?
!! More than 100 foods contain certain chemicals that
are known to set off migraines.! These chemicals
include tannin, nitrates, sulfites, monosodium
glutamate (MSG), tyramine, and phenylethylamine (in
aspartame). The most common food triggers are:
!! Any processed, fermented, pickled, or marinated foods
!! Baked goods, chocolate, nuts, peanut butter, and dairy
products
!! Foods containing tyramine: red wine, aged cheeses,
smoked fish, chicken livers, figs, and certain beans
!! Some fruits: avocado, banana, citrus fruit, tomato
!! Meats containing nitrates: bacon, hot dogs, salami,
cured meats
!! Onions

19. WITH ALL OF THESE POSSIBLE TRIGGERS AROUND
YOU, WHAT CAN YOU DO TO PREVENT MIGRAINES??
First off, don’t cry like this child….

20. THE BEST PREVENTION TOOL: TAKE CARE OF
YOURSELF!

21. Questions?
Thank you!
Easy-Reading References:
National Institutes of Health:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001728
Mayo Clinic:
http://www.mayoclinic.com/health/migraine-headache/DS00120

22. Thank You!
Alissa Caron