My concerns now are wondering what the difference is between the symptoms of
migraine and optical neuritis and whether to accept the diagnosis or pursue
checking for neurological or blood vessel blockage causes. I have to see my
regular dr. soon, so I'll ask him then.
Barbara
General Information
DEFINITION--Migraine refers to a group of symptoms that may occur together.
The most noted one is an incapacitating headache, usually on one side of the
head, which can last from 2 to 72 hours. Episodes of migraines can occur
weekly in some people; others may have less than one a year.
BODY PARTS INVOLVED--Blood vessels, central nervous system, gastrointestinal.
SEX OR AGE MOST AFFECTED
•Both sexes, but more common in females. •Adolescents and adults.
SIGNS & SYMPTOMS--
The nature of attacks varies between persons and from time to time in the
same person. Symptoms appear as follows: •An aura that precedes the headache.
This may affect vision, hearing or smell. •The most common symptom is the
inability to see clearly, followed by seeing bright spots and zig-zag
patterns. Visual disturbances may last several minutes or hours, then
disappear. •Dull, boring pain in the temple that spreads to the side of the
head. Pain becomes intense. •Nausea and vomiting. In other types of migraine
attack, the above symptoms (vision disturbances, headache or vomiting) may be
absent, or other symptoms may be present.
CAUSES--
Exact cause is uncertain. A disturbance in blood circulation in the head
accompanies migraine and may be a cause. Attacks may be triggered by:
•Tension. Emotional problems are probably the most common reason for migraine
attacks, but headaches don't necessarily coincide with emotional upset. They
often occur on weekends when stress is decreased. •Menstruation; use of oral
contraceptives. •Fatigue; missing meals. •Consumption of alcohol or certain
foods.
RISK INCREASES WITH
Stress; family history of migraines; smoking; excess alcohol consumption; use
of many prescription and non-prescription drugs.
HOW TO PREVENT
•Reduce stress in your life where possible (see How to Cope with Stress in
Appendix). •Take a prescription drug to help prevent attacks. Ask your
doctor. •Avoid those factors that trigger attacks. •Learn to look for warning
signs of a headache and do something different (take a walk,etc.).
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What To Expect
DIAGNOSTIC MEASURES--
•Medical history and exam by a doctor. •Laboratory blood studies or CT scan
(see Glossary) of the head may be done to rule out other disorders.
APPROPRIATE HEALTH CARE
Self-care after diagnosis; doctor's treatment.
POSSIBLE COMPLICATIONS--None expected.
PROBABLE OUTCOME--Symptoms can be controlled with treatment.
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How To Treat
GENERAL MEASURES--
•At the first sign of a migraine attack: Apply a cold cloth or ice pack to
your head or splash your face with cold water. Lie down in a quiet, dark room
for several hours. Wedge pillows to support head. Relax and sleep if
possible. Minimize noise, light and odors (especially cooking odors and
tobacco smoke). Don't read. •See Resources for Additional Information.
MEDICATION--A wide variety of drugs can be prescribed for migraine symptoms
and prevention. Follow all prescription instructions carefully. Your doctor
may prescribe:
•Ergotamines (contain caffeine) in oral form, suppository or inhaler.
•Aspirin, acetominophen or ibuprofen. •Drugs that combine acetominophen and a
narcotic (codeine). •Antihistamines to expand blood vessels. •Antiemetics to
decrease nausea and vomiting. •Vasoconstrictors to narrow blood vessels.
•Sumatriptan (Imitrex) in self-administered subcutaneous (under the skin)
injection or oral tablet. •Beta-adrenergic or calcium channel blockers or
tricyclic antidepressants to prevent attacks, if headaches are so frequent
that you can't function normally. These medications may have undesir-able
side effects and may not help everyone.
ACTIVITY--Rest during attacks; exercise regularly; keep a regular sleep
pattern.
DIET--
•Don't skip meals. At least snack. •Because some attacks are caused by foods,
avoid or limit: cheese, chocolate, spicy foods, mixed spices, monosodium
glutamate (MSG), nitrites or nitrates (used in preserved meats such as bacon,
hot dogs or deli meats). Keep a record of what you ate before each attack.
Avoid foods that may trigger migraine attacks. •Avoid alcohol.
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Call Your Doctor If
You have a migraine attack that persists longer than 24 hours, despite
treatment.
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