Migraine Headache

A migraine headache is an often severe type of headache. It's different from other types of headaches in that symptoms other than pain occur with it. For instance, a classic migraine headache means visual symptoms (or aura) such as flashes of light, blind spots, or other vision changes, warn you a headache is coming on. Nausea and vomiting, lightheadedness, sensitivity to light or sound, and other visual disturbances are common migraine symptoms. The pain may last from a few hours to several days. It's not clear why migraines occur, but certain factors called triggers can raise the risk of having a migraine attack. A migraine may be triggered by emotional stress or depression, or by hormone changes during the menstrual cycle. Other triggers include certain birth control pills, overuse of migraine medicines, alcohol or caffeine, and foods with tyramine, such as aged cheese and wine. Eyestrain, weather changes, missed meals, or too little or too much sleep can also trigger a migraine.

Home care

Follow these tips when taking care of yourself at home:

  • Don’t drive yourself home if you were given pain medicine for your headache or are having visual symptoms. Instead, have someone else drive you home. Try to sleep when you get home. You should feel much better when you wake up.

  • Cold can help ease migraine symptoms. Put an ice pack wrapped in a thin towel on your forehead or at the base of your skull. Put heat on the back of your neck to help ease any neck spasm.

  • Drink only clear liquids or eat a light diet until your symptoms get better. This will help you prevent nausea and vomiting.

How to prevent migraines

Pay attention to what seems to trigger your headache. Try to stay away from the triggers when you can. If you have headaches often, consider keeping a headache diary. In it, write down what you were doing, feeling, or eating in the hours before each headache. Show this to your healthcare provider to help find the cause of your headaches.

If stress seems to be a trigger for your headaches, figure out what is causing stress in your life. Learn new ways to handle your stress. Ideas include regular exercise, biofeedback, self-hypnosis, yoga, and meditation. Talk with your provider to find out more information about managing stress. Many books and digital media are also available on this subject.

Tyramine is a substance found in many foods. It can trigger a migraine in some people. These foods contain tyramine:

  • Chocolate

  • Yogurt

  • All cheeses, but especially aged cheeses

  • Smoked or pickled fish and meat, including herring, caviar, bologna, pepperoni, and salami

  • Liver

  • Avocados

  • Bananas

  • Figs

  • Raisins

  • Red wine

Try staying away from these foods for 1 to 2 months to see if you have fewer headaches.

How to treat future headaches

  • Take time out at the first sign of a headache, if possible. Find a quiet, dark, comfortable place to sit or lie down. Let yourself relax or sleep.

  • Put an ice pack wrapped in a thin towel on your forehead or on the area of greatest pain. A heating pad and massage may help if you are having a muscle spasm and tightness in your neck.

  • If you have been prescribed a medicine to stop a migraine headache, use this at the first warning sign of the headache for best results. First signs may be an aura or pain.

  • If you have been prescribed a medicine to prevent the headaches, it's important to take the medicine as directed. Many of these medicines may take a few weeks to start preventing headaches, so it's important to not give up on them right away. If you continue to have just as many headaches after taking these medicines for a while, talk with your healthcare provider to see if the dose needs to be changed or if a different medicine is advised.

  • If you need to take medicine often for your migraine, talk with your provider about other ways to prevent your headaches.

Follow-up care

Follow up with your healthcare provider, or as advised. Talk with your provider if you have frequent headaches. They can figure out a treatment plan. Ask if you can have medicine to take at home the next time you get a bad headache. This may keep you from having to visit the emergency department in the future. You may need to see a headache specialist (neurologist) if you continue to have headaches.

When to get medical care

Call your healthcare provider right away if any of these occur:

  • Your head pain gets worse, or doesn’t get better within 24 hours

  • You can’t keep liquids down (repeated vomiting)

  • Pain in your sinuses, ears, or throat

  • Fever of 100.4º F (38º C) or higher, or as advised by your provider

  • Stiff neck

  • Extreme drowsiness, confusion, or fainting

  • Dizziness, or dizziness with spinning sensation (vertigo)

  • Weakness or trouble feeling in an arm or leg, or on one side of your face

  • Trouble talking or seeing

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