About Migraines
Causes - Identifying Migraines - Treatments - Diet

Migraine has been a well known medical problem for over 5,000 years and represents one of the most investigated types of head pain. Research on large groups of people has shown that in the U.S. 18% of women and 6% of men suffer from migraine - 18 million females and 5.6 million males over the age of 12.The prevalence of migraine, according to the Center for Disease Control, has increased 60% from 1981 to 1989. The economic impact of migraine is staggering, with annual cost of the disease estimated at 18 billion dollars.

What Causes a Migraine?
The basic cause of migraine is still unknown. Although genetics may play a role, with 50 to 70% of migraine sufferers reporting a familial occurrence, no consistent biochemical or physiological characteristic can be recognized in the relatives of those afflicted with the condition.

There are several theories as to what causes a migraine and what happens to us when they occur. One of these theories suggests that certain arteries in our brain contract and cause a reduction blood flow to the visual area of our brain. It is suggested that this reduction of blood flow results in the visual and other symptoms that accompany a migraine. This is why using agents to support cerebrovascular health, or maintaining blood flow, is so important.

This theory further suggests that the pain that often follows these symptoms was the result of dilation (expansion) of the carotid artery and pressure on the nerves in the artery wall. Yet another theory proposes that nerve cells in the brain begin to lose function which causes a reduction blood flow, which reduces levels of magnesium, which in turn adds to decreasing nerve cell function and that this dysfunction spreads in a wave like fashion to all effected areas. Many researchers feel that serotonin, an important brain chemical may fuel migraines.

Identifying Migraines
The two most important categories are migraine without aura (common migraine) and migraine with aura (classic migraine). A diagnosis of migraine without aura is made a person has a history of five previous similar episodes, with pain lasting between 4 and 72 hours. Additionally, they must meet two of the following four characteristic symptoms: (1) unilateral head pain; (2) pain must be throbbing or pulsing; (3) an experience of moderate to severe pain which inhibits or restricts the ability to function;(4) pain is made worse by routine physical activity. Furthermore, they must have one of the following two symptoms present: (1) nausea and/or vomiting; (2) adverse reactions to light or sound.

In contrast, migraine with aura employs the same diagnostic criteria as common migraine with the following exceptions. Patients only need a history of two prior migraine attacks and must fulfill three of the following four criteria: (1) one or more aura symptoms; (2) aura symptoms that develop over more than 4 minutes; (3) aura lasts less than 60 seconds; (4) headache follows within 60 minutes of the aura ending. Auras represent several forms of visual disturbances that are described as dark or black point(s) that may or may not expand and obscure the patient's vision. The black spot may be surrounded by lights with zigzag lines. Patients with classic migraine symptoms may exhibit stroke-like symptoms including symptoms affecting one hand, arm, or side of the face.

Treatment
For the migraine sufferer, there is a wide variety of therapeutic approaches both with and without drugs. However, for practical reasons the management of migraine can be divided into two categories; abortive and preventative. An abortive treatment of migraine simply address the symptoms via the use of drugs including aspirin, ibuprofen, etc. These pain relievers, along with sleep in a quiet, dark room, an ice pack on the head and an anti nausea drug can help relieve the pain.

Phtyomedicines, formulas made using naturally occurring ingredients have been shown to be quite effective in preventing migraines as well as reducing the severity of the headache. MigreLief, which contains feverfew, magnesium and riboflavin seems to be especially effective, according to a number of studies.

Certain drugs that constrict arteries are used with varying degrees of success and side effects. Another drug, sumatriptan (Imitrex), has been shown to reduce the intensity of moderate to severe migraine headaches. Propranolol is widely prescribed in the United States as a treatment for migraine prevention. Although it has proven to be effective in migraine prevention, its side effects include fatigue, depression, impotence, insomnia, dizziness, and cold extremities.

Like drug intervention, non-pharmaceutical preventive therapies may also be effective. These include behavioral modification techniques such as stress management, biofeedback, exercise, acupuncture, trigger point injections and numerous physical therapy techniques (e.g. massage, manipulation and transcutaneous nerve stimulation).

Dietary Approaches
It is generally accepted that a small proportion of migraine patients will react to tyramine, a chemical found in aged cheese, yogurt, beer, wine, liver, yeast and certain other foods. In these patients, avoidance of tyramine-containing foods will often prevent recurrences of migraine. Abnormal glucose metabolism has been identified in some patients with migraines.

Food allergy has also been implicated as an important factor in migraine. In one study, the foods most frequently causing symptoms and/or pulse changes were wheat (78%), orange (65%), egg (45%), tea and coffee (40% each), chocolate and milk (37% each), beef (35%), corn, cane sugar and yeast (33% each), mushrooms (30%), and peas (28%). When the offending foods were avoided, all patients improved.

People with recurrent migraines should be evaluated for possible blood-sugar abnormalities and food allergies. When either of these abnormalities is found, appropriate dietary modifications should be made. In addition, a trial of a low-tyramine diet should be considered.

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