How to prevent migraine

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While it is not always possible to prevent migraine episodes, there are ways to reduce their frequency and severity.

Medication to prevent episodes

The following prescription drugs may help reduce the number of episodes that a person with severe migraine experiences:

  • topiramate an antiseizure drug
  • proponalol, for treating high blood pressure
  • antidepressant medications
  • botox
  • gepants

It may take several weeks to see an improvement.

The best treatment in children or adolescents may be different from that in adults. A doctor can advise on the best option.

Identifying and avoiding triggers

A migraine episode is often a response to a trigger. To figure out the culprit, a person might try keeping a diary and recording what they did, ate, and drank before an episode.

It may be particularly helpful to avoid:

  • low blood sugar
  • physical overexertion
  • stress
  • certain foods, such as chocolate and any that contain tyramine
  • certain medications, including HRT and some birth control pills
  • bright lights and flickering screens

The following strategies can also help reduce the frequency of migraines:

  • getting enough sleep
  • reducing stress
  • drinking plenty of water
  • improving posture
  • avoiding dietary triggers, such as caffeine, alcohol, and cheese
  • getting regular physical exercise

If making these changes does not ease the severity and frequency of migraine episodes, a doctor may suggest medication or other options.

There are various types of migraine. A major distinguishing factor is whether they involve aura, or sensory changes.

Migraine with aura

Aura is a disturbance of the senses in the early stages of an episode. It can act as a warning that a migraine headache is approaching.

Aura can involve:

  • having confusing thoughts or experiences
  • seeing strange, sparkling, or flashing lights that are not there
  • seeing zig-zagging lines of light
  • having blind spots or blank patches in the vision
  • feeling pins and needles in an arm or leg
  • having difficulty speaking
  • having weakness in the shoulders, neck, or limbs
  • seeing things that are not there out of one eye, such as transparent strings of objects
  • not being able to see part of something clearly
  • having part of the field of vision disappear, then reappear

Aura may feel similar to the sensation that follows exposure to a very bright camera flash, but the visual changes can last for several minutes or up to an hour.

 

Migraine without aura

More commonly, a person experiences no sensory disturbances before an episode.

According to the Migraine Trust, 70 to 90 %%of episodes occur without aura.

Other types

Other types of migraine include:

  • Chronic migraine: This involves having an episode on more than 15 days per month.
  • Menstrual migraine: This occurs in a pattern that follows the menstrual cycle.
  • hemiplegic migraine: This type causes temporary weakness on one side of the body.
  • Abdominal migraine: This involves migraine episodes linking with irregular function in the gut and abdomen, often with nausea or vomiting. It mainly affects children under 14 years of age.
  • Vestibular migraine: Severe vertigo is a symptom of this form of migraine.
  • basilar migraine This rare type is also known as migraine with brainstem aura, and it can affect neurological functions, such as speech.

Anyone who may be experiencing migraine should consult a doctor.

Diagnosis

The internationnal headache society  recommend the “5, 4, 3, 2, 1” criteria to diagnose migraine without aura. This number series stands for:

  • having five or more attacks, each with a duration of 4 hours to 3 days
  • the headache having at least two of the following qualities:
    – occurring on one side
    – pulsating
    – causing moderate-to-severe pain aggravated by activity
  • having at least one additional symptom, such as:
    – nausea
    – vomiting
    – sensitivity to light
    – sensitivity to sound

The doctor may recommend imaging or other tests to exclude other causes of symptoms, such as a tumor.

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