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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Article Home Adult and Senior Health Prevention of Migraine attacks

Prevention of Migraine attacks

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Migraine is a neurological syndrome characterized by altered bodily perceptions, headaches, and nausea more common to women than men. Migraine is a very painful type of headache with throbbing or pulsating pain in one area of brain caused by a combination of enlargement of blood vessels and the release of chemicals from nerve fibers that surround the blood vessels and is often accompanied by nausea, vomiting, and extreme sensitivity to light and sound.

 

Preventive Treatment:

This is the most important in the treatment of migraine, there are many strategies from taking certain drugs or nutritional supplements, to lifestyle alterations such as increased exercise and avoidance of migraine triggers

Goals:

  • To reduce the frequency, painfulness, and/or duration of migraines, and to increase the effectiveness of abortive therapy
  • To avoid medication overuse headache or rebound headache

Avoidance of Triggers:

  • Patients should attempt to identify and avoid factors that promote or precipitate migraine episodes
  • Moderation in alcohol and caffeine intake
  • Consistency in sleep habits, and regular meals may be helpful
  • General dietary restriction and eliminating particular foods that are known to trigger migraines in an individual can be very effective
  • Reduce the effects of estrogen: If you're a woman with migraines and estrogen seems to trigger or make your headaches worse, you may want to avoid or reduce the amount of medications you take that contain estrogen. These medications include birth control pills and hormone replacement therapy.

Gluten -Free Diet:

  • Celiac disease in which processing of gluten occurs in an inappropriate manner and is associated with migraine also called gluten intolerance
  • Gluten-free diet has been demonstrated to reduce, if not completely eliminate, migraines in these individuals.
  • Gluten-free diet stops getting headaches completely.
  • Gluten-free diet also improved blood-flow to the brain and either eliminated migraines or reduced migraine frequency, duration, and intensity

Drugs:

Cardiovascular drugs:

  • Beta blockers: Commonly used to treat high blood pressure and coronary artery disease — can reduce the frequency and severity of migraines.
  • Calcium channel blockers: Verapamil also may be helpful in preventing migraines and relieving symptoms from aura.
  • Antihypertensive medications: Lisinopril and candesartan are useful in reducing the length and severity of migraines.

Side effects: Dizziness, drowsiness or lightheadedness

Central Nervous System drugs:

  • Tricyclic antidepressants: Amitriptyline, nortriptyline and protriptyline
  • Selective serotonin reuptake inhibitors (SSRIs) and serotonin and nor epinephrine reuptake inhibitors (SNRIs): Venlafaxine may be helpful in preventing migraines.
  • Anti-seizure drugs: Divalproex and Topiramate, and Gabapentin

                 Side effects: Nausea and vomiting, diarrhea, cramps, hair loss, and dizziness.

  • Cyproheptadine: This antihistamine specifically affects serotonin activity. Doctors sometimes give it to children as a preventive measure.
  • Botulinum toxin type A: Botulinum toxin type A is sometimes used for treatment of chronic migraines.

Herbal and Nutritional supplements:

  • Butterbur 50 mg or 75 mg/day of butterbur rhizome extract
  • Cannabis helps people through an attack by relieving the nausea and dulling the head pain
  • Coenzyme Q10
  • Feverfew
  • The plant feverfew
  • Magnesium citrate
  • Riboflavin
  • Vitamin B12
  • Melatonin

Surgical Treatments:

Surgery may be used to treat migraines by

  • Severing the corrugator supercilii muscle and zygomaticotemporal nerve and this treatment may reduce or eliminate headaches in some individuals.
  • Closure of Patent foramen ovale (PFO), a hole between the upper chambers of the heart if closed clears the migraine attacks as there is no mixing of blood which was a cause for migraine
  • Botulinum toxin has been used to treat individuals with frequent or chronic migraines
  • Spinal cord stimulators are an implanted medical device sometimes used for those who suffer severe migraines several days each month.

Noninvasive medical Treatments:

  • Tran cranial Magnetic Stimulation (TMS): a medically non-invasive technology for treating depression, obsessive compulsive disorder and tinnitus, and also helped to prevent and even reduce the severity of migraines among its patients
  • Hyperbaric oxygen therapy has been used successfully in treating migraines
  • Nociceptive trigeminal inhibitor (NTI) is used in Bruxism, clenching or grinding of teeth, especially which occurs at night, is a trigger for many migraineurs
  • Vision correction particularly with prism eyeglasses provides with complete relief from migraine symptoms

Behavioral treatments:

  • Exercise for 15–20 minutes per day is helpful for reducing the frequency of migraines
  • Specific exercises have been developed that are believed to effectively reduce the severity and frequency of migraines
  • Sleep is often a good solution if a migraine is not as severe as to prevent it, as when a person awakes the symptoms will have most likely subsided
  • Diet, visualization, and self-hypnosis are also alternative treatments and prevention approaches
  • Sexual activity has been reported by a proportion of male and female migraine sufferers to relieve migraine pain significantly in some cases
  • Letting a headache "run its course" by not using painkillers can sometimes decrease the length of an episode. This is especially true of cases where vomiting is common, as often the headache will subside immediately after vomiting.

Alternative medicine:

A number of forms of alternative medicine, particularly bodywork, are used in preventing migraines they include

  • Chiropractic care, Massage therapy, physical therapy, and Bowen Technique are often very effective forms of treatment to reduce the frequency and intensity of migraines
  • Sometimes acupuncture is used to relieve the pain of an active migraine headache
  • The smell and incense of peppermint and lavender have been proven to help with migraines and headaches more so than most other scents.