FAQ on Migraines
– Answers by Dr. Katz, MD, PhD, of the Moran Eye Institute at the University of Utah Medical Center
Q: When is a headache a migraine?
A: So, differentiating migraines from other headache syndromes is really not that difficult to do. Almost all migraine headaches will be associated with some light sensitivity and/or sound sensitivity. So the way that I ask people about that is I say, “When you have a headache, do you avoid going outside? If you were to have a headache and somebody was watching television, would you tell them to turn it down? When you have a headache, do you try to go to a dark and quiet room in order to feel better?” So those are some of the things that differentiate migraines from other headache syndromes.
The headache of a migraine often has a throbbing quality to it. It sort of goes along with your heartbeat. Migraine headaches are often, but not always, just on one side of the head, whereas other kinds of headaches tend to involve the entire head and then any kind of nausea and certainly vomiting associated with headache would differentiate migraines from other sorts of headache syndromes.
People with migraines often have a history of being car sick as a child or have a history of episodic belly pain when they were kids and then there’s also sometimes a family history of migraine.
Q: Are migraines real?
A: Migraines are very real. About 9% of men and about 18% of women have migraine headaches. It’s the most common neurologic disease there is. It is a very real thing and there are very specific criteria that help differentiate a migraine headaches from other sorts of headache syndromes.
Q: What does it feel like to have a migraine?
A: People that don’t have migraines might ask, “What does it feel like to have a migraine?” I think everybody’s had a headache at some point in their life, but a migraine is really different because of the additional associated symptoms.
I’ve seen countless migraine patients in my clinic. A migraine attack is already a very bad headache and the associated neurologic symptoms that accompany an attack really make it so much worse than just a tension type headache.
Many people with migraine have light sensitivity, sound sensitivity, nausea, vomiting, they feel ill, they feel physically sick, it can make them irritable, and it makes it hard to focus and hard to think. So it’s these other associated neurologic symptoms that go along with the headache that make it such an awful disease with which to contend.
Q: What is causing my migraine?
A: There are a number of factors that contribute to people having migraines. There’s almost always a strong family history, but a lot of times migraine is misdiagnosed or undiagnosed or patients are simply unaware of their family history, but there’s definitely a strong genetic component to it. Gender plays a big factor. The number of women with migraines outnumber the number of men by about three to one. Why that is, we’re not entirely sure. There’s probably some hormonal component. And then two, there are certain things that set certain people off, like light, skipping meals, not getting enough sleep, stress, certain smells, certain foods. There are different things that trigger migraines, but aside from a genetic predisposition, I can’t really say why one person has a migraine and other people don’t.
Q: What are the exact mechanisms of migraines?
A: The mechanism that causes migraine is really not completely understood. It definitely has something to do with irritating the trigeminal nerve. The trigeminal nerve is the nerve that supplies sensation to the face, the eyes, the eye sockets, the covering around your brain, the blood vessels in your brain. Something about migraine irritates that nerve and causes the pain and discomfort associated with migraine, but how that all happens, what cascade has to happen, what chemical events take place, that’s still under investigation.
Q: Should someone exercise with migraine?
A: Exercise effects people with migraines differently. Some people find that exercise can actually alleviate a migraine, but I’d say most people find that exercising makes their migraine worse. I don’t know that there are a lot of people for whom exercise will precipitate a migraine, but that certainly can happen as well. So all I can say is that it’s up to the individual person to try to figure out what things make them feel better and what things don’t.
A: Medical therapy for migraine can be very effective for some people. Some people can’t tolerate the side effects. For some people it’s very expensive, and for other people they just don’t like the idea of taking medications and that’s one of the reasons we founded Axon Optics — to have a non-pharmaceutical approach to treating migraine with therapeutic glasses for migraines
But in many ways, the two therapies can be complementary.
Q: What causes headaches? What is the biology behind them?
A: The biology and causes of headache and migraine are not well understood. There is a strong genetic component to migraine, so we know that some of the predisposition to migraine is inherited.
We also know that many more women have migraine than men, so there appears to be a hormonal component too. We do know that the trigeminal nerve, the nerve that supplies sensation to the head, face and eyes is a critical part of the chain of events that results in a migraine.
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