Migraine Pt Migraine Headaches Typically Cause an

Migraine Pt Migraine headaches typically cause an intense, throbbing, headache in a specific area of the head (most often one side of the head) and are commonly accompanied by nausea and sensitivity to either light or sound. For many people these headaches are so debilitating that it can take hours or days before the person can return to their normal level of functioning. The etiology of migraine headaches is not well understood; however, genetic factors are thought to play a significant role (Burton, Landy, Downs, & Runken, 2009).

Is it estimated that in the United States more than 30 million people have at least one migraine headache per year. Migraine headaches occur more commonly in females, who are diagnosed with approximately 75% of all migraine headaches (Bigal & Lipton, 2009). Generally a treatment program for migraine headache begins with a diagnosis, an assessment of the effects of the headaches on the particular person, educating the person regarding their headaches, managing the person's headaches by taking both abortive treatment and prophylactic treatment measures (Bigal & Lipton, 2009; Burton et al., 2009).

In the case of a 24-year-old female recently diagnosed with migraine headaches one of the first things that the treating clinician would want to do would be to have the patient keep a daily journal regarding their headaches (Martin, 2010). The following information should be kept in the journal and recorded daily: 1. The date. 2. The time the headache began and the time the headache stopped (if there was no headache on a particular day simply enter: "No headache"). 3. The presence of any warning signs such as an aura any other sign. 4.

The presence of any other symptoms such as nausea, light sensitivity, etc. 5. The type of pain experienced (e.g., pressing, piercing, throbbing, etc.). 6. The intensity of the pain on a scale of 1 to 10. 7. Any medication or treatment taken to relieve the headache. 8. The effectiveness of any treatment taken to relieve the headache. 9. The number of hours and quality of sleep the night before the headache occurred. 10. Activities occurring before the headache including any food or beverages consumed. 11. Any events, including stressful events, occurring before the headache. 12.

How the headache affected the person's normal routine. The best way to do this is develop a template and as a sort of graph or spreadsheet and then either copy the pages and put them in a notebook and write in the information daily, or enter it in a computer in a spreadsheet. The main purposes of keeping a headache journal are to identify the effectiveness of the treatment prescribed for the headache and to determine any particular triggers or other events that are associated with the headaches.

This can allow the clinician to adjust treatment accordingly and also to help the patient engage in potential preventive measures to avoid having headaches in the future. In addition, headache journals also add to the overall knowledge on how migraine headaches present in the population and how treatment affects them (Martin, 2010). Is not uncommon for individuals who suffer from migraine headaches to have certain "triggers" that appear to be associated with headache onset (Martin, 2010). These triggers can include: 1.

Hormonal changes, especially in women as many women often report migraine headaches immediately before or during their menstrual cycle, during pregnancy, or during menopause. 2. Taking certain medications including oral contraceptives or hormone replacement medications. 3. Eating certain foods or having certain drinks or after skipping meals. 4. Certain stressors (although this is somewhat controversial). 5. Changes in routine such as sleeping habits or other changes. 6. Being exposed to certain sensory stimuli such as loud sounds or bright lights. 7.

Environmental factors such as physical exertion or a change of weather (barometric pressure changes often appeared from migraine headaches; Martin, 2010). While auras occur prior to having a migraine headache in many patients (Martin, 2010) they are not considered triggers but are considered symptoms of the migraine headache. In the current case it is important to identify any specific triggers that appear to be associated with the onset of a migraine headache so the person can learn to develop preventive strategies in order to better control their migraines.

Most people with migraine headaches take some form of medication as an abortive treatment for their headaches, and in the current case this would be advisable. These medications aim to stop the progression of the headache that has already begun as opposed to identifying triggers or using medications to prevent the onset of headaches (Sheikh & Matthew, 2012). Abortive medications include analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), selective serotonin receptor (5-HT1) agonists (triptans), ergot alkaloids, and antiemetics.

Triptans are believed to work via vasoconstriction of the cerebral blood vessels which results in a decrease in neuropeptide release and the neurons in the trigeminal complex. The most widely studied triptan is sumatriptan (Imitrex; Sheikh & Matthew, 2012). Sumatriptan relieves migraines via enhancing the action of serotonin receptors in the brain leading to vasoconstriction. It is also believed to reduce pain signal transmission in the brain. Sumatriptan comes as a tablet, nasal spray, or as an injectable.

Typically there are few side effects, but these can include dizziness, flushing, pain or tightness in the chest or throat, abdominal discomfort, sweating, and in rare cases elevated blood pressure. Combining it with selective serotonin reuptake inhibitors (SSRI's) will increase serotonin levels and other medications should be monitored (Sheikh & Matthew, 2012). There are other triptans available that vary in their chemical composition, time of onset, and tolerability.

There are also some agents that are prophylactic in nature and these include the following: antiepileptic drugs, beta blockers, tricyclic antidepressants, calcium channel blockers, SSRIs, NSAIDs, other serotonin antagonists, and botulinum toxin (Sheikh & Matthew, 2012). Preventive medications for migraine appeared to be under used and that about one third of people who suffer from migraine headache could benefit from the use of prophylactic medications (Sheikh & Matthew, 2012). These medications can help to decrease the intensity and the frequency of a person's migraine headaches.

People who have migraine headache frequency greater than 15 days a month (chronic migraine headache; Olesen, J., Bousser, M.G., Diener, H.C., Dodick, D., First, M, et al., 2006) typically do get started on some form of preventive/prophylactic medication. There some basic guidelines that involve selecting a prophylactic medication use for patient with migraine headache (Sheikh & Matthew, 2012). The first one is to be fully informed of the patient's comorbid medical conditions.

The reason for this is medications are often used to treat more than one condition and the person may already be on a medication that is considered a prophylactic treatment for migraine. In addition, understanding a person's comorbid conditions and current medication regime also helps to determine whether a specific prophylactic medication is not indicated for the patient. The beta blocker propranolol (Inderal) has received good empirical support as a potential prophylactic medication for migraine headache (Sheikh & Matthew,.