Common migraine

Alternative names:

headache - migraine (common); migraine headache, common

Treatment:

There is no cure for common migraine. The goals of treatment include controlling symptoms and preventing further attacks.

Rest in a quiet, darkened room often will reduce the severity of symptoms.

Several medications may be advised for relief of symptoms, because the response of migraine to medications is highly variable. If a medication has been effective in relieving a previous migraine, it may be tried before others. Over-the-counter analgesics may reduce pain if they are taken early in the development of the headache. If mild analgesics are ineffective, vasoconstricting or other medications may be beneficial. Ergotamine tartrate preparations constrict the arteries of the head and may be used alone or in combination with other drugs such as caffeine (Cafergot), phenobarbital, or belladonna. Ergonovine maleate may provide relief of symptoms. Propoxyphene or other medications that relieve pain or inflammation may provide relief for some people. Nausea should be treated early with Reglan, Compazine, or other antiemetics.

Any factors that have triggered a migraine in the past should be avoided.

Preventive (prophylactic) medications include propranolol, amitriptyline, ergonovine, cyproheptadine, clonidine, methysergide, calcium channel antagonists, and others. Several medications may need to be tried before a medication that is effective in preventing migraine is found. Imitrex is a newly released medication that has been found very effective in the treatment of migraine. It is self-administered as an injection under the skin (cost: about $35.00 per dose).

Support groups:

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See migraine - support group.

Expectations (prognosis):

Common migraine does not indicate a life-threatening disorder. It usually is painful and annoying at the time. It may be chronic and recurrent, which can interfere with a persons lifestyle.

Rarely, permanent neurologic symptoms occur, probably because of prolonged constriction of the blood vessels. The side effects of medications may be severe.

Complications:

• frequent, recurrent attacks may interfere with lifestyle
• permanent neurologic impairments (rare)
• side effects of medications

Calling your health care provider:

Call for an appointment with your health care provider if symptoms of migraine are severe, persistent, recurrent, or accompanied by other symptoms.

Call your health care provider if previously effective treatments no longer are helpful, or if symptoms indicating side effects of medications occur, including irregular heartbeat, changes in skin color (pale or blue), extreme sleepiness or sedation, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain or cramps, dry mouth, extreme thirst, or others (see specific medication).

Call for an appointment with your health care provider if taking an ergotamine-containing medication, and you are likely to become pregnant (these medications should not be taken when pregnant).

Call for an appointment with your health care provider if any other new symptoms develop, or there is a change in the severity or pattern of symptoms.