Stopping the pain of a migraine

Intense pulsing, throbbing pain, nausea, vomiting, sensitivity to light and sound - all are symptoms of migraine headaches, which affect more than 10 percent of people throughout the world and have no cure. Much more than a basic headache, migraines are a debilitating disorder that can drastically affect the quality of life of sufferers.

Dr. Vikram Udani, a neurosurgeon affiliated with Sharp Grossmont Hospital, recently answered a few questions about migraines, their causes, treatment and current research to find a drug that could better prevent or interrupt migraine attacks.

What causes migraines?
The exact cause of migraines remains unknown. The belief used to be that migraines were related to excessive dilation of the cerebral arteries, which decreased the blood supply to the brain. More recently, certain proteins have been found in high levels in conjunction with migraines.

Triggers for migraines vary from person to person, and include stress, fatigue, dehydration or hypoglycemia. Hormonal changes, bright or flashing lights, lack of food and dietary substances like alcohol or caffeine might also contribute to migraines.

What is the difference between a basic headache and a migraine?
Migraines are generally unilateral, throbbing and triggered by the risk factors already mentioned. Some migraines are preceded by an "aura," which is a visual disturbance that appears as flashing lights, lines or blurred vision.

Generally, treatment should be sought immediately if someone is experiencing a sudden onset "thunderclap" headache that is the worst headache of their life. This could be due to an intracranial hemorrhage that requires urgent neurosurgical evaluation and treatment.

Are there known cures or effective treatments for migraines?
We don't have a cure as of today. Certain medications can help control symptoms of migraines. The National Institute of Neurological Disorder and Stroke reports that drugs developed to treat epilepsy, depression and high blood pressure have been shown to be effective in also preventing migraines, as has botulinum toxin A, commonly known as Botox.

The best treatment is prevention. Avoid the personal stressors that can induce your migraines. Stress management strategies, such as exercise and relaxation methods, along with lifestyle changes including diet improvement, eating regularly scheduled meals with proper hydration, and establishing a consistent sleep schedule can also help. Hormone therapy may be effective in women whose migraines seem to be related to their menstrual cycle.

What does the future hold in terms of migraine treatment?
Recently, a molecule called calcitonin gene-related peptide, or CGRP, has been found to spike during migraine attacks. Drugs are currently being developed to block the activity of this molecule. This has the potential to be revolutionary for migraine treatment, as it addresses the source of the problem rather than just managing the subsequent symptoms.

Talk to your doctor if you are experiencing severe headaches or migraines. It may be helpful to keep track of your headaches, the symptoms experienced, duration and possible triggers of the attack to help determine a diagnosis and appropriate treatment.