Migraine: Symptoms, prevention and treatment of migraine

Common migraine headaches in today’s society have negative consequences for people’s occupational and social functioning. In this article, we take a comprehensive look at this disease. (Pneumonia; Symptoms Of Pneumonia, Causes And Treatment Methods Of Pneumonia)

Migraine is a severe headache that is often accompanied by nausea, vomiting, and photosensitivity. Migraines can last from 4 hours to three days and sometimes even longer. Migraines are more common in women than in men. Migraine symptoms usually start between the ages of 10 and 40.

Doctors do not know the exact cause of migraine headaches, although they appear to be related to changes in the brain and genes. Scientists have believed for years that migraines are caused by changes in blood flow to the brain. Many now believe that this condition results from brain defects inherited from parents to children. A migraine begins when overactive nerve cells stimulate the trigeminal nerve by sending signals; The nerve responsible for creating a sensation in the head and face. Activation of this nerve triggers the release of certain chemicals such as serotonin and the calcitonin gene-dependent peptide (CGRP). CGRP causes the blood vessels in the brain’s lining to swell, releasing neurotransmitters in the brain that eventually cause inflammation and pain. Some studies show that 85% of people with migraine headaches have a history of head or neck injuries. In most cases, these injuries were caused by accidents or childhood injuries.

Symptoms of migraine, depending on the stage, can be accompanied by symptoms that change over time and usually have several stages:

  • The premonitory or warning phase
  •  aura stage
  • The headache or main attack stage
  • Recovery or postdrome stage

Premonitory stage: At this stage, early warning signs appear. Hours before a migraine starts and sometimes even days before, many people may experience the following symptoms:

  • Abnormally high energy, excitement, or depression
  • Irritability
  • Thirst
  • Intense craving for certain foods
  • Excessive drowsiness and yawning
  • Frequent need to urinate
aura stage:

This stage is the beginning of strange feelings. One in three or four people with a migraine develops it before the headache begins. It can include the following:

* Vision changes:

  • Seeing flashes of light or a jagged arc of light: This condition usually occurs on the left or right side of the vision and may become larger within minutes.
  • Blindspot in the field of view: This problem, combined with blinking lights, can make it difficult for the eye to drive or focus on small objects.
  • See images that are related to the past or illusions.

* Skin sensations:

During it, the person may experience a murmur and tingling sensation. Anesthesia may also occur. These feelings often affect the face and hands but may even spread throughout the body.

* Language problems:

  • Difficulty expressing thoughts while speaking or writing
  • Difficulty in understanding words
  • Confusion
  • Difficulty concentrating
  • Attack stage: the onset of headache
main attack stage:

Migraine pain:

  • It usually starts at the top of the eyes
  • It usually affects one side of the head but may cover the entire head or go from one side to another. This condition can also affect the lower part of the face and neck
  • Pulsating pain that is exacerbated during physical activity or forward flexion

Symptoms may increase as you move. Other symptoms may also occur at this stage:

  • Abnormal sensitivity to light, sound, and smell
  • Feeling light-headed
  • Nausea and vomiting
Post-effect stage: After the headache:

After a severe migraine, a person may not feel well for a day. Symptoms of this stage may include the following:

  • Severe fatigue
  • Slowness
  • Confusion
  • Headache that gets worse when you lean forward or move fast

Migraines may change over time, depending on the number or frequency of migraines. The same steps may not be seen in all attacks. Also, a person may get it without having a headache. Because many of the symptoms of these migraine stages can also occur in more severe conditions such as stroke or seizures, you should see your doctor if you notice any new symptoms or things that your doctor has not checked.

Types of migraine headaches:

Migraines are not all the same. One person’s migraine can be very different from another person’s migraine.

Migraine headache with aura stage:

In this type of migraine, the person knows that the headache is starting because before that, he has a strange feeling: he feels dizzy, he feels a ringing sound in his corners, he sees zigzag lines, and the light bothers him. Although migraines can be excruciating and inactive, they are not fatal. Things can be done to reduce them, and there are medications and devices for treatment and prevention.

Symptoms: About one-third of people experience warning signs such as the following hours or days before a migraine starts:

  • Specific food trends
  • Happiness or moodiness
  • Fatigue and yawning
  • Feeling of stiffness, especially in the neck.
  • Need to urinate frequently
  • Constipation or diarrhea

It often starts about an hour before the headache and includes the following:

  • Blind spots in the center of vision (scotoma)
  • Loss of vision in one or both eyes
  • See zigzag-like patterns
  • See sparks of light
  • Seeing, hearing, or smelling things that are not there (illusion)
  • Shooting, murmuring, or numbness (drowsiness)
  • Difficulty finding words or speaking (aphasia)

It usually takes less than an hour. Some symptoms may continue until the headache stage.

Pain stage: Migraine pain is persistent or throbbing and may be felt in the forehead or on one side of the head around the eye. Adults are more likely to have this problem on one side of the head. The headache may last from 1 hour to 3 days. In addition to pain, other symptoms of the headache stage include:

  • Stomach upset or vomiting
  • Feeling hot and cold
  • runny nose
  • Dizziness or dizziness
  • Neck or jaw discomfort
  • Sensitivity to light, sound, smell, touch, or movement
  • Confusion


The doctor performs a physical examination and examines the muscles, reflexes, speech, and senses to test the head’s nerves. He will also ask about the patient’s health history.

  • Do other family members have migraines with other types of headaches?
  • Types of drugs used, especially contraceptives or blood pressure control
  • Do headaches get worse after working hard, coughing, or sneezing?

Blood tests and imaging, such as X-rays, CT scans, or MRIs, can help rule out other causes, such as infection or bleeding.


When a person has a migraine with him, he should stay quiet in the dark. Cold compresses or pressure on painful areas can be helpful. Over-the-counter painkillers such as aspirin, acetaminophen, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be helpful. Prescription drugs, called triptans, include Almotriptan, Altriptan, Ferrovatriptan, Rizatriptan, and Sumatriptan. Ergots may also be useful in treating migraine pain. Other medications can relieve related symptoms such as nausea and vomiting.

Several devices are also designed to help treat migraines. A device called a SpringTMS, or eNeura Stems, uses a technique called transcranial magnetic stimulation (TMS). The device is placed in the back of the head for one minute and sends a wave of magnetic energy to the brain. The pottery device, designed in the form of a headband, is turned daily for 20 minutes to prevent migraines and sends electrical waves through the forehead’s skin to the brain. Gamacor is also a device that non-invasively stimulates the vagus nerve in the neck. A doctor’s prescription is required to use any of these devices.


If you do not respond to other treatments and have a migraine for four days or more a month, your doctor may prescribe preventative medication. One should take medication regularly to reduce the severity or frequency of headaches. These include anticonvulsants, antihypertensive drugs (such as beta-blockers and calcium channel blockers), and some antidepressants. CGRP inhibitors are also a new group of prophylactic drugs prescribed if other drugs are not sufficient. Avoid typical initiators such as:

  • Some foods
  • medicines
  • Stress
  • Fatigue, illness, or starvation
  • Changes in hormone levels
  • Flashing light
  • Changes in air pressure and altitude

A daily headache diary can help the person, and their doctor understands what is causing the headache. The date and time of the onset of the migraine, any food eaten, what is being done, and any medications are taken should be noted before the onset of the headache. It takes several weeks to take notes to discover the pattern of migraines.

Migraine headache without aura:

Migraine without aura is more than a headache. Only the pain can stop you from doing your daily chores, and there may also be symptoms such as nausea and vomiting. Migraine without it is the most common type of migraine headache, accounting for about 75% of all migraines. This type of migraine has no early symptoms (aura).

Migraines are more common in some families, so researchers believe the condition has a genetic basis. Factors that trigger migraine attacks include certain foods, odors, stress, and things in the environment. Migraines often begin in childhood and worsen during adolescence. Boys are more likely to have migraines than girls, but it is more common in adult women than men.


Often, people experience pain in the forehead or on one or both sides of their temples. The pain may be continuous or throbbing. The headache will last 4 to 72 hours. A person may also have some of the following symptoms:

  • Nausea
  • Vomit
  • Yawn
  • Irritability
  • low blood pressure
  • Happiness
  • Sensitivity to light, sound, smell, or movement
  • Creating dark circles around the eyes


First, you need to make sure that the cause of these headaches is nothing else. For this purpose, the treating physician will perform special physical and neurological examinations and will ask questions such as the following:

  • Do other family members have migraines or other types of headaches?
  • Does the patient have allergies?
  • What is the level of stress in his life?
  • Does she use medications such as birth control pills and vasodilators? (These drugs can cause headaches)
  • Does the headache start after coughing or sneezing or after strenuous exercise?

Your doctor may order the following tests:

  • Blood tests
  • Imaging tests such as X-rays, CT scans, or MRIs
  • Tests to diagnose infection, bleeding, or other medical problems that can cause similar symptoms

Treating migraines without aura has two purposes: relieving symptoms and preventing future attacks.

To help relieve migraine symptoms:

1.Stay in a quiet, dark room

2. Apply cold compresses or apply pressure to painful areas

3.They were taking painkillers such as aspirin, acetaminophen, ibuprofen, ketorolac, naproxen, or taking medications such as almotriptan, eletriptan, Ferro-triptans, naratriptan, rizatriptan, and sumatriptan that help narrow blood vessels. Ergots may also be useful in treating migraine pain.

4.Use medications to treat other migraine symptoms such as nausea and vomiting

Migraine prevention:

  1. If other treatments do not work, and the person has a migraine for four days or more a month, your doctor may suggest preventative medications. The patient should take these medications regularly. This group of medications includes anticonvulsants, antihypertensive drugs, and some antidepressants. CGRP inhibitors may be prescribed if other drugs are not sufficient.

2. Use of devices such as Pottery, SpringCM, and Gamacor may also be recommended.

3.A headache diary helps identify the pattern of headaches and triggers.

4.Avoid food starters. The patient can use the information in the notes and the trial and error method to find out which of the following foods can cause migraines:

  • Chocolate
  • Cheese
  • Red wine and other alcohols
  • Citrus
  • Avocado
  • the banana
  • Raisins
  • Plums
  • Artificial sweeteners
  • Food preservatives such as nitrates, nitrites, and monosodium glutamate (MSG)
  • Ice cream or other cold foods

5.Avoid migraine triggers. Many over-the-counter and over-the-counter medications can cause migraines:

  • Cimetidine
  • Estrogen
  • Hydralazine
  • Nifedipine
  • Nitroglycerin
  • Ranitidine
  • Reserpine

Relieving Psychological or Emotional Triggers: Stress, depression, anxiety, and intense emotions such as sadness can trigger migraines. Although these can not always be avoided, they can be managed. Relaxation exercises, biofeedback, and self-hypnosis techniques can help relieve these stress sources and prevent migraines, especially in children. Illness, skipping meals, and extreme tiredness can trigger migraines. Excessive exercise, movement, and head injuries can also cause this condition. Even menstruation can trigger migraines. Some people are also sensitive to flashing lights, fluorescent lights, changes in pressure, and altitude.

Migraine with aura Compared to ‌ Migraine without aura:

In both cases, the patient develops the usual migraine symptoms that may last from a few hours to a few days. These may include the following:

  • Sensitivity to light, smell, sound, and touch
  • Blurred vision
  • Pain that usually starts on one side of the head and gets worse with movement
  • Stomach upset and vomiting
  • Stiffness in the shoulders and neck

When a person develops it, the condition usually appears slowly for 5 to 20 minutes and may last for up to an hour. These symptoms often act as a warning sign and appear before the onset of pain, but migraines can also occur.

Visual aura is one of the most common types of aura. You may see strange shapes or effects that enlarge or move, such as:

  • Blind spots
  • Colored dots
  • Flashes of light
  • Flashes and stars
  • Tunnel vision
  • Zigzag lines

It can affect other senses and even the ability to move. The patient may experience the following:

  • Confusion and difficulty understanding others
  • Movements that are out of control, such as sudden jolts
  • Muscle weakness
  • Hear music or sounds that do not exist
  • The tingling sensation that starts from the fingers goes to the arm and spreads all over the face.
  • Speech problems

Of course, these symptoms may also be signs of a stroke. If a person has any of these symptoms, and the doctor has not previously said that they are part of a migraine, they should seek medical help.

Do you need different tests to diagnose these two types of migraines?

For each migraine type, your doctor will perform tests to look for other problems causing the symptoms. Depending on the patient’s symptoms, a blood test or imaging, such as a CT scan or MRI, may be needed. Some of the symptoms are like a more severe migraine problem, such as a stroke or seizure. Experiments should be performed to rule out these cases. Once it is sure that there is no other problem, there is no need to see a doctor every time the patient experiences the same, but they should be checked if the symptoms change.

It should be noted that migraine with it slightly increases the risk of stroke. This is essential for women taking birth control pills, hormone replacement therapy, or people who smoke. These can even increase the risk of stroke and migraines.

Ocular migraine:

If a person has an ocular migraine, he may lose sight for a short time. A person may develop this condition with or after a migraine headache. This is a rare problem. Some research has shown that in many cases, these symptoms are caused by other problems. Regular migraine attacks may cause vision problems, including blurred vision and blind spots. But these symptoms usually occur in both eyes. An ocular migraine is not the equivalent of retinal migraine, and the second case, which occurs in one eye, is a more dangerous condition that requires more medical attention. Warning signs in this case are:

  • It is not possible to say with certainty that the symptoms occur in one or both eyes. This condition can be noticed by covering the eyes alternately.
  • A headache that lasts for 4 to 72 hours and affects one side of the head
  • Pain intensity is moderate to severe.
  • Pulsating pain
  • Feeling worse when moving
  • nausea
  • Vomit
  • Sensitivity to light and sound


Experts are not sure what causes ocular migraines. Some believe that these problems are related to the following:

1.Retinal blood vessel spasm

2. Changes that spread to all the nerve cells in the retina

This is rare, but people with this type of migraine may be at risk for permanent vision loss. Experts do not know if migraine-preventing medications, such as tricyclic antidepressants or anticonvulsants, can help prevent this vision loss. Still, if a person has an ocular migraine, it resolves its own better for the symptoms. Consult a doctor.

How to diagnose ocular migraine:

The doctor will ask about the symptoms and examine the patient’s eyes. He tries to look at the possibility of other problems that could cause similar symptoms:

  • This condition can occur due to the blockage of an artery leading to the eye.
  • Spasm of the arteries that carry blood to the retina.
  • Other vascular problems associated with autoimmune diseases
  • Drug abuse
  • Problems that prevent normal blood clottings, such as sickle cell disease and polycythemia

Treatment of ocular migraine

The symptoms of ocular migraine usually go away on their own within 30 minutes, so most people do not need to be treated for it. The patient should stop and rest his eyes until his vision returns to normal. Loss of vision in one eye can be caused by problems not related to migraines and referred to a doctor for a diagnosis. Little research has been done on the best way to treat or prevent ocular migraines. Your doctor may prescribe one or more of the following medications:

  • Drugs that treat epilepsy such as sodium (Depakote, Depakine) or Topamax
  • Tricyclic antidepressants such as amitriptyline or nortriptyline
  • Blood pressure monitors (beta-blockers)

silent migraines:

Silent migraine means that it may have any of the usual migraine symptoms except one, pain. Your doctor may prescribe medications or devices that can treat the problem. Avoiding migraine triggers is also helpful.


A person may have symptoms that may occur at any stage of a migraine but do not experience the classic migraine pain. During the introductory phase, the following symptoms may occur:

  • Being moody or energetic
  • Food cravings
  • More fatigue and yawning
  • Feeling of stiffness, especially in the neck area
  • Frequent urination
  • Constipation or diarrhea

After that, his stage begins, which usually lasts about an hour. This type of migraine is known for its unusual visual symptoms:

  • See uneven or wavy lines
  • See flashlights
  • Existence of a point in the field of view
  • See blind spots
  • Tunnel vision

Other senses, movement, and speech may also be involved, and the person may experience the following:

  • Hearing problems or hearing sounds that are not there
  • The feeling of strange smells or tastes
  • Feeling numb, tingling
  • Weakness
  • Difficulty remembering or expressing words

Even if a person does not have a headache, a migraine can affect them in other ways, such as the following:

  • Stomach upset or vomiting
  • Feeling hot and cold
  • Nasal congestion or runny nose
  • Dizziness and dizziness
  • Jaw or neck pain
  • Sensitivity to light, sound, smell, touch, or movement
  • Confusion

After that, the patient may feel very tired and bored for a day.

Not all migraine attacks follow the same pattern. Even in the case of a person, these symptoms can be unpredictable.

Migraine triggers off

Silent migraines can be triggered by the same factors that cause painful migraines. Common triggers are:

Environmental factors can also trigger them:

  • Lights on or flashing
  • Loud noises
  • Extreme cold or heat

Changes in hormone levels (during menstruation, pregnancy or menopause, or while taking birth control pills)

Public welfare is also paramount:

  • Stress; physical or emotional
  • Lack of sleep
  • Ignore meals


Having a diary is a crucial step. The patient should try to follow everything he eats and changes in sleep or stress levels and other possible triggers. Signs and time of onset and end are also vital. Medical history and notes will help the doctor know what is going on. In rare cases, the symptoms can sign a different and more serious medical problem, such as a stroke or cerebral hemorrhage. Tests such as CT scans or MRIs are needed to rule out these cases.

Treatment and prevention

More than 100 medications can treat migraines, but the patient must choose the best medication with a doctor’s help. The patient should try to avoid them by identifying their primers. Having a healthy lifestyle and managing stress also helps to improve this situation.

Hemiplegic migraine headaches

Hemiplegic migraine is a rare and severe form of migraine headache. Many of the symptoms are similar to those of a stroke. For example, muscle weakness can be so severe that it causes temporary paralysis of one side of the body called hemiplegic (half-body paralysis).


Sometimes the symptoms appear before the real headache:

  • Severe, throbbing pain that often occurs on one side of the head
  • A tingling sensation that often moves from the hand to the arm
  • Anesthesia on one side of the body, which can include the arm, leg, and half of the face
  • Weakness or paralysis on one side of the body
  • Loss of balance and coordination
  • Dizziness and dizziness
  • nausea and vomiting

There may also be problems with the senses, communication, and drowsiness:

  • See zigzag lines, binoculars, or blind spots
  • Severe sensitivity to light, sound, and odor
  • Language problems such as word mixing or difficulty remembering words
  • Unintelligible speech
  • Confusion
  • Loss of consciousness and (rarely) coma

It usually appears gradually over half an hour and then can continue for hours until it resolves slowly. Stroke-like symptoms can range from annoying symptoms to debilitating symptoms. Unlike strokes, they come slowly, shrink, and they may go away completely. Muscle problems usually go away in 24 hours but can last for several days. This type of migraine does not have predictable patterns. Headaches are usually followed by paralysis, but they can occur before that, or they may not occur at all. The person may experience severe pain, with a slight weakness, and may experience severe paralysis without pain in the next attack. Although unusual, some people may have long-term problems with movement and coordination over time. Symptoms of hemiplegic migraine often begin in childhood or adolescence and sometimes disappear with age.

Cause of hemiplegic migraine:

Researchers have identified four genes associated with hemiplegic migraine:

  • ATP1A2
  • SCN1A
  • PRRT2

Mutations in any of these genes lead to the body’s inability to make a specific protein. Without the associated protein, nerve cells have difficulty transmitting and receiving messages. One of these chemical messengers or neurotransmitters is serotonin. About half of people with hemiplegic migraine receive the mutated genes associated with the disease from their parents.


To diagnose this problem, your doctor should perform a thorough examination. A CT scan or MIR can show signs of a stroke. Cardiovascular tests on the neck can rule out problems with blood clots. If a patient’s family member has similar symptoms, a genetic test may be done. Familial hemiplegic migraine (FHM) means that a person receives the gene for the disease from their parents and can pass it on to their children. Patients who do not have a problem with these genes develop diffuse hemiplegic migraine (SHM).


Doctors disagree on how to treat hemiplegic migraines. Some doctors prescribe triptans for treatment. However, there is weak evidence that triptans, beta-blockers, and ergotamine derivatives may lead to ischemia in patients with hemiplegic migraine. CGRP inhibitors may be prescribed to prevent most migraines, but these drugs do not seem to treat hemiplegic migraines effectively.

Vestibular migraine

Vestibular migraine is a nervous system problem that causes dizziness (dizziness) in people with migraine histories. This type of migraine, unlike common migraines, may not always be accompanied by a headache.


Vestibular migraine does not always cause headaches. The main symptom is dizziness that comes and goes. The vestibular refers to the inner ear that controls hearing and balance. A person with vestibular migraine may experience the following:

  • Dizziness that lasts more than a few minutes
  • nausea and vomiting
  • Balance problems
  • Severe sensitivity to movement, feeling sick, or dizzy when moving the head, eyes, or body
  • Feeling confused or confused
  • Feeling shaken, as if riding a moving boat
  • Sensitivity to sound


Doctors do not have a definite opinion on this. There are many theories as to why, but how exactly this disease occurs is not well understood. It is sometimes attributed to faulty connections between nerve cells in the brain.

Who has this type of migraine?

It is difficult to say how many people live with this problem. Its symptoms are similar to many other diseases. Researchers think that one percent of the population has such a problem, but that number could be higher. Like common migraines, this type of migraine is more common in women than men. Symptoms of dizziness usually appear around the age of 40, but the condition affects adults and children.

Diagnosis of vestibular migraine:

There is no blood test or imaging that can reliably diagnose this condition, but medical organizations have defined criteria for this type of migraine; A person may have a vestibular migraine if:

  • Have you had migraines in the past or now?
  • Have at least five episodes of dizziness that cause you to feel dizzy or move (this is not like traveling sickness or fainting)
  • These feelings last between 5 minutes and 72 hours.
  • Symptoms are moderate to severe: they cannot do daily activities or are so severe that the patient can do nothing.

At least half of all episodes of this type of migraine occur with one of the following migraine symptoms:

  • A headache has two of these characteristics: It is on one side of the head, it is throbbing, it is moderate to severe, or it is aggravated by activity.
  • Sensitivity to light or sound
  • See flashing lights

Similar diseases: Your doctor will perform tests to rule out other problems with your brain and ears. Two conditions that cause similar symptoms are:

  1. Meniere’s disease: The patient usually feels fullness or pain in one of his or her corners before dizziness. During an attack, one or both ears may ring, or the patient may lose their hearing. This condition does not usually occur in vestibular migraines.
  2. Stroke: In this condition, the person will experience dizziness, numbness, weakness, difficulty speaking, and other stroke symptoms. In this situation, you should see a doctor.


There are no specific medications for treating vestibular migraines. Your doctor may prescribe different medications to stop the attack. These drugs include:

  1. Triptans: The patient should take these drugs at the first sign of a headache.
  2. Vestibular suppressants (symptoms): These drugs reduce dizziness and sensitivity to movement by acting on the inner ear’s balance center.

Your doctor may also prescribe nezodiazepines such as lorazepam, antiemetics such as promethazine, and antihistamines such as meclzin.

If a person has recurrent or debilitating vestibular migraines, your doctor may prescribe medications similar to regular migraine medications. These include anticonvulsants (such as gabapentin and topiramate), antihypertensive drugs, and some antidepressants. CGRP inhibitors may also be prescribed. Use of the device may also be recommended.

Knowing the triggers may also help a person avoid migraine-related dizziness.

Hormonal headaches and menstrual migraines

Some headaches are associated with changes in the levels of the hormones estrogen and progesterone. Women with this complication often have menstrual migraines two days before the onset of menstruation and up to three days after menstruation. But anything that changes the levels of these hormones in the body can cause it.


1.Contraception: Birth control pills can make migraines worse in some women and less so in others. These pills keep hormone levels constant in the body for three weeks each month. When a person takes a placebo or does not take a pill at all, estrogen levels drop during the menstrual week and cause headaches. If a person is prone to hormonal migraines, taking birth control pills that contain little estrogen or only progesterone can be helpful.

  1. Alternative Therapy: This type of treatment, which some women use to control their hormones during menopause, can also trigger headaches. Headaches are less likely to be exacerbated by estrogen labels (patches) because this type of estrogen injects a small, continuous amount of the hormone.
  2. Menopause: When your period is over, you are less likely to get a migraine. In this case, your doctor may reduce the amount of medication or suggest another treatment. Often, an estrogen patch is the best option. This skin tag keeps estrogen levels constant, thus reducing the risk of menstrual migraines.
  3. Menstruation: Some women experience migraine headaches near their period. About 60% of women with migraines also experience menstrual migraines. Just before starting the menstrual cycle, the amount of estrogen and progesterone in the body decreases. This reduction can trigger throbbing headaches.
  4. Premenopause: In the premenopausal years, a declining estrogen can cause migraine headaches.
  5. Pregnancy: During the first trimester of pregnancy, estrogen levels rise rapidly and then decrease. Thus, many women feel that their migraines have improved or gone away after the third month of pregnancy.
  6. Contraceptives: Birth control pills can make migraines worse in some women and less so in others. These pills keep hormone levels constant in the body for three weeks each month. When a person takes a placebo or does not take a pill at all, estrogen levels drop during the menstrual week and cause headaches. If a person is prone to hormonal migraines, taking birth control pills that contain little estrogen or only progesterone can be helpful.

* Keep in mind that migraine medications during pregnancy can be dangerous, and it is necessary to consult a doctor in this regard *


Menstrual migraines are similar to regular migraines. The person may have the following symptoms:

  • Before the headache
  • Pulsating pain in one side of the head
  • Nausea
  • Vomit
  • Sensitivity to light and sound

Premenstrual headaches can have different symptoms:

  • Headache
  • Fatigue
  • Acne
  • joint’s pain
  • Decreased urination
  • Constipation
  • Lack of coordination
  • Increased appetite
  • The tendency to chocolate, salt, or alcohol


Nonsteroidal anti-inflammatory drugs (NSAIDs): A nonsteroidal anti-inflammatory drug such as ibuprofen can treat menstrual migraines. This medicine can also help relieve menstrual cramps. Triptans are another option. These drugs inhibit pain signals in the brain and show their effectiveness within two hours after consumption. Sometimes your doctor may recommend using a Gamacor device.

Home Remedies and Alternative Therapies: Talk to your doctor about these options, especially supplements that may affect other medications’ performance. These treatments include:

  1. Acupuncture: This ancient Chinese practice, which involves inserting needles along with the body’s energy points, may reduce tension headaches and prevent migraines.
  2. Biofeedback: Biofeedback can positively affect tension headaches and migraine headaches by helping the patient monitor how the body responds to stress, but doctors do not know the exact cause.
  3. Butterbur: This plant can reduce the number of migraines and relieve headaches. Supplements made from this plant can be helpful but may cause belching and other mild stomach problems. Supplements should be used not to contain air, as this substance can cause liver damage and cancer.
  4. Coenzyme Q10 (Co Q10): This antioxidant, available as a supplement, may help prevent headaches.
  5. Feverfew: This plant can help prevent migraines, but supplements can cause acne, pain, and mouth sores.
  6. Ice: It helps place a cold cloth or ice on the head’s painful area, or neck ice should be wrapped in a towel.
  7. Limit salt intake: Excessive consumption of salty foods can also cause headaches. It is best to limit salt intake near menstruation.
  8. Massage: There is evidence that massaging the sore spot can help relieve migraines.
  9. Magnesium: Low levels of the mineral magnesium can cause headaches. Supplements may be helpful but can cause diarrhea.
  10. Relaxation Techniques: These techniques include progressive muscle relaxation, guided visualization, and breathing exercises.
  11. Riboflavin: Vitamin B2 may help prevent migraines


There are several ways to prevent this type of migraine:

  1. Hormonal methods: Birth control pills or estrogen patches and vaginal rings may reduce or reduce menstrual migraines. But these methods are not useful for everyone and, in some cases, can even aggravate migraines. Your doctor may tell you to take birth control pills for 3 to 6 months without taking a placebo. This prevents menstruation and may stop the person from having headaches.

If a person with migraines is associated with it, taking birth control pills that contain estrogen and progesterone is not a good option. Taking these pills can increase the risk of stroke. There are also situations in which your doctor may advise you not to use birth control pills to treat menstrual migraines; As:

  • History of smoking
  • High blood pressure
  • Obesity
  • Diabetes

If no other method works, a medicine called leuprolide acetate may be prescribed. It lowers estrogen levels but has side effects. Because of this, this drug is often considered a last resort.

2.Medications that treat migraines: Medications used to treat menstrual migraines can also help prevent them. These include NSAIDs and triptans, such as the following:

  • Al-Triptan
  • Frovatriptan
  • Naratriptan
  • Rizatriptan
  • Sumatriptan
  • Sumatriptan
  • Zooming
  1. Medications and treatments that prevent migraines:
  • Anticonvulsant drugs
  • Blood pressure medications and some antidepressants
  • CGRP inhibitors
  • Devices such as Pottery and SpringTMS

Abdominal migraine

Abdominal migraines are not a headache but instead cause abdominal pain. These pains often occur in response to migraine triggers. Abdominal migraines can cause a lot of pain and can cause nausea, abdominal cramps, and vomiting. Children with a family history of migraines are more likely to develop abdominal migraines. Fifteen percent of children with chronic abdominal pain may have abdominal migraines. This disease is rare in adults. It is more common in girls than boys, and children with abdominal migraines are more likely to have migraine headaches in adulthood.

Causes and initiators

The exact cause of abdominal migraine is not known. According to one theory, this condition’s cause is a change in histamine levels and serotonin in the body. Experts believe that anxiety and worry can affect the level of these two substances. Foods such as chocolate, foods containing monosodium glutamate, and meat processed with nitrates may trigger migraines in some people. Swallowing large volumes of air can also trigger it or cause similar abdominal symptoms.


Abdominal migraine affects the middle part of the abdomen or around the navel. A child with this condition may have the following symptoms:

  • Nausea or vomiting
  • Pallor or blush
  • Yawning, drowsiness, or lack of energy
  • Loss of appetite or inability to eat
  • Darkening under the eyes
  • Abdominal migraines are often sudden and very severe. They can start without any warning signs. The pain may go away after an hour, but sometimes it can last up to 3 days.


This problem is challenging to diagnose because children often cannot explain the difference between a normal abdominal or stomach migraine, stomach flu, or other stomach and intestine problems. Because abdominal migraines are seen in some families, your doctor will inquire about relatives with migraine headaches. She then tries to look at other causes of stomach pain and examines how well the child’s symptoms match the list made by migraine specialists.


Sometimes knowing what the problem is making it easier to deal with it. Because we do not know much about abdominal migraines, our doctor may prescribe common migraine medications if needed. In most cases, no medications are prescribed; Unless the symptoms are very severe or recurrent.


Having a notebook and recording events related to the onset of pain can help identify the triggers. If foods cause abdominal migraines, they should be avoided as much as possible.

Some medications, such as cyproheptadine, propranolol, and valproic acid, may reduce this type of migraine’s severity or frequency. Children with abdominal migraines should eat a nutritious diet high in fiber. Other healthy habits such as exercising daily, getting enough sleep and managing emotions, and dealing with problems can also be useful.

Migraine with aura of the brainstem

Migraine with brainstem aura or MBA (also called basilar migraine or basilar artery migraine) is a headache that starts in the brain’s lower part, the brainstem. These headaches cause symptoms such as dizziness, diplopia, and lack of coordination. Bacillary migraine headaches often start on one side of the head and then gradually spread and become more severe. An MBA can involve people of all ages, although it generally begins in childhood or adolescence. It is slightly more likely to occur in women than in men.

Initiators can include the following:

  • Alcohol
  • Stress
  • Lack of sleep
  • Some medications
  • Hunger
  • Changes in female hormones
  • Bright lights
  • Caffeine
  • Nitrate in some foods such as sandwiches, bacon, and processed foods
  • Excessive physical activity
  • Climate or altitude


Symptoms vary from person to person, but the most common are:

  • Nausea
  • Vomit
  • Sensitivity to light and sound
  • Cold hands or feet
  • Vertigo
  • Binoculars or gray vision
  • Difficulty speaking and vague speech
  • Temporary blindness
  • Loss of balance
  • Confusion
  • hearing problem
  • Skin rash
  • Loss of consciousness

When a headache begins, the person may experience severe throbbing pain on one or both sides of the head or sometimes behind the head.


Many of the symptoms of this type of migraine are similar to hemiplegic migraines. But the hemiplegic type usually causes weakness on one side of the body or difficulty speaking. Symptoms of an MBA can be similar to those of more severe problems such as seizures, stroke, meningitis, or brain tumors.


In general, the goal of MBA treatment is to relieve the symptoms of pain and nausea. The patient may take painkillers such as acetaminophen, ibuprofen, naproxen, and antidepressants such as chlorpromazine, metoclopramide, and prochlorperazine.


To help prevent an MBA, you need to avoid the factors that cause it. By recording the events during the attack, its initiators can be identified. Having a healthy lifestyle also helps:

  • Getting enough sleep
  • Limit stress
  • daily exercise
  • Consume a balanced diet
  • Avoid drugs and alcohol
  • Do not forget meals
  • Limit caffeine intake

Some typical dietary initiators include:

  • dairy
  • Wheat
  • Chocolate
  • egg
  • Rye
  • tomato
  • Citrus

Postural migraine:

A migraine that lasts more than 72 hours is called a conditional migraine. In such a situation, the patient may need to go to the hospital to resolve the pain and dehydration. A typical migraine can sometimes turn into a postural migraine if:

  1. When a migraine starts, the patient should not take his medicine on time
  2. The patient does not receive the appropriate medication during an attack
  3. The patient should take a lot of headache medicine


Migraine warning signs are similar to typical migraine symptoms. With a headache, the following symptoms may occur:

  • Vision changes
  • nausea and vomiting
  • Problems in thinking

Because this condition lasts for at least three days, the person is at risk of dehydration due to prolonged vomiting and lack of sleep due to pain.


If a patient has to go to the hospital because of a migraine, he or she may take various medications to relieve the symptoms and side effects of the disease, such as the following:

Drugs that stop vomiting:

  • Chlorpromazine
  • Metoclopramide
  • Prochlorperazine

A common medication to stop postural migraines is dihydroergotamine. It is given as an injection or nasal spray. Another drug is sumatriptan, which comes in injections, nasal sprays, pills, or skin tags. Intravenous valproate may also be used. The corticosteroids dexamethasone and prednisolone can also help improve postural migraines.


Suppose regular migraine medications do not work and the patient has a migraine for four days or more a month. In that case, prophylactic medications such as blood pressure medications or some antidepressants may be prescribed. If these drugs do not work, GCR inhibitors are prescribed. Although Botox is more commonly known as a treatment for wrinkles, the FDA has approved it to prevent recurrent migraines. The use of devices such as springs, Pottery, and Gamakor is also sometimes recommended.

Altered or chronic migraine

Chronic migraine headaches, formerly known as modified migraine headaches, last more than 15 days a month. Most people with migraines have migraines for years, usually from adolescence and even earlier. Chronic migraine headaches usually begin during the third and fourth decades of life. When chronic migraine headaches begin, a person’s headaches may be less severe but increase in frequency as long as they deal with them daily. This change may be related to the continued use of painkillers.

Of course, some people with chronic migraine headaches, like other types of migraines, experience severe headaches and nausea and vomiting. It is often difficult to tell the difference between tension headaches and chronic migraine headaches. Because of the difficulty of diagnosing this type of headache, many people may not receive proper treatment. They consume housing. The person may become resistant to the drug in such a situation. Also, taking too many painkillers with caffeine can lead to headaches due to overdose. In many cases, people with chronic migraine headaches also have other health problems, such as high blood pressure and depression, which complicate treatment.

Alice in Wonderland Syndrome

Sometimes the world is strange to a migraine sufferer. Colors change. Straight lines become wavy. Objects move, and even time may change. In 1955, John Todd, an English psychiatrist, called this strange condition Alice in Wonderland Syndrome (AIWS).

You must be familiar with the story of Alice in Wonderland. Alice sees the world in other forms after falling into a rabbit’s nest. At one point, he drinks from a bottle that says “Drink Me” and becomes small enough to pass through a small door. He then eats the cake with the words “Eat Me” written on it and becomes so large that he reaches for a key placed on a high table. Todd used the term to describe the strange features he had heard from people with migraine headaches and epilepsy.


A person with an AIWS episode may experience strange things:

  • Organs or surrounding objects appear larger, smaller, closer, or farther away from the actual situation.
  • Straight lines look wavy.
  • Inanimate objects appear to be moving.
  • Three-dimensional objects look flat.
  • Objects may change color or look crooked
  • People’s faces may look crooked
  • The colors look very bright
  • People may look stretched


Doctors are not sure why some people experience these abnormal changes in perception, but it often begins when they are very young. AIWS involves changes in parts of the brain that deal with sensory information. Doctors believe that AIWS may be a migraine. AIWS often occurs before, during, or after a migraine but can also occur in some other health problems:

  • Epilepsy
  • Infections such as the Epstein-Barr virus
  • Stroke
  • Depression or schizophrenia

It can also occur after taking medications such as cough syrup, anti-allergy medications, and topiramate anticonvulsant medication.


If a person thinks they may have this syndrome, they should see a neurologist. They will ask about migraines’ symptoms and history and recommend tests such as blood tests, MRI, and EEG.


There is no cure for AIWS, but the patient may avoid these strange feelings by avoiding migraine triggers. Medications from the following medications may be prescribed for him:

  1. Antidepressants
  2. Anticonvulsant drugs
  3. Blood pressure medications
  4. Diet tips can also help:
  • Eat foods such as fruits, vegetables, eggs, fish, meat, and poultry.
  • Avoid starvation (for example, eat five to six smaller meals instead of three large meals)
  • Avoid foods such as alcohol, the artificial sweetener aspartame, soft or leftover cheeses, monosodium glutamate, and processed meats that trigger migraines in many people.

Cyclic migraines

These migraines occur in cycles. They are sometimes called cluster migraines, but this is not true. Cluster headaches vary in the duration and treatment of cyclic migraines.


These headaches may occur daily or several times a week for 1 to 6 weeks. People with this condition experience an average of about ten attacks a month. These headaches can last from several hours to two days during the cycle. The average attack lasts about 6 hours. After that, a period of cycle extinction begins that will last for weeks or months. This pain may occur on one or both sides of the head. Even if the headache starts on one side of the head, it may come together when attacking the other side. Before the onset of this type of migraine, a person may experience visual symptoms or experience the following:

  • Fatigue
  • Difficulty concentrating
  • Stiffness in the neck area

Depression may accompany them. As usual, cyclic migraines may cause nausea, vomiting, or sensitivity to light and sound. This type of migraine starts around the age of 20. It is more common in women. More than half of these people have a family history of migraines.


There is no single test to diagnose this condition. The doctor begins the diagnosis process by reviewing the patient’s medical history and then tries to check for other health problems with tests:

  1. Blood tests: These tests look for problems with blood vessels and infections.
  2. MRI: MRI shows the brain and blood vessels and helps doctors look for tumors, cerebral hemorrhage, or other neurological problems.
  3. CT scan: This type of scan uses X-rays to create an accurate picture of different parts of the brain and helps the doctor assess the possibility of brain damage.
  4. Cerebrospinal fluid test: If your doctor suspects an infection or bleeding in the brain, they will order this test. In this test, also called a lumbar puncture, a sample of the patient’s spinal fluid is collected using a needle and tested.


The exact cause is not entirely clear, but two factors may play a role:

  1. Changes in brain chemicals, including serotonin levels, which decrease during a migraine
  2. Hormonal changes such as estrogen depletion in women before or during menstruation or pregnancy, or menopause

Changes in how the brain interacts with the trigeminal nerve may play a role. Imbalances in brain chemicals can also play a role. Serotonin levels decrease during a migraine attack. These chemicals help manage pain in the nervous system.


Cyclic migraine treatment is different from the usual type. In this case, your doctor may prescribe a non-prescription NSAID drug such as acetaminophen, aspirin, or ibuprofen. Caffeine may even be recommended. The most effective treatment for migraine cysts is lithium carbonate. It is a lithium salt that is present in tablet form and calms the central nervous system. A prescription is required to receive this medicine. The most common side effects of lithium carbonate are:

  • Drowsiness
  • Nausea
  • Loss of appetite
  • Diarrhea
  • Vertigo
  • A slight tremor of the hands
  • We need to urinate more.
  • More thirst

Your doctor may also prescribe indomethacin. It is an NSAID used to relieve pain. Most people can take this medicine without side effects, but some may experience stomach upset, heartburn, indigestion, or nausea. If you have heart or kidney disease, you should consult your doctor before taking this medicine type.

A migraine diary can help a person manage their attacks. These notes may help the person identify the causes of this condition. The most common triggers are:

  • Stress
  • Change in good patterns (too little sleep or too much sleep)
  • Climate change
  • Dehydration
  • Alcohol
  • Some types of foods such as chocolate, dairy products, artificial sweeteners, and caffeine
  • Strong odors such as food, chemicals, or perfumes

Botox injections to treat migraines

Botox, or Botulinum toxin, was approved in 2010 to treat migraine headaches in adults with chronic migraines.

Botox is a nerve toxin; A toxin produced by a bacterium called Clostridium botulinum. If a person eats this toxin from spoiled food, the toxin can cause a fatal reaction called botulism because it blocks nerve signals and causes muscle paralysis. However, injecting this toxin is safe because the toxin does not enter the stomach and its amount is much less than the amount that may enter the body through rotten food.

Doctors have found that Botox injections can help smooth out wrinkles because they relax the facial muscles. This treatment can also help people who suffer from tics and spasms due to a neurological condition such as cerebral palsy. Doctors believe that Botox effectively treats migraines because it inhibits neurotransmitters that transmit pain signals to the brain.

In a study of adults with chronic migraine headaches, Botox injections were shown to reduce the number of days of migraine headaches. In another study, nearly half of those who injected Botox twice reported halving the number of days a month they had a headache. After five treatments, this number reached about 70% of people.

Botox treatment method

The patient receives several Botox injections around his head and neck every 12 weeks to help prevent or reduce pain. A total of 30 to 40 injections may be needed, which are used in equal numbers on both sides of the head. If a person has a headache at a certain point, more injections are given at that point. The results of this treatment will appear two or three weeks after the first injection.

The critical point here is that this type of treatment should only be obtained from a doctor who has been trained to use Botox to treat migraines, not people who use Botox to treat skin wrinkles and other cosmetic conditions.

side effects

Neck pain and headache are the most common side effects for chronic migraine headaches and use Botox. In rare cases, a person may be allergic to Botox. An allergic reaction’s symptoms can include hives, shortness of breath, or swelling of the lower legs. Although there is no proven evidence that Botox is spread to other parts of the body, this is possible and can be fatal. These warnings also appear on the label of this medicine.

Does caffeine trigger a headache, or does it cure it?

Caffeine is a substance that many people like, but it can also be a trigger or a headache preventer. Caffeine is found in some drinks, chocolates, and even some over-the-counter painkillers, but how does it affect headaches?

Before the onset of a headache or migraine, the blood vessels dilate. Still, caffeine has the property of constricting the arteries, narrowing the brain’s blood vessels, restricting blood flow, and helping relieve pain. When caffeine is added to acetaminophen and aspirin, the drug’s sedative effect increases by up to 40%.

If you feel that your headache is about to start, a cup of coffee may alleviate your symptoms. On the other hand, although caffeine does not directly cause headaches, large amounts of this substance can trigger recurrent caffeine headaches. This type of headache occurs when a person quits after consuming large amounts of caffeine. Although the physical side effects can be severe, only 2% of the population suffers from this condition. However, most people with headaches can consume up to 200 mg of caffeine a day; The National Headache Foundation in the United States advises patients with recurrent headaches to avoid caffeine daily. But this does not mean that you have to stop consuming caffeine; try to reduce your consumption slowly and remember that it is always better to observe moderation.


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