Migraine: More Than “Just a Headache”

Migraines seem to be the “Rodney Dangerfield” of medicine. They get no respect despite the fact they are one of the leading causes of disability and missed school or work in teens and adults.

Isn’t a migraine just a bad headache?

Yes, but there is more to it than that.  In addition to moderate to severe headaches, migraines affect the autonomic nervous system (ANS). The ANS is the part of the nervous system that controls things we don’t think about, like balance, vision, hearing, and many more things. People suffering from a migraine can also have problems with:

  • Light sensitivity
  • Sound sensitivity
  • Sensitivity to smells
  • Dizziness
  • Nausea and vomiting

A migraine sufferer will indeed have a bad, or even severe, headache, but she may also be trying to keep from vomiting. She may be keeping her eyes covered due to light sensitivity, holding her ears to block out noise and may feel too dizzy to walk.

Do you always see wavy lines before a migraine?

Some people do have visual disturbances before a migraine; called an aura. Aura’s are usually visual, but can be smells or sounds that precede the migraine also.  However, only about 20% of people with migraines have auras.

Can migraines be treated with acetaminophen or Ibuprofen?

For many migraine suffers, ibuprofen is adequate treatment, but Acetaminophen is usually not as effective. Many patients find that Naprosyn can be helpful. If these medications are not helpful or if they are being used more than 2-3 times a week, you should contact your primary care provider. Your provider may prescribe a medication called a triptan.

Triptans are medications that specifically treat migraines. If the migraines are occurring more than weekly, a preventative medication can be prescribed. Often patients needing preventative medications will be referred to a neurologist or headache specialist to manage the care.

What else can be done?

In addition to prescription medications, there is good evidence that magnesium supplements can be helpful for migraines. Migraine sufferers have a lower level of magnesium in the brain and magnesium supplementation is easy and can be helpful.

The following are also important to decrease migraine suffering. These are as important, if not more important than medications.

  • Eat three meals a day – breakfast is very important and should not be skipped.
  • Get adequate sleep – for a teenager, eight hours of continuous sleep is essential (no daytime napping)! Younger children will need even more sleep.
  • Drink plenty of fluids – at least 64 oz. per day.
  • Exercise at least three times per week. Exercise improves brain function and has been shown to decrease migraines.
  • Stress management is vital. Numerous studies have shown that psychological support improves migraine outcomes.

I don’t need to see a psychologist!

When we refer a patient to a psychologist it does not mean it’s due to a behavioral health concern. It means we think you need help dealing with stress and psychologists are trained to help you do that.

If you have more questions, contact your primary care provider who may refer you to a specialist. For more information on treatment at Nationwide Children’s Hospital, click here or listen to our PediaCast.

Howard Jacobs, MD
Howard S. Jacobs, MD, is an attending headache specialist and hospitalist at Nationwide Children’s, and Clinical Associate Professor of Pediatrics at The Ohio State University. Dr. Jacobs has published numerous articles and book chapters on topics relating to pediatric headaches. He has a particular interest in the effect genetics play in migraine therapy and the relationship of weather and migraines.

2 thoughts on “Migraine: More Than “Just a Headache”

  1. Margie Horton on said:

    Migraines in children can also be caused by Chiari Malformation. My daughter wasn’t diagnosed until her late teens.

  2. Howard Jacobs MD on said:

    Though not a common cause of headache, Chiari malformation can cause headaches, particularly in the back of the head, and should be considered in patients who are not improving as expected on the usual therapies

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