The symptoms are intense throbbing pain often on one side of the head, which may spread to the entire head, neck and shoulders. Sometimes bright spots, flashing lights or zigzag patterns may be seen prior to the headache.

The headache is often present on awakening and may be accompanied by nausea, vomiting, dizziness and tingling in the lips. Bright lights and noises become unbearable. The headache is due to swelling of the blood vessels that go to the scalp and brain. Before swelling, the blood vessels first tighten up, decreasing the amount of blood going to the brain. This produces the visual disturbances and in severe attacks may cause paralysis, and loss of ability to speak. During attacks, some people become pale, with bloodshot eyes and runny nose.

Migraine headaches occur most often when unwinding from stress such as during weekends or holidays. In some women, migraine headaches coincide with their menstrual cycle. Get enough rest and minimize stress. Avoid irregular eating habits (which may decrease your blood sugar), certain medications e.g. birth control pills, nitrates. About 20% of migraine sufferers have a sensitivity to certain beverages and foods. Beverages which can trigger an attack include red wine, beer, whiskeys, scotch, tanin containing beverages e.g. apple juice and caffeinated drinks such as coffee, tea and colas, chocolate or cocoa. Foods which can trigger an attack include dairy products such as milk, buttermilk, cream, sour cream, yogurt, hard/aged cheeses, cheddar, brie, processed cheeses, fats and lard. Meats/poultry triggers include processed meats containing sodium nitrite (e.g. hot dogs, bologna), aged, cured smoked, marinated meats, organ meats (e.g. chicken livers).

Fish triggers include smoked or dried fish, pickled herring. Vegetable triggers include broad beans, most peas, onions, pickles, olives, sauerkraut. Grains/breads that may precipitate an attack include yeast breads, #003366 breads and sourdough. Soup triggers include any soup containing the additives MSG or yeast and soups from bouillon cubes. Fruit triggers include citrus fruits, other fruits e.g. bananas, figs, raisons, papaya, kiwi, plums, pineapples, avocados. Deserts triggers include chocolates, ice cream, cookies/cakes made with yeast, potato chip products, nuts. Additives such as MSG and other flavor enhancers, artificial sweeteners, seasonings and spices may sometimes be dietary triggers.

Start a headache diary for everything you eat or drink and all the medications you take. By checking the diary later you may be able to find out which foods or medicines are bringing on the attacks. If you have menstrual migraine, you may obtain relief by wearing a low dosage (one-fifth of the birth control dosage) estrogen patch on your buttocks. This is worn for three to nine days or during the time you normally get the migraine attack. The estrogen patch evens out the hormonal level, which usually drops just before your cycle starts. If you have more than two migraine attacks a month, you may need to take migraine prevention medications. Serotonin blockers such as Sansert, antidepressants such as Elavil or Paxil, beta-blockers such as Inderal help to prevent migraine attacks when taken regularly. Riboflavin (Vitamin B2) has been shown to prevent migraines when taken regularly. Take 200 mg twice daily. This may also be combined with Valerian root to get a restful nights sleep (1000 mg at bedtime). Another herbal medication that may help prevent and treat migraine headache is feverfew. Take one to three capsules daily. It takes a few weeks to notice the effects. Feverfew is available at your local health food store. The label should state that it contains 0.2% parthenolide - the active ingredient.

Apply a cold cloth or ice pack to your head, or splash your face with cold water. Take over the counter pain relievers such as Excedrin or prescription pain relievers, such as Fioricet (which is a combination of caffeine, acetaminophen, and butalbital). Relax if possible. Lie down in a quiet, dark room for several hours. Listen to soft music, sleep or meditate. Your doctor may prescribe vasoconstrictor drugs such as Ergostat. Ergostat tablets are taken sublingually which means you place the tablet under your tongue. Medications such as Inderal or Ergostat are more effective if taken at the onset of an attack. Carry your medications with you at all times.

If you cannot tolerate Ergostat due to your medical condition e.g. hypertension or the side effects such as increasing headache or cold extremities, your doctor may prescribe Imitrex, Zomig or Midrin tablets - three other types of vasoconstrictor medications with fewer side effects. Imitrex is available as an injection and a nasal spray. D.H.E. (Dihydroergotamine ) is another effective migraine drug that is given by injection. The nasal spray formulation is called Migranal and is made by Novartis. You may call the company hotline at 888 697-3543 to obtain a free video on how to use D.H.E. spray. Migranal may be expensive and if you cannot afford the price, a compounding pharmacists can make up generic D.H.E. nasal spray for you at a fraction of the price. Other medications used to treat migraine attacks include capsaicin (0.075% ointment applied in the affected side of your nostrils), lidocaine nose drops, antidepressants, beta-blockers e.g. Inderal and medications such as Phenergan or Reglan to treat nausea and vomiting. A strong but gentle anti-inflammatory medication is Tolmetin sodium. It is 10 times stronger than Motrin and very effective if part of the migraine pain is due to inflammation. Strong short acting painkillers such as Vicodin ES or Norco 10 may be given. With severe pain, your doctor may prescribe strong long acting painkillers such as Oxycontin.

Call your Doctor if your headache is associated with crossed eyes, paralysis or inability to speak or if it persists for more than 24 hours.

Note: All medications mentioned on this site--including, specialty compounded ointments such as Capsaicin, Gabapentin, Ketamine, Vitamin E--may be ordered directly from L.A. Pain Clinic.