Migraine headache

Encyclopedia of Alternative Medicine, Apr 06, 2001 by Belinda Rowland

Migraine is diagnosed by a careful medical history. So far, lab tests and imaging studies such as computed tomography (CT scan) or magnetic resonance imaging (MRI) scans have not been useful for identifying migraine. However, for some patients, these tests may be needed to rule out a brain tumor or other structural causes of migraine headache.

At the onset of symptoms, the migraine sufferer should seek out a quiet, dark room and attempt to sleep. Placing a cold, damp cloth or a cold pack on the forehead may help. Additionally, tying a headband tightly around the head can relieve migraines.

Migraine headaches are often linked with food allergies or intolerances. Identification and elimination of the offending food or foods can decrease the frequency of migraines and/or alleviate these headaches altogether.

Alternative treatments for migraine include:

• Acupressure. Pressing on the Gates of Consciousness (GB 20) points can relieve migraine.
• Acupuncture. A National Institutes of Health (NIH) panel concluded that acupuncture may be a useful treatment for headache.
• Aromatherapy. The essential oil rosemary eases migraine pain.
• Cognitive behavior therapy.
• Herbals. Valerian (Valeriana officinalis), passionflower (Passiflora incarnata), feverfew (Chrysanthemum parthenium), ginger, ginkgo (Ginkgo biloba), goldenseal (Hydrastis canadensis), hawthorn (Crataegus oxyacantha), linden, wood betony (Stachys officinalis), skullcap (Scutellaria lateriflora), or cramp bark (Viburnum opulus) may relieve migraines.
• Hydrotherapy. Contrast showers, in which a short hot shower is followed by a longer cold shower, may halt an oncoming migraine. A hot enema can temporarily relieve migraine pain.
• Relaxation techniques. Meditation, yoga, hypnosis, visualization, breathing exercises, or progressive muscular relaxation may halt the progression of a migraine.
• Supplements. Clinical studies have shown that vitamin B2 (riboflavin), magnesium, 5-HTP, or melatonin can reduce the severity of migraines.
• Transcutaneous electrical nerve stimulation (TENS).

Nonsteroidal anti-inflammatory drugs (NSAIDs) acetaminophen (Tylenol), ibuprofen (Motrin), and naproxen (Aleve) are helpful for early and mild headache. Exedrin Migraine is a combination product that is indicated for migraine headache.

More severe or unresponsive attacks may be treated with ergotamine (botulinum toxin), dihydroergotamine, sumatriptan (Imitrex), beta-blockers and calcium channel-blockers, antiseizure drugs, antidepressants (SSRIs), meperidine, or metoclopramide. Some of these drugs are also available as nasal sprays, intramuscular injections, or rectal suppositories when vomiting prevents taking the drug by mouth.

Continued use of some anti-migraine drugs can lead to "rebound headache," marked by frequent or chronic headaches, especially in the early morning hours. Rebound headache is avoided by using anti-migraine drugs under a doctor's supervision, with the minimum dose necessary to treat symptoms.

Most people can control migraines through recognizing and avoiding triggers, and by use of effective treatments. Some people with severe migraines do not respond to preventive or drug therapy. Migraines usually wane in intensity by age 60 and beyond.