What makes this headache a migraine? What does it mean to have a migraine without aura? How is this different from other headaches or other migraines? Most important, what can you do to make the migraine go away?
What Is It and What Causes It?
A migraine without aura is the most common type of migraine headache. They account for about 75% of all migraines. Another name you might hear is "common migraine." It doesn’t have the early symptoms, called an aura, that some people have before a migraine begins, like vision changes, dizziness, confusion, feeling prickling skin, and weakness.
Scientists aren't sure what causes migraines. They think that many brain chemicals such as– serotonin, calcitonin gene-related peptide, and dopamine -- play a role. According to the theory, a wave of nerve cell activity spreads across the brain and excites the trigeminal nerve. This excitation causes the release of a variety of neurotransmitters which caused a change in the size of the blood vessels releasing more neurotransmitters and ultimately causing an inflammatory process and pain.
Migraines often run in families, so researchers think there may be a genetic link for the condition. Other things can trigger migraine attacks for some people, like some foods, smells, stress, and things in the environment.
Migraines often begin in childhood and get worse through adolescence. Although more boys than girls have migraines, more adult women than adult men have them. But they usually happen less over time. Migraines become rare after age 50.
Although painful, a migraine without aura is not life-threatening.
What Are the Symptoms?
Most people feel migraine pain in the front of the head, on one or both sides of the temples. It may throb or be steady. The headache may last from 4 to 72 hours.
You might also have any of these other symptoms:
How Is It Diagnosed?
Your doctor will want to be sure that there are no other causes for your headache. So, it’s likely she’ll do physical and perhaps neurologic exams. She’ll also ask you about your health history, including questions like:
- Do other people in your family have migraines or other kinds of headaches?
- Do you have any allergies?
- What is the level of stress in your life?
- Do you use medications such as birth control pills or vasodilators that could cause headaches?
- Do you notice that headaches start after coughing or sneezing or after intense exercise?
Your doctor may also use some tests to be sure that your headache isn’t caused by something else:
What Are the Treatments?
Treatment for migraines without aura has two goals: Relieve your symptoms and prevent future attacks.
To help relieve migraine symptoms :
- Stay in a quiet, dark room.
- Put cold compresses or use pressure on the painful areas.
- Take pain-relieving medications such as aspirin, acetaminophen (Panadol, Tylenol), ibuprofen, ketorolac (Toradol), or naproxen (Naproxyn). (Do not use aspirin in anyone under the age of 19)
- Or take prescription drugs, such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), lasmiditan (Reyvow), naratriptan (Amerge), rizatriptan (Maxalt), and sumatriptan (Alsuma, Imitrex, Onzetra, Sumavel, Zembrace), which help narrow blood vessels.
- Ergots (Cafergot, Migergot) may also be effective in treating migraine pain.
- Or take prescription pain relievers.
- Use medications to treat other migraine symptoms such as nausea and vomiting.
To prevent migraines without aura:
If you don’t respond to other treatments and you have 4 or more migraine days a month, your doctor may suggest preventive medicines. You take these regularly to reduce the severity or frequency of the headaches. These include seizure medicines, blood pressure medicines (like beta blockers and calcium channel blockers), and some antidepressants. CGRP inhibitors are a new class of preventive medicine that your doctor may recommend if other medicines don’t help.
Devices: Cefaly is a portable headband-like device sends electrical impulses through the skin of the forehead to stimulate a nerve linked with migraine headaches. You use it once a day for 20 minutes, and when it's on you'll feel a tingling or massaging sensation. SpringTM or eNeura sTMS may be another option. You hold this device at the back of your head at the first sign of a headache, and it gives off a magnetic pulse that stimulates part of the brain. In addition, there is a noninvasive vagus nerve stimulator called gammaCore. When placed over the vagus nerve in the neck, it releases a mild electrical stimulation to the nerve's fibers to relieve pain.
Keep a headache diary. It will help you spot anything that might trigger your migraines. Diary entries should include the date and time of your headache, any foods you ate, what you did, and medication you took just before the headache began. It may take 6 to 8 weeks or longer to begin to see patterns and triggers.
Avoid common food triggers. Use information from your diary and from trial and error to figure out if any of these foods might be causing your migraines.
- Red wine or other alcohol
- Citrus fruits
- Artificial sweeteners
- Food preservatives, such as nitrates, nitrites, and monosodium glutamate (MSG)
- Ice cream or other cold foods
Avoid medication triggers. Many over-the-counter and prescription drugs can bring on migraines. Check with your doctor if you think any of these may lead to your headaches:
- Hydralazine (Apresoline)
- Nifedipine (Procardia)
- Ranitidine (Zantac)
Never stop taking a medicine unless your doctor tells you to.
Relieve mental or emotional triggers. Stress, depression, anxiety, and strong feelings such as grief can trigger migraines. Although you can’t always avoid these things, you can learn to control how you handle them. Relaxation, biofeedback, and self-hypnosis techniques can help relieve these sources of stress and prevent migraines, especially in children.
Reduce physical triggers. Illnesses, missing meals, and being too tired can all trigger migraines. So can overdoing exercise, motion, and head injuries. Even menstruation can set off migraines. To curb the effect of these things, know how they affect you, keep a regular routine, treat illnesses quickly, and take steps to avoid other physical triggers.
Look for environmental triggers. Some people are sensitive to flickering lights, fluorescent lights, changes in air pressure or altitude, or even bold visual patterns. Use your headache diary to spot any possible triggers in your environment -- and then take steps to get rid of them or avoid them.