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 60% to 80% 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 at least two brain chemicals -- serotonin and dopamine -- play a role. The theory is something goes awry in the way these chemicals regulate how the brain works, which makes the brain and the body's immune system overreact. When that happens, a flood of immune cells flows through the blood vessels to the brain. The brain's blood vessels open wider to accommodate these cells. Then even more chemicals are released to help control the vessels' muscles. The vessels open and constrict. A severe, sometimes throbbing headache results.
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:
- Blood tests
- Imaging tests such as X-ray, CT scan, or MRI
- Tests for infection, bleeding, or other medical problems that could cause similar symptoms
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, ibuprofen, ketorolac (Toradol), or naproxen.
- Or take prescription drugs, such as sumatriptan (Imitrex) and rizatriptan (Maxalt), which help narrow blood vessels.
- Or take prescription pain relievers.
- Use medications to treat other migraine symptoms such as nausea and vomiting.
To prevent migraines without aura:
Medications. Some drugs that treat other conditions also work for preventing migraines. These include:
- Drugs that lower blood pressure, called beta-blockers. They include atenolol (Tenormin), propranolol (Inderal), and timolol (Blocadren).
- Antidepressants such as amitriptyline (Elavil) and nortriptyline (Pamelor)
- Headache medicines called ergot derivatives, such as methysergide (Sansert)
- Antihistamines such as cyproheptadine (Periactin)
- Epilepsy drugs such as valproic acid (Depakene, Depakote)
Cefaly is the first FDA-approved device for preventing migraines in people over 18 years old. The 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.
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:
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.