Migraines are severe headaches that can be
debilitating. A migraine is more than a headache, and can include sensitivity to light, sound, and smell, as well
as nausea and vomiting. In some cases, people experience an aura or visual
disturbances. Migraines are usually treated with pain medication, but due to
their frequent and recurring nature, overuse of medication is a concern.
Migraines generally don’t get worse over time,
but they can lead to more serious complications.
Headache Society created a system for classifying
headaches and migraines and their complications, known as the ICHD-3. Some of these include:
This rare and severe migraine with aura lasts
for longer than 72 hours. Some people have been hospitalized due to the intense
This is when a migraine is associated with
stroke. Typically, this is a migraine headache with an aura that lasts more
than an hour. Sometimes, the aura is present even when the headache disappears.
An aura that lasts longer than an hour can be a sign of bleeding in the brain.
If you have a migraine with an aura that lasts more than an hour, see your
doctor right away.
Persistent Aura Without Infarction
This complication arises if an aura lasts for
more than a week after a migraine has ended. This complication has similar
symptoms to migrainous infarction, but there is no bleeding in the brain. See
your doctor immediately for a proper diagnosis.
This is a condition where an epileptic seizure
is triggered by a migraine. Typically the seizure will occur within an hour
after a migraine. This condition is rare.
A stroke occurs when blood supply to your
brain is cut off or blocked by a blood clot or fatty material in your arteries.
According to England’s National Health Service, people who
have migraines have about twice the risk of having a stroke, and women with
migraines who take oral contraceptives also have a greater risk of stroke. The
reasons for this are not fully understood.
Mental Health Issues
According to the Anxiety and Depression Association of America, migraines have been associated with a small increased risk of:
- major depression
- general anxiety disorder, GAD
- bipolar disorder
- panic disorder
- substance abuse disorders
- post-traumatic stress disorder,
Migraines can also bring on episodic
syndromes including motion sickness, sleepwalking, sleep talking, night
terrors, and teeth grinding. Additionally, migraines can bring on abdominal
pain, cyclical vomiting, and vertigo.
Complications Due to
Because migraines recur, people frequently
overuse pain medications. Here are some complications to watch out for when treating
Common pain relievers may cause abdominal
pain and bleeding if you take them in large doses or for a long period of time.
These include NSAIDS, or nonsteroidal anti-inflammatory drugs, including
ibuprofen, such as Advil, Motrin IB, and others.
Medication Overuse Headache (Rebound Headache)
Continual, long-term use of medications used
to treat migraines can cause a rebound headache, also known as a medication
overuse headache. This can lead to a cycle where taking too much medication
causes a rebound headache, which then necessitates taking more medication,
which causes worse headaches, and so on.
As a general guideline, over-the-counter
medication should not be used more than 10 times per month. If you use
painkillers, ergotamines, or triptans to relieve migraine symptoms, you should
keep a record of when you take them and consult your doctor if you exceed 10 doses
Some NSAIDS and other medications include
caffeine. Caffeine intake in particular should be watched because overuse and
then withdrawal can lead to a “caffeine headache,” compounding your migraine.
Generally, rebound headaches will go away
once you stop taking the pain medication. But it’s important to consult with
your doctor before you adjust any of your medication regimens.
Serotonin is a chemical in your nervous
system associated with regulation of mood, appetite, and sleep. Serotonin
syndrome is a rare condition caused by too much serotonin in your brain. Taking
a combination of certain migraine medications, like triptans, and
antidepressants, specifically serotonin reuptake inhibitors, can cause your
serotonin levels to rise.
- heavy sweating
- rapid heart rate
- muscle twitching
If you experience any of these symptoms
within a few hours of taking a new medication or a higher dose of a medication,
go to the emergency room immediately. Untreated, serotonin syndrome can lead to
irregular heartbeat, seizures, and even death.
Pain medication isn’t the only way to treat a
migraine. Some other simple things you can do to relieve headache pain are:
- lie down in a quiet, dark room
- place a cold cloth over your
forehead or behind your neck
- massage your scalp or temples
Sometimes the best treatment method for
migraines is trying to prevent them in the first place. This is not always
possible, but there are triggers to look out for. These include certain foods,
activities, smells, and environments.
Talk to your doctor about avoiding these
- pickled foods
- aged cheese
- hot dogs
- diet soda
- beverages high in caffeine
Skipping meals can also lead to migraines.
Additionally, try to avoid these triggers:
- lack of sleep or jet lag
- food additives
- hunger or dehydration
- odd smells
- bright lights and loud sounds
You should keep a migraine journal to note
any specific triggers and instances when you get a migraine. You may notice a
Although there are complications associated
with migraines and migraine treatments, they don’t have to ruin your life.
Migraine pain can be managed and prevented. Remember to use medication according
to instructions and in moderation. Also, consider using alternative therapies
to treat migraines. As always, speak to your doctor about severe or recurring
pain to properly diagnose migraines, and be sure to bring any questions or concerns
you may have.