Migraine headaches are a type of headache that some people get repeatedly over time. Migraines are different from other headaches because they occur with symptoms such as nausea, vomiting, or sensitivity to light.

Some people who get migraines have warning symptoms, called an aura, before the actual headache begins. Most people, however, do not have such warning symptoms.

The exact cause of migraine is not known. Migraine headaches are related to problems with blood flow through parts of the brain. At the start of a migraine, blood vessels in certain areas of the brain constrict (narrow), leading to symptoms like visual disturbances, difficulty speaking, weakness, or numbness. Minutes to hours later, the blood vessels dilate (enlarge), leading to increased blood flow in the brain and a bad headache.

Why these changes in blood vessels and blood flow occur in the brain is not understood. Certain triggers, however, make it more likely for you to get migraines:

• Allergic reactions

• Bright lights, loud noises, and certain odors or perfumes

• Physical or emotional stress

• Changes in sleep patterns

• Smoking or exposure to smoke

• Skipping meals

• Alcohol or caffeine

• Menstrual cycle fluctuations, birth control pills

• Tension headaches

• Foods containing tyramine (red wine, aged cheese, smoked fish, chicken livers, figs, and some beans), monosodium glutamate (MSG), or nitrates (like bacon, hot dogs, and salami)

• Other foods such as chocolate, nuts, peanut butter, avocado, banana, citrus, onions, dairy products, and fermented or pickled foods

Migraine headaches, which can be dull or severe, usually:

• Feel throbbing, pounding, or pulsating

• Are worse on one side of the head

• Last 6 to 48 hours

Symptoms accompanying migraines include:

• Nausea and vomiting

• Sensitivity to light or sound

• Loss of appetite

• Fatigue

• Numbness, tingling, or weakness

Warning signs that a migraine is coming include seeing stars or zigzag lines, having tunnel vision, or temporary blind spot.

Migraine headache may be diagnosed by your doctor based on your symptoms, history of migraines in the family, and your response to treatment. Your doctor will take a detailed history to make sure that your headaches are not due to tension, sinus inflammation, or a more serious underlying brain disorder. On physical examination, your doctor is likely to find nothing wrong with you.

Sometimes an MRI or CT scan is obtained to rule out other causes of headache like sinus inflammation or a brain mass. In the case of a complicated migraine, an EEG may be needed to exclude seizures. Rarely, a lumbar puncture (spinal tap) might be performed.

There is no specific cure for migraine headaches. The goal is to prevent symptoms by avoiding or altering triggers. When you do get migraine symptoms, try to treat them right away. The headache may be less severe.

When migraine symptoms begin:

• Rest in a quiet, darkened room.

• Drink fluids to avoid dehydration (especially if you have vomited).

• Try placing a cool cloth on your head.

Over-the-counter pain medications like acetaminophen, ibuprofen, or aspirin are often helpful, especially when your migraine is mild. If these don't help, ask your doctor about prescription medications.

Many of the prescription medications for migraines narrow your blood vessels. Therefore, these drugs should not be used if you have heart disease, unless specifically instructed by your doctor.

If you wish to consider an alternative, feverfew is a popular herb for migraines. Several studies, but not all, support using feverfew for treating migraines. If you are interested in trying feverfew, make sure your doctor approves. Also, know that herbal remedies sold in drugstores and health food stores are not regulated. Work with a trained herbalist when selecting herbs.

Call your doctor immediately if:

• Your headache pattern or intensity is different.

• Your headache gets worse when you lie down.

Also, call your doctor if:

• Previously effective treatments no longer help.

• Side effects from medication occurs (irregular heartbeat, pale or blue skin, extreme sleepiness, persistent cough, depression, fatigue, nausea, vomiting, diarrhea, constipation, stomach pain, cramps, dry mouth, extreme thirst, or others).

• You are likely to become pregnant. (Some medications should not be taken when pregnant.)

• Avoid smoking, caffeine, and alcohol.

• Exercise regularly.

• Get enough sleep each night.

• Learn to relax and reduce stress. Try progressive muscle relaxation (contracting and releasing muscles throughout your body), meditation, biofeedback, or joining a support group.