Dr. Alexander Feldman is one of few specialists in Colorado with knowledge, training, and extensive experience in procedural treatment of chronic headaches/migraines including therapeutic Botox injections.
What is Migraine?
The pain of a migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. It is often accompanied by extreme sensitivity to light and sound, nausea, and vomiting. Migraine is three times more common in women than in men. Some individuals can predict the onset of a migraine because it is preceded by an “aura,” visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a number of different factors, including bright or flashing lights, lack of food or sleep, or exposure to light. Migraine in women often relates to changes in hormones and hormonal levels. Anxiety, stress, or relaxation after stress can also be triggers. For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine is caused by inherited abnormalities in genes that control the activities of certain cell populations in the brain.
Is there any treatment?
There are two ways to approach the treatment of migraine headache with drugs: prevent the attacks, or relieve the symptoms during the attacks. Everyone with migraine needs effective treatment at the time of the headaches. Many people with migraine use both approaches by taking medications originally developed for epilepsy, depression, or high blood pressure to prevent future attacks, and treating attacks when they happen with drugs called triptans that relieve pain and restore function. Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle. Stress management strategies, such as exercise, relaxation, biofeedback, and other therapies designed to help limit discomfort, may also reduce the occurrence and severity of migraine attacks. Lifestyle changes that can reduce or prevent migraine in some individuals includes avoiding food and beverages that trigger headaches, eating regularly scheduled meals with adequate hydration, stopping certain medications, and establishing a consistent sleep schedule. A weight loss program is recommended for obese individuals with migraine.
What is the prognosis?
Taking a combination of drugs to prevent and treat migraine attacks when they happen helps most people with migraine to limit the disabling effects of these headaches. Women whose migraine attacks occur in association with their menstrual cycle are likely to have fewer attacks and milder symptoms after menopause.
What research is being done?
Researchers believe that migraine is the result of fundamental neurological abnormalities caused by genetic mutations at work in the brain. Investigations of the more rare, familial subtypes of migraine are yielding information about specific genes and what they do, or don’t do, to cause the pain of migraine headache. Understanding the cascade of biological events that happen in the brain to cause a migraine, and the mechanisms that underlie these events, will give researchers opportunities to develop and test drugs that could prevent or interrupt a migraine attack.