What Happens During a Migraine Diagnosis?
A headache is the most commonly experienced neurological problem in adults. Migraine headaches are characterized by intense, pulsating pain on one side of the head with possible nausea and vomiting.
It has been suggested that migraine attacks occur due to a change in cerebral blood flow which causes nerve cells (neurons) to release chemicals (neurotransmitters). These chemical substances act as messengers between neurons; when they are released, they carry the signals across synapses.
Afterward, neurotransmitters must be removed from the space between neurons before they can be taken up again or broken down into other compounds.
Migraine diagnosis usually begins with taking a thorough history of the patient’s current attack and any previous episodes he/she may have experienced. There are many types of medications that can trigger headaches in sensitive individuals, including some used to reduce high blood pressure. If the patient is taking any prescription medications it may be helpful to communicate with the prescribing doctor about possible migraine-triggering effects.
A physical exam is commonly performed for all patients with migraines, which includes a basic assessment of the head and neck. Sometimes this may include an MRI brain scan or CT head/brain scan if there are concerns related to other medical conditions such as bleeding in the brain (intracranial hemorrhage). It has been suggested that migraines occur due to changes in cerebral blood flow which cause neurons within specific areas of the brainstem called “nuclei” to release chemicals that lead to pain and other symptoms.
Migraine diagnosis is usually based on the patient’s clinical history, after ruling out other disorders such as intracranial hemorrhage or transient ischemic attack (TIA). Although many types of medication can trigger headaches in sensitive individuals, including some used to reduce high blood pressure, diagnosing migraines only requires the use of a basic set of criteria:
The ICHD-3 beta defines a “probable migraine” if 4 or more of the following 12 features are present:
The ICHD-3 beta also defined 3 levels of “definite migraine”, depending upon whether additional information is available and whether the headache has fully resolved.
The ICHD-3 beta also proposed a new classification of “migraine equivalents” to better describe the many other kinds of recurrent headache disorders that may mimic migraine.
Treatment varies widely according to the frequency and severity of attacks experienced by the individual patient, some people only have one or two severe attacks per year while others suffer from headaches daily.
The most common medications used are opioids which are effective for severe pain but have significant side effects including nausea, vomiting, drowsiness, itching, dry mouth, and constipation. Recently botulinum toxin A has been tested successfully on some patients. There is evidence for various other pharmaceuticals such as triptans (Imitrex), dihydroergotamine (Migranal), DHE nasal spray, and naratriptan (Amerge).
What causes migraines in females:
Migraine headaches happen when the arteries in the brain dilate or open wider, causing more blood to circulate in these vessels. Magnesium is a mineral that is critical for electrical conduction in neurons, including those involved in triggering migraines. When magnesium levels are too low, neurons can be hyperexcitable leading to migraine.
Some researchers believe that low magnesium levels make it easier for the trigeminal nerve (the major pain pathway of the head) to send abnormal signals to other nerves and blood vessels, thus developing a migraine attack with increased inflammation and pain.
The many ways in which magnesium aids in pain reduction and migraine include:
Magnesium is a muscle relaxant that eases tight muscles. This occurs by inhibiting the N-methyl D-aspartate (NMDA) receptor, which is involved in transmitting nerve impulses to the brain.
Magnesium also inhibits the release of neurotransmitters from nerve endings which serve as signals for the transmission of pain throughout the nervous system. In addition, magnesium inhibits the activities of certain enzymes such as lipoxygenase and phospholipase A2, reducing inflammation that can cause headaches. All these actions of magnesium help reduce the pain of migraine.
Pre migraine symptoms:
A pre-migraine symptom is a condition that occurs before the migraine attack. Magnesium deficiency causes many of these symptoms. One study showed that migraine patients had significantly lower blood levels of magnesium than healthy controls. Low or depleted levels of magnesium may therefore be one explanation for the common pre-migraine symptoms such as mood changes, depression, and fatigue. 
Preventing migraines naturally:
The key to treating and preventing migraines with natural means is to avoid than treat dietary factors that contribute to low magnesium status and depletion: refined sugars, then alcohol, coffee/caffeine, and salt (in excess). These dietary factors deplete your body’s stores of magnesium, so eating regularly and including magnesium-rich foods in your diet can help prevent depletion.
Exercise is another way to avoid magnesium deficiency. Regular aerobic exercise increases the rate at which cells turn over, increasing magnesium use by up to 40%. Exercise also stimulates the kidneys to hold onto more magnesium. However, too much exercise can be harmful to migraine sufferers as it may increase the risk of triggering migraines.
Migraine triggers are conditions or situations that bring on a full-blown migraine attack. Common triggers include stress (either emotional or physical), lack of sleep, menstrual periods, smelly perfumes/scents, some medications (such as oral contraceptives), dehydration, or skipping meals. All these factors can lead to magnesium deficiency, which itself is a trigger for migraines. Therefore certain lifestyle changes are needed to prevent the triggering of migraines.
1) Avoiding known triggers can reduce the number of migraine attacks. Keeping a headache diary will help you identify your triggers and learn how to avoid them or minimize their impact.
2) Sticking to regular mealtimes, eating healthy balanced snacks throughout the day, staying hydrated (by drinking at least eight glasses of water daily), avoiding caffeinated drinks and alcohol altogether, and getting adequate sleep all to contribute to increased magnesium levels in the body. These dietary measures alone may be enough for some people.
3) Magnesium supplementation can help prevent migraines from occurring. It is safe and effective for both children and adults. However, a magnesium deficiency must first be identified either through a blood test or by identifying low dietary intake of magnesium rich-foods before supplementation begins.
4) During a migraine attack, certain supplements can help reduce pain and other symptoms. These include CoQ10 (100-200mg/day), feverfew (daily as needed), and butterbur (daily as needed). If the migraine is accompanied by nausea, vitamin B2 (riboflavin) can help relieve this symptom.