The word migraine comes from the Greek hemikrania. Hemi- means half and kranion means skull. If you take the he- off of hemikrania is shortens to mikrania. A migraine is a moderate to severe headache usually on one side of the head. However, migraine headaches can occur on different sides of the same migraine sufferer at different times. Migraine causes sharp pain that usually throbs and patients with migraine usually lose their appetite, feel nauseous and may vomit. Migraine often disrupts a migraine sufferer's life so greatly that she can not do anything but lie down.

          Most migraine sufferers are women who have a family history of migraine headaches. The migraine patient's mother , grandmother and siblings often have migraines. Migraine headaches can last from a few hours to a few days. Migraines strike some people about two or three times a year and others as often as twice a week or more.
In some patients migraine headaches are preceded by warning symptoms that tell the patient that the migraine headache is coming. These warning symptoms are called migraine aura. Migraine auras can be sensed as disturbances of vision such as flashes of light, blind spots (scotoma ), shooting stars, floating visual images or dizziness. An aura can be slurred speech, weakness, numbness, or tingling on one side of the tongue, face or body. Migraine auras can be experienced as gastrointestinal pain.

           Migraines preceded by an aura are called classic migraines. Migraines that are not preceded by an aura are called common migraines.

          To date, no medical test exists to diagnose migraine so the diagnosis of migraine headache is based on the migraine knowledge of the physician you visit. As a result, there is a high rate of mis-diagnosis of migraine headache. TMJ headache is located in the same area of the head as migraine so they are often confused.

          There are numerous patients who claim that a physician told them that they had migraine headaches; however, none of the migraine headache medications worked in reducing their pain. This is strange.

          TMJ headache hurts outside of the head and migraine hurts inside the migraine sufferer's head. Most physicians today do not perform a physical, hands on examination; they prefer to run tests or just ask questions. This may come from the fact that medical schools are currently eliminating human dissection and reducing the number of hours a medical student studies human anatomy. As a result, there can be confusion identifying all the structures in an area that may be causing a patient pain.

          Migraines are triggered by different things. Different migraine patients often have different migraine triggers. Some migraine triggers are:

               Certain foods such as chocolate, dairy products, citrus fruits, onions, nuts, beans, coffee, wheat, red wines, cheeses, saurekraut, drinks with alcohol, or fatty foods.
               Foods containing tyramine such as sour cream, yogurt, smoked fish, Chianti wine, pickled herring, aged cheeses and yeast extracts.
               Food additives such as nitrites used in luncheon meats and hot dogs, monosodium glutamate (MSG) used often in Chinese food, sulfites used to preserve produce and aspartame, an artificial sweetener in NutraSweet and Equal.
              Environmental irritations such as bright light (photophobia ), perfumes, strong odors, cigarette smoke, fluorescent lighting, air pollution, weather changes and loud sounds.
              Too much time between meals ( low blood sugar ), sleeping too long, and changes in hormone levels (some women get migraines during menstruation or during ovulation).
              Some medications such as blood vessel dilators ( such as nitroglycerin ), blood pressure reducing medications ( such as hydralazine and reserpine ), diuretics, asthma drugs ( such as aminophyline ) and over use of analgesics.
              Psychological stress,( however, the migraine headache may first begin during the let down period after the stress is gone ), irregular and disrupted sleep, fatigue, irregular eating, smoking

          Magnesium deficiency can be a cause of migraine headaches and other related symptoms in some patients.

           In allergic patients, the immune system over reacts to triggers in the air or in food. It is strange that migraine also has many different triggers much like allergies have many different triggers. Some medical authorities believe that migraine is a symptom of a hypersensitive nervous system that over reacts by tightening (constriction) and suddenly opening (dilation) the blood vessels in the head, neck or scalp when irritated by triggers. This triggers pain receptors in the area and the patient gets headache. Other authorities believe that migraine headache is caused by an abnormal release of neurochemicals, such as serotonin or noradrenaline, in the brain.

           It has been documented that allergies can badly distort a growing child's bite, face, and neck. However, many allergists are not alarmed by anatomical distortion and frequently argue when a patient with a severe dental malocclusion is sent to them for allergy therapy.

          Patients are not required to just have one problem at a time. They can have lots of problems all of which can interact to make it difficult to diagnose the cause. American physicians are often guilty of thinking simply and attributing causes only to onething. Proof of this is when a patient presents with pain in the side of the head, they almost always call it migraine. In fact, migraine is probably triggered by a combination of many different factors. If it was simple, we would have figured it out by now and there would be less migraine sufferers.

           Many patients with real migraine problems also have TMJ dysfunction problems. It is possible that in many migraine sufferers, a TMJ headache precedes and perhaps, triggers a migraine. Interestingly, the artery that dilates in a migraine enters the skull under a biting muscle.

          If you are a migraine sufferer, you must take complete responsibility for controlling your migraine problem. You spend all of your time with yourself so that only you are going to be identify all your migraine triggers. This can be done by keeping a detailed diary of what you are doing, where you go, and the things that you are around. When a migraine headache strikes, go back and carefully review your diary to find out what triggered your migraine. You can later confirm a migraine trigger by exposing yourself to a small amount of the suspected trigger to see if it causes a migraine. Once everything that triggers your migraine headaches is identified, carefully avoid these migraine triggers.
          Taking magnesium supplements with each meal can often help reduce migraine headaches.
          A natural herb called feverfew can help reduce migraine headaches. Feverfew stops the blood platelets from releasing an excessive amount of serotonin which can trigger a migraine headache.
           Exercise increases the circulation in all parts of the body and it releases endorphins, natural opiate substances that reduce pain and provide a person with a sense of well being. In some patients, exercise can abort the onset of a migraine.
          Over-the-counter ( OTC ) drugs are drugs that you can buy in a pharmacy without a prescription. You should always read the labels carefully and you should always determine what the active ingredient of the OTC is. Many analgesic manufacturers are designing analgesics specifically for migraine headaches. Excedrin Migraine is a product that was approved for this use. These over the counters can be effective if taken as soon a the migraine patient senses that a migraine is beginning.
Some over the counter drugs contain active ingredients that stop nausea and vomiting (anti-emetics ) and can reduce the aggravation of the migraine sufferer.
            Prescription migraine medications are eletriptan, nartriptan, rizatriptan, sumatriptan (Imitrex), zolmitriptan (Zomig), ergotamine tartrate - a vasocontrictor (Cafergot, Wigraine, Ergostat), isometheptene mucate combinations (Midrin, Isocom), and dihydroergotamine (DHE-45), naratriptan (Amerge), and a nasal spray of dihydroergotamine (Migranol). Many of these migraine drugs can be dangerous if used improperly so that prescription drugs for migraine should be reserved for patients who have frequent migraine headaches that disrupt their lives and who have carefully tried all of the methods for controling their migraine headaches.
            Many patients who take headache medicine more than a couple of days a week experience rebound headaches. Rebound headaches are when the migraine pain reappears as each dose of medicine wears off, leading migraine patients to take even more medicine.

           The word doctor comes from the latin word docerere, to teach. Your doctor is your teacher, but you are in charge of your own body. It is very important to seek medical help because your headache might be due to something serious, like a brain tumor. Your physician will rule out life threatening problems and then help you get down to the business of managing your migraine.
           Your first task is to identify all of your migraine triggers by keeping a detailed diary. Then you can test different thing to see if they trigger a migraine and once confirmed, you must avoid your triggers.
           Managing migraine requires lifestyle changes. You must become aware of what makes you healthy and what doesn't. Daily exercise strengthens your body. Your work and home situations should be modified to decrease your stress to as much as possible. You have to be in touch with yourself. Go to bed when you are tired and get regular sleep.
When necessary your doctor will help you by prescribing migraine medications. Work hard at keeping the use of these medicines to a minimum by identifying and avoiding your triggers,eating well, keeping healthy, and taking the supplements that you find help you.

           As a practicing dentist, I examine thousands of patients each year and I am interested in head and neck pain because it effects my patients. Many of my patients were incorrectly diagnosed with migraine headaches or were hospitalized to determine what was causing their headaches. In many cases, nothing was found.

         You are welcome to schedule a migraine headache consultation but be sure to schedule it with Dr. Padolsky and let our Appointment Manager know it is related to headaches.