Migraine, tension and cluster type headaches are caused by electrical and chemical instability of certain brain centers. These centers regulate blood vessels around the head and the flow of pain messages to the brain. The body's chemical serotonin is thought to be responsible, but the exact mechanism is not well understood. The headache involves dilated, inflamed blood vessels and tight, aching muscles.

Those who suffer from migraine include 6% of males and 18% of females. Until puberty, migraines are equally common among boys and girls. Females are likely to have their most severe attacks during or just before their menstrual period, due to changes in estrogen. Half of those who have migraines have never been diagnosed. Many migraine sufferers (70-90%) have other family members who have been affected.

People have different experiences during a migraine attack. A "prodome" is a warning several hours or even a day before the attack. A prodome might include mood changes, fatigue, craving, or sensitivity to light or odors. Early in a migraine, 20% of sufferers experience an "aura" or changes in vision such as flashing lights or zigzag lines. This may precede the headache by 20-40 minutes. People can experiences these symptoms without developing a headache. This situation is referred to as an ocular migraine. With the headache, there is often nausea or vomiting, and/or sensitivity to light or noise. The pain is usually severe, throbbing and usually on one side of the head. Light-headedness and dizziness may accompany this pain. The migraine attack may last for hours or days. It usually worsens with activity and can be severe enough to interfere with normal activities.

Fatigue, hormone changes, and especially stress can predispose a person to migraines. The following items may act as "triggers" and set a migraine attack in motion: alcohol, especially red wine, nitrates in processed meats, MSG, NutraSweet, chocolate, aged cheese, whole milk, sour cream, ice cream, citrus, fruits, nuts, onions, peas, certain beans, pickles, sesame seeds, salty foods, yeast, excessive caffeine, lack of caffeine, eyestrain, bright lights, glare, loud noises, weather changes, missed meals, birth control pills and other medications, missed medications and other factors.

For migraine sufferers, a routine healthy diet along with nutritional supplementation, proper routine sleep habits and regular exercise is the best place to start. Whenever a migraine occurs, write down the possible stress triggers that you have been exposed to over the 2-4 hours before the prodome and up to 24 hours before the headache. After several episodes, you see some common elements that may be your triggers. There will probably be several, not just one. Once you know your triggers, you can avoid them, or at least moderate your exposure to them. Also if you can recognize your prodome early, you may be able to prevent the migraine with rest, aspirin or less medication than otherwise. Before starting long-term treatment, it might be beneficial to try to control migraines without medication. Caution should be used with over-the-counter medications such as aspirin and other pain relievers because extended use (greater than 2-3 times per week) can lead to rebound headaches.

Several medications are available that can be taken daily to prevent frequent migraine attacks. There are also medications to help manage the nausea and the pain once a migraine has started. The decision to treat migraine must be based on the frequency, the severity and the duration of the attacks. Your family physician should be consulted for pharmaceutical treatment.