When to See a Neurologist

Your head hurts, but is the pain from a common tension headache or could it be a migraine? Migraines are fairly common, with 12 percent of adults in the U.S. experiencing them. 

What are Migraines?

Migraines are recurring headaches that can be moderate or severe and may affect one side of the head. If you have a migraine, your head may feel as if it is throbbing. You may feel nauseous or sensitive to lights, sounds or smells. Migraines can also be long-lasting, lingering from a few hours to a few days.

Several types of migraines can occur, including migraine with aura, migraine without aura, and migraine without headache. 

Migraines have four stages, although you may not go through every stage every time.

• Prodrome—occurs up to 24 hours before the headache begins. Symptoms can be subtle and include food cravings, unexplained yawning, mood changes, and increased urination.
• Aura—about 25 percent of people who have migraines also have auras, which include changes in vision, such as seeing wavy lines or black dots; numbness on one side of the body or difficulty speaking. Auras can last ten to thirty minutes and occur shortly before or during a migraine.
• Headache—the pain may start gradually and then escalate, becoming worse with movement.
• Postdrome—occurs during the day after the headache is over. You may feel tired and weak.

Causes of Migraines

Family history of migraines is the greatest risk factor. But certain factors can trigger the onset of a migraine. The American Headache Society lists some of the typical triggers as:

• Aged cheese
• Alcohol
• Chocolate
• Citrus Fruits
• Cured Meat
• Dehydration
• Excess caffeine
• Excessive exercise
• Eyestrain or other visual triggers
• Fatigue
• Menstruation
• NutraSweet
• Nuts
• Salty foods
• Sleep deprivation
• Skipped meals
• Stress

Diagnosing and Treating Migraines

The occasional migraine is not necessarily a cause for concern, but if the severity or frequency of your headache interferes with your lifestyle, work or ability to function, it’s time to see your primary care physician. If you have more than 15 headaches per month, your doctor will likely refer you to a neurologist—a specialist who focuses on diagnosing and treating conditions in the nervous system. 

To diagnose a migraine, your doctor will ask about your symptoms and triggers. Prior to your appointment, begin keeping a journal of your headaches. When do they occur? How long do they last? What have you eaten or what activity were you involved in before the migraine started? If you’re a woman, where are you in your menstrual cycle—this is a common trigger. What have you tried to relieve the headache? What worked or didn’t work? By detailing this information, you and your doctor may be able to identify trends that contribute to your headache pain.

Migraines cannot be cured but they can be treated. Over the counter medicines like Tylenol, Motrin, Aleve or Excedrin Migraine are good places to start. If these medicines aren’t effective, your doctor may give you a prescription for other medicines to get the migraines under control. In addition to medicines, taking riboflavin, melatonin and magnesium can help with headaches. Lifestyle changes such as incorporating relaxation techniques, maintaining a good diet and getting eight to ten hours of sleep each night can also help reduce the frequency of migraines.

Migraines can be temporarily debilitating, but by working with a neurologist or primary care physician to recognize the symptoms and triggers and then developing a treatment plan, you can reduce the frequency and severity of a full migraine attack.