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Migraine is a common neurologic disorder, affecting 36 million people in the United States. Migraine affects about 3 times more women than men. Research shows that migraine is more common than asthma and diabetes, combined. Migraine severity generally peaks between the ages of 25 and 55, though it is common for children to also suffer migraine attacks. Migraine tends to run in the family. Children are 40% more likely to suffer from migraine if one parent has migraine and 90% more likely to have migraine if both parents also have migraine. It is common for migraine sufferers to have 1-2 migraines per month with about 4% of migraine sufferers developing chronic daily headache; 15 or more headache days per month. A migraine can last between 4 and 72 hours. Greater than 90% of migraine sufferers are unable to work or function normally during a migraine.

Common Migraine Symptoms
• Visual disturbances
• Dizziness
• Nausea with or without vomiting
• Extreme sensitivity to lights, sounds, smells
• Tingling or numbness in the extremities or face
• 15-20% of migraine sufferers experience neurologic symptoms before the start of head pain

Common Migraine Triggers:

•Strong odors (perfume, gasoline)
•Caffeine or withdrawal of caffeine
•Skipping meals
•Changes in the weather
•Alteration in sleep (including sleep apnea)
•Stress or let-down from stress
•Changes in weather
•Exposure to bright light

Potential Food Triggers:

•Cured, deli and smoked meats
•Aged cheese
•Avocado, guacamole, bananas and dried fruit
•Alcohol, particularly beer and red wine
•Monosodium glutamate (MSG, think Chinese food!)
•Cold foods ("ice cream headache" is more common among migraine sufferers)



Preventative migraine treatment uses medications to reduce the number of migraines and lessen the severity of pain or associated symptoms. For some patients, life-style changes can help prevent migraine.
• Cardiovascular medications (beta-blockers and calcium channel blockers)
• Tricyclic antidepressants , SSRIs or SNRIs.
• Anti-seizure medications
• Botulinum toxin type A (Botox)

Complementary treatments for prevention of migraine can include biofeedback, relaxation techniques, exercise, proper rest and a healthy diet that avoids potential food triggers.


Acute migraine treatment includes medications for relief of symptoms as they occur.
• Over-the-counter pain relievers (Ibuprofen, Aleve, Tylenol, Excedrin Migraine, etc.)
• Triptans (Imitrex, Amerge, Maxalt, Zomig, Frova, Axert, Relpax, Treximet)
• Fioricet, Fiorinal

Natural Headache Preventatives
Researchers have studied the use of various minerals, herbs and vitamins for the treatment of migraine. Below is a list of natural headache treatments.
• Magnesium 400 mg/day (magnesium oxide or magnesium sulfate, not magnesium hydroxide)
• Petasites (Butterbur root) 75 mg twice daily
• Riboflavin (Vitamin B2) 400 mg / day
• Feverfew 50-82 mg / day
• Coenzyme Q10 (CoQ10) 150 mg twice daily
• Melatonin 3 mg at bedtime

Migrelief contains magnesium, riboflavin and feverfew.
Can be purchased at health food stores or at www.Migrelief.com

Medication Overuse
Sometimes called "rebound headache", medication overuse headache can occur when too much headache medication is used. Overuse can be defined as the use of over-the-counter pain relievers on 15 or more days per month for 3 months. For ergotamine, triptan or opioid medications, use on 10 or more days per month for 3 months meets the criteria for overuse. Acute pain medications should not be used more than 2-3 days per week.

Hormones & Migraines
Before puberty, migraine occurs in males and females at approximately the same rate. After puberty, females suffer from migraine at a much higher rate (3 times more females have migraines than males!). Menstrually-associated migraine begins at menarche for 33% of women. 60-70% of women with migraine have migraine associated with menses.

Female life events that can influence migraines:
• Menarche (start of monthly periods)
• Menses (some women notice increased migraine frequency or severity with their monthly period)
• Oral Contraception
• Pregnancy
• Lactation
• Menopause
• Hormone Replacement Therapy

Patient Resources

Recommended Reading
Heal Your Headache by David Buchholz
Conquering Headache by Alan Rapoport

American Headache Society

Headache Cooperative of New England

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99 Campus Avenue, Suite 402
Lewiston, ME 04240
Fax: 207-777-4458


Neurology Associates is managed by Liz Hebert.
To make an appointment or learn more about
Neurology Associates, please call 207-777-4455.

Migraine Expert
Melissa Hackett, BS, RN, FNP-BC
Migraine Expert
Melissa Hackett, BS, RN, FNP-BC

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