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A migraine- a word that is thrown around a lot in modern society but this is something more than just a typical headache. The frustrating thing about this disease from a medical perspective is there are a lot of underlying physiological factors that can lead to the manifestation of the symptoms. Changes in weather, ovulation cycles, stress from work or lack of sleep are all possible trigger events that can lead to a migraine.

Migraines are part of a spectrum of diseases in medicine terms "great imitators." Other diseases like this would include thyroid disorders, syphilis, and AIDS. Although not nearly the same level of severity as these other dangerous conditions, migraines are termed to be great imitators because patients can present with an abundance of symptoms that can be different every time. 

You can start to expect that you may be having a migraine if you notice that the pain is localized to one side of your head. Even if it starts on one side of your head, most migraines evolve so both halves of your head are involved. This will generally be around your forehead or your ears. There will also be an intense pain associated with the onset and patients find the most relief when they avoid loud noises and find a dark, quiet room to fight it out. In some cases, patients will notice "flashing lights"  or "ringing in their ears" called auras and it acts as a precursor for a migraine to follow. Because there could be rapid changes in blood pressure as well, many patients will feel dizzy, fatigue and even tachycardic. If blood pressure becomes too low, our heart naturally responds by pumping faster to make sure that we have sufficient blood delivered throughout our bodies. These symptoms will typically resolve within a few hours but it is possible to have these complaints that will last multiple days. [1]

Migraines are a common occurrence in our population and are most common in patients between 12 and 65 years old. Women are much more likely to suffer from migraines than men, and their symptoms are more numerous and severe in most cases. In a study of over 2,000 patients that suffered from chronic headaches, researchers determined that only 38 percent of women and 26 percent of men did have a migraine episode. [2]

Once you start to notice these symptoms, the next step is to meet a neurologist to help make the diagnosis: imaging studies are also clean, and patients can have completely normal lab values; a detailed past medical history is the only way to get closer to a migraine diagnosis.

Patients can do their part as well. They should keep a detailed history of all the symptoms, the time of the month and note any changes in weather or increased stress at work to become better at identifying their specific risk factors. Patients need to have five episodes of these advanced headaches to begin to assume it was a migraine. 

Migraines are self-limited, but there are ways that you can help manage these symptoms. Preventive and abortive medications are utilized to reduce the frequency of a migraine headache. Beta blockers are the first-line therapy but responses are specific to each patient so it important to have frequent contact with your neurologist as you try to determine an effective management plan to live with your migraines. Patients are also encouraged to reduce stress, get adequate sleep and investigate if menstruation cycles or weather patterns lead to their migraines to anticipate when preventative therapy may be warranted. 

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