patient notes
Migraine
.:.A migraine is more than a bad headache. It is an arrack that is usu- i:
.::
ally made up of many symptoms. Severe migraines knock sufferers
completely off their feet. Researchers think that a migraine begins
with electrical and chemical disturbances in the brain . These lead to
inflammation of blood vessels in the head, resulting in pain.
What are the symptoms of a migraine?
Migraine headaches usually begin as a dull ache, often in only one
side of the head. The pain gets worse and turns into pounding or
throbbing. Regular pain medications do little good, and movement
makes the pain worse. The headache often lasts for hours or days.
Often, some of these symptoms are also present: visual distur-
bances (blurring, sparkles, wavy lines of color or light, temporary loss
of vision--often occurring just before an arrack), nausea or vomiting
(and sometimes diarrhea), numbness or tingling in the fac:e or hand,
weakness and chills, extreme sensitivity to light, noise, or smells. Many people f;nd thQt
eel-to',n tr",sger Q
What causes migraines? migt'"a·.ne.
This is not clear. Migraines run in families and affect more women
than men. Many people find that certain things trigger a migraine:
• Some items in the diet, such as chocolate, aged cheese, nuts, MSG,
caffeine, red wine, artificial sweeteners
• Strong odors (perfumes, exhaust fumes, paint, smoke)
• Changes in the barometric pressure
• Fatigue, Stress, and sleep disturbances
• Hormonal fluctuations (use of oral contraceptives, pregnancy, men-
struation, menopause)
• Nitroglycerin, anti-inflammatories, and other drugs
What can I do for migraines?
Start by keeping a record of the date and time attacks begin and end,
accompanying symptoms, possible triggering factors (including whar
you ate), and any medications you tried and their effects. You and SomE" people Who have
your doctor may see a pattern and a trigger that you can avoid. and Severe
YouF doctor may prescribe a drug to relieve pain (an ergotamine m'1I3t""a',l1es .fl"otTl
preparation or a strong analgesic) or a drug ro narrow the blood ves- tak;ng prevenTIve
sels in the head when an attack is starting. You can often ease the pain
mec;f,cQt',on
by lying quietly in a dark room with cold packs around your head. This information is not a substitute
Some people who have frequent and severe migraines benefit from for medical treatment. Uses other
than photocopying for patients re-
raking preventive medication every day. Together, you and your doc-
quire written permission.
tor can choose the best treatment for your migraines.
238 POSTGRADUATE MEDICINE August 1995 C The McGraw-Hili Companies. Inc
HEADACHE-FREE
DIET*
"'Adapted from American Council for Headache
Education Tyramine Restricted Diet and Theisler CW:
Migraine Headache Disease: Diagnostic and Management
Strategies.Austintown:Aspen Publishers,Inc;1990, pp.lll-1l2.
Dawn Marcus, University of Pittsburgh
CATEGORY AVOID ALLOWED CHEMICAL
J.V[EATS Aged/cured meat: bacon, Beef Nitrates
bologna, chicken liver, Chicken Tyramine
ham, pepperoni,salami, Turkey
-
sausage. Fish
Marinated meat Eggs
Nuts: peanuts & peanut Deli Meats: roast turkey
butter; pumpkin, sesame breast, chicken roll, tuna.
& sunflower seeds.
Pickled herring
Snails I
DAlRY Buttermilk Cheese: American, Velveeta, Histamine
RiDened cheese: Bleu, cream, cottage, Ricotta Phenylethylamine
Brick, Cheddar Milk: whole, 2%, skim Tyramine
Emmentaler (Swiss), .' Yogurt (limit 112 cup/day)
Gruyere, Parmesan,
Provolone, Brie, Stilton,
Gouda.
Sour cream
FRUITS Avocados Apples Tyramine
Bananas Apricots
Figs Cherries
Kiwis Cranberries
Mangos Nectarines
Raisins Peaches
Papaya Pears
Plums Prunes
Strawberries Citrus fruits (1imit 112 cup/day)
VEGETABLES Avocados Artichoke Histamine
Beans: broad, [ava, Asparagus Tyramine
garbanzo, lentils, lima, Beets
navy, pinto, soy Broccoli
Corn Carrots
Eggplant Cauliflower
Olives Lettuce
Onions Peas
Pickles & food Potatoes
Sauerkraut Squash
Spinach String Beans
Snow peas Zucchini
Tomatoes
5.23
