Migraine headache is a recurrent incapacitating neurovascular disorder characterized by attacks of debilitating pain. Migraine headache symptoms include photophobia (light sensitivity), phonophobia (sensitivity ot noise), nausea and vomiting. Migraine affects a substantial fraction of world population and is a major cause of disability in the work place.

Migraine Headache Treatment -- simple suggestions for natural Migraine relief or Migraine pPrevention
Wake up at the same time each morning.
Exercise at least 3 times a week. Exercise stimulates endorphins.
No smoking, no caffeine after 3 pm.
No artificial sweeteners, use stevia instead.
No MSG (monosodium glutamate).
Reduce or eliminate red wine, cheese, alcohol use, chocolate, and caffeine. These foods can sometimes trigger migraine headaches. For a healthy diet that can reduce your risk for migraine attacks, see diet.
Try a gluten free diet.

Nutrients and Herbs potentially helpful as natural migraine headache remedy
I am currently not aware of any herbs or supplements that are a migraine cure, but some of the following could help reduce the frequency or severity of migraine headaches and can be considered a migraine home remedy
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5-HTP may be helpful - 5-htp concerts into serotonin which influence migraine headache
Feverfew may help a small percentage of users. 1 capsule 3-4 x/day for one month, then decrease dosage to 25 mg of dried herb twice daily.
Petasites also known as butterbur. A product with a standardized extract of butter is called Petadolex and is available for sale.
Magnesium can sometimes reduces migraine severity when used for prevention
Melatonin is a pineal hormone that may reduce migraine headaches when used in the evenings.
Pine bark extract, vitamin C and vitamin E combination may be helpful. Eleven men and women with a long history of migraine who did not respond to several type of drugs, including beta-blockers, antidepressants and anticonvulsants, had fewer and less severe headaches, on average, after taking capsules containing an extract of pine bark, vitamin C and vitamin E every day for three months. In one study, doctors treated 12 patients to 10 capsules containing 120 mg pine bark extract, 60 mg vitamin C and 30 IU vitamin E every day for three months. The patients reported an average of 44 days of headache within a 90 day period before treatment, compared to 26 days during the three-month treatment. Before treatment, participants rated their headache severity, on average, as 7.5 out of 10; this fell to 5.5 out of 10 after treatment. Two patients showed no reduction in disability, headache severity or headache days after treatment. Headache, May 2006.

CoQ10 and Migraine
Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial.
Neurology. 2005 Feb 22;64(4):713-5. Headache and Pain Unit, Neurology Department, University Hospital Zurich, Frauenklinikstrasse 26, 8091 Zurich, Switzerland.
We compared CoQ10 (3 x 100 mg/day) and placebo in 42 migraine patients in a double-blind, randomized, placebo-controlled trial. CoQ10 was superior to placebo for attack-frequency, headache-days and days-with-nausea in the third treatment month and well tolerated; 50%-responder-rate for attack frequency was 14% for placebo and 47% for CoQ10 (number-needed-to-treat: 3). CoQ10 is efficacious and well tolerated.

Migraine relief - easing migraine pain
If you get a migraine, eest in a dark, quiet room with the lights out, apply a cool, damp rag or a cool compress to your forehead, firmly massage your scalp and apply pressure to your temples.

Migraine Cause
Though migraine headache causes are still unclear, three major theories proposed with regard to the mechanisms of migraine are vascular (due to cerebral vasodilatation), neurological (abnormal neurological firing which causes the spreading depression and migraine) and neurogenic dural inflammation (release of inflammatory neuropeptides). The modern understanding of the pathogenesis of migraine is based on the concept that it is a neurovascular disorder.
   Many people with nasal allergies suffer from migraine headaches as well. This suggests that the compound that causes allergy misery -- histamine -- may also be one of the factors involved in triggering migraines.
   People who get migraine headaches have structural differences in their brains particularly in the cortex area that processes pain and other sensory information from the body. It is unclear whether these structural brain differences actually cause migraines or are themselves caused by these recurrent headaches.

Migraine Cause - Obesity
The frequency and severity of painful migraine attacks increase as body weight increases, suggest results of a telephone interview study of nearly 3800 migraine sufferers. Overall, 50 percent of interviewees had a normal body mass index (BMI), the ratio of weight to height used to estimate obesity, whereas 30 percent were overweight, 10 percent were obese and 5 percent were morbidly obese. Only 3 percent of subjects were underweight. Sixty-five percent of those interviewed were women and the average age of participants was 38 years. No association was observed between BMI and the prevalence of migraine. However, as BMI increased, so did the frequency of migraine attacks. The percentage of subjects who reported severe migraines also increased with BMI group, from 53 percent in subjects of normal weight to 57 percent in the overweight group, 59 percent in the obese group and 65 percent in the morbidly obese group. A similar relationship was observed between BMI and migraine-related disability, light and sound sensitivity, which increased as weight increased.

Migraine Cause - Birth Control Pill and Migraine
Women who take oral contraceptives have increased chances of suffering from both migraines and non-migraine headaches. Some women have migraines during menstruation, when levels of estrogen drop. These women also are more likely to have migraines while taking oral contraceptives. Birth control pills can boost estrogen levels up to four-fold above normal, resulting in a particularly steep estrogen drop-off with menstruation.

Estrogen withdrawal as migraine cause
There is a relationship between fluctuations in estrogen levels during the menstrual cycle and the incidence of migraine. If timed correctly, transdermal estrogen therapy may prevent these migraines. Dr. Anne MacGregor from the City of London Migraine Clinic and UK colleagues studied 38 women (average age 43 years) with menstrual migraine and regular menstrual cycles. Over three menstrual cycles, the incidence of migraine peaked on the first full day of bleeding and on the preceding day, which correlated with a drop in estrogen levels. As estrogen levels began to rise, migraine incidence began to decline. In a second study with the same group of women, MacGregor's team confirmed that treatment with estrogen supplements, around the time the menstrual cycle begins, can reduce the severity and duration of menstrual migraine attacks. During six menstrual cycles, the women began treatment with an estrogen gel or placebo 10 days after day 1 of peak fertility and continued daily through the second full day of bleeding. Estrogen gel was associated with a 22-percent reduction in migraine days. Migraine attacks were also less severe and less likely to be associated with nausea. However, in the 5 days after estradiol was discontinued, migraine incidence increased by 40 percent, consistent with a delayed estrogen withdrawal. Neurology, December 26, 2006.

Migraine Headache Variants - Types of Migraine
There are many types of migraine. Abdominal migraine or cyclic vomiting syndrome (abdominal migraine): Patients have violent and sometimes prolonged episodes of vomiting. Attacks may be precipitated by stress, infections, or menses. Many of these individuals with abdominal migraine have prodromal symptoms including nausea, headache, fever, emotional withdrawal, lethargy, sleep pattern changes, and crying.

Ophthalmic migraine - Ocular Migraine
Other terms used are optical migraine - ocular migraine (sometimes misspelled as ocular migraine - eye migraine - visual migraine - optic migraine>
   Ocular migraines are characterized by abnormal visual sensations. They occur most often in people with a history of classic migraines. Ocular migraines are sometimes followed by head pain. Ophthalmologists are often the first physicians to evaluate patients with headaches, eye pain, and headache-associated visual disturbances. Although ophthalmic causes are sometimes diagnosed, most eye pain and many types of visual disturbances are neurologic in origin.

Retinal migraine
Retinal migraine is a primary headache disorder, clinically manifested by attacks of transient monocular visual loss associated with migraine headache. Although isolated reports suggest that retinal migraine is rare, it likely is under-recognized. Retinal migraine usually is reported in women of childbearing age who have a history of migraine with aura. It typically is characterized by negative monocular visual phenomena lasting less than 1 hour. More than half of reported cases with recurrent transient monocular visual loss subsequently experienced permanent monocular visual loss.
    
Hemiplegic Migraine
Hemiplegic migraine is defined by the occurrence during the attacks of unilateral weakness. This simple definition is however far from reflecting the wide range of clinical situations reported under this term. Familial hemiplegic migraine (FHM) is a well individualized autosomal dominant condition. Attacks start in childhood, adolescence, or early adulthood. They invariably include a unilateral weakness lasting 30 to 60 minutes and almost always associated with visual, sensory, or speech disturbances. They are occasionally very severe with a dense hemiplegia, confusion, coma or fever.

Menstrual migraine
Menstrual migraine occurs during the menses. Attacks of migraine occurring in a consistent relationship with menstruation can be classified as "pure" menstrual migraine if they occur at no other time of the month, and as "menstrually related" if other attacks occur throughout the month. It remains controversial whether such migraine pain attacks are longer, more severe or more difficult to treat than other attacks, but this form of migraine pain does lend itself to pre-emptive treatment because its timing and trigger can be anticipated.

Hormonal Migraine
During the reproductive years migraine is three times more common in women than in men. Although it is often assumed that this female preponderance is associated with the additional trigger of fluctuating sex hormones of the menstrual cycle, few studies have been undertaken to confirm or refute this. There is increasing evidence confirming an association between estrogen 'withdrawal' and attacks of migraine without aura, as well as evidence for an association between high estrogen states and attacks of migraine with aura.

Basilar migraine
Migraine with aura symptoms clearly originating from the brain stem or from both occipital lobes.

Botox and Migraine
The use of Botox for the prevention of migraine came about accidentally. Plastic surgeons have been using Botox to treat wrinkles for a few years. Several patients who also happened to have migraines reported that their migraines improved following the injection of Botox into forehead and brow muscles.

Medical Migraine Treatment -  Migraine prescription medication - Migraine medicine - Migraine Drugs
A patient with migraine needs acute treatment with migraine meds as early as possible when the attack occurs. The most frequently used drugs are non-steroidal anti-inflammatory drugs and triptans. Ergotamine is less and less used.
     The drugs used in the treatment of migraine either abolish the acute migraine headache or aim its prevention. The last decade has witnessed the advent of Sumatriptan and the 'triptan' class of 5-HT1B/1D receptor agonists which have well established efficacy in treating migraine. Currently prophylactic treatments for migraine include calcium channel blockers, 5-HT2 receptor antagonists, beta adrenoceptor blockers and gamma-amino butyric acid (GABA) agonists. Unfortunately, many of these treatments are non specific and not always effective. Despite such progress, in view of the complexity of the etiology of migraine, it still remains undiagnosed and available therapies are underused.
     Topamax (generic - Topiramate) migraine treatment can lead to a reduction in the frequency of migraine headaches. Topamax was originally introduced as a medication for treating epilepsy and, as with many other anticonvulsants such as Depakote and Tegretol, was found to be effective as a mood stabilizer for those with bipolar disorder. Migraine patients taking topiramate may experience disturbances in language.
     Treatment with the blood pressure drug olmesartan (sold as Benicar) reduces migraine in patients with high blood pressure (hypertension) or pre-hypertension. Olmesartan belongs to a class of drugs called angiotensin II receptor blockers (ARBs).
     The migraine medication zolmitriptan when administered as a nasal spray appears to be a treatment of acute cluster headache.
     The overuse of ergotamine increases the risk of cardiovascular complications, such as heart attack and stroke, among migraine patients who are taking drugs for cardiovascular disease. However, this effect was not seen with triptans, another class of drugs frequently prescribed for migraine.
   Other drugs sometimes used for migraine prophylaxis include beta blockers.

Overuse of Migraine Drugs
People with chronic migraines who overuse pain relievers may have abnormalities in certain hormonal responses. It's known that overusing migraine medications can sometimes cause periodic migraines to become chronic. Altered hormone regulation may be one reason. Though it's not clear why migraines sometimes become chronic, medication overuse has been considered a risk factor. Drugs used to treat migraine attacks -- including certain non-steroidal anti-inflammatory drugs (NSAIDs), ergot alkaloids and triptans -- may change the body's secretion of hormones such as growth hormone and the stress hormone cortisol.

Over the Counter Migraine Medications
The United States Food and Drug Administration granted in 1998 marketing clearance to Bristol-Myers Squibb’s Excedrin Migraine for the relief of migraine headache pain, a condition suffered by approximately 25 million Americans. Excedrin Migraine was the first migraine medication available to consumers without a prescription.

Migraine Study - Migraine and Mast Cells
Mast cells are critical players in allergic reactions, but they have also been shown to be important in immunity and recently also in inflammatory diseases, especially asthma. Migraines are episodic, typically unilateral, throbbing headaches that occur more frequently in patients with allergy and asthma implying involvement of meningeal and/or brain mast cells. These mast cells are located perivascularly, in close association with neurons especially in the dura, where they can be activated following trigeminal nerve, as well as cervical or sphenopalatine ganglion stimulation. Neuropeptides such as calcitonin gene-related peptide (CGRP), hemokinin A, neurotensin (NT), pituitary adenylate cyclase activating peptide (PACAP), and substance P (SP) activate mast cells leading to secretion of vasoactive, pro-inflammatory, and neurosensitizing mediators, thereby contributing to migraine pathogenesis.

Migraine is a genetically determined recurrent pain syndrome accompanied by neurological and gastrointestinal features, involving interaction of external triggers and internal pathophysiology and the cause of considerable disability to sufferers. A "stepped care" approach to management of acute migraine involves initial nonpharmacological methods followed by antiemetics and simple analgesics or nonsteroidal anti-inflammatory medications. Moderate episodes are treated with antiemetics and migraine specific medications. More severe migraines often require parenteral medications and sometimes intravenous fluids. Prophylaxis involves adoption of a chronic disease model, identifying and avoiding triggers and causative factors for migraine, nonpharmacological methods such as dietary modification and biofeedback, and for some patients, pharmacological prophylaxis.

Migraine and pregnancy
Migraine is common during pregnancy.  The greatest frequency of migraine attacks occurs during the first trimester. It is in the first trimester that the fetus is at greatest risk from abortifacient and teratogenic drugs, and when very early pregnancy may be undiagnosed. Ergot alkaloids (including methysergide) should be avoided during pregnancy because of their teratogenicity, and most other drug classes should be used only when unavoidable. The use of prophylactic agents during pregnancy should be the exception, not the rule, and preferably only during the second and third trimesters; propranolol is probably safest in this situation. Tylenol in small doses (acetaminophen) is the mainstay for the patient whose typical attacks continue into the first trimester. If acetaminopehn is insufficient, then partial agonist opioids may be used if typical migraine attacks persist in the second and third trimesters (which is uncommon).

Acupuncture and Migraine Help
Overall, the existing evidence supports the value of acupuncture for the treatment of headaches. However, the quality and amount of evidence are not fully convincing and the skill and talent of the acupuncturist can make a significant difference in the outcome.

Cluster migraine

Child migraine
Migraine is a chronic disorder that can be debilitating, especially when the attacks are severe and frequent. Children and adolescents are significantly affected. The prevalence of migraine in this age group is higher than predicted due to more recognition of the disease in this population throughout the past century. Severe chronic migraine can cause failure in academic work and may lead to depression. Multiple medications are used to break an acute attack. Most approaches are based on outpatient treatments and include the use of over-the-counter medications and triptans and narcotics.
     Children who have migraine with aura are at substantially increased risk of developing epilepsy.

silent migraine
atypical migraine
migraine headache medicine
menopause migraine

Herbal migrane remedy
A product that combines extracts of Tanacetum parthenium, commonly known as feverfew, with Salix alba, also called white willow, appears to be effective in reducing the frequency, severity and duration of migraine attacks. The herbal combination goes by the commercial name of Mig-RL and is marketed by Naturveda-VitroBio Research Institute, the French company that sponsored the study. In the study, Dr. R. Shrivastava, from Issoire, and colleagues enrolled 12 patients with migraine who were treated with Mig-RL for 12 weeks. Two Mig-RL capsules were given twice daily. Migraine frequency was reduced by 57 percent at 6 weeks and by 61 percent at 12 weeks in 9 of 10 patients. Seventy percent of the patients experienced a 50 percent or greater reduction in headache frequency.
Mig-RL therapy was also tied to improvements in quality of life and the medicine was well tolerated and not associated with any side effects. The encouraging results suggest that a larger, placebo-controlled randomized trial of Mig-RL is warranted, the authors conclude. Clinical Drug Investigation, May 2006.

Migraine Headache questions
Q. Can saw palmetto, tongkat ali or yohimbe cause migraine headache?
   A. It's possible that tongkat ali and yohimbe in high doses could cause headache, I am not sure if they would be classified as migraine headache. I doubt if saw palmetto causes headache.

Q. I have recently been prescribed “choline supplements” 350mg twice a day for prevention of migraines. Has any research been done to show if choline helps in the prevention of migraines? (Or if you recommend something else). I am having trouble finding any documentation on the effectiveness in choline as used for migraine prevention.
   A. We have not come across studies regarding choline and migraine headache.

Q. I was experiencing severe silent migraines w/ aura about every 2 months for 3 to 4 years, each lasting 20-30 minutes. So severe, I became dizzy and forced to lie down until they passed. I had an MRI and my Doctor found no evidence of TIA or stroke. At that time, I lived at an apartment complex in a ground-floor apartment; build on-slab (no basement). In August 2005, I moved to a house and the migraines stopped and I have never experienced another. I can think no reason (house vs. apartment) other than maybe RADON poisoning.
   A. We'll see if others email us a similar experience to determine whether radon was the cause or other changes that may have occurred, (diet, new restaurant, etc?) that may have influenced it. Radon may be a possibility but sometimes it is difficult to determine an exact cause. Indoor air quality problems or molds could be another possibility.

Q. Just wanted to let you know that I experienced something similar to the person describing migraines that ceased once he moved from an apartment to a house. For me, though, it was the reverse. In my case, the migraines began after we moved. Finally, after suffering for a few months, I realized that the windows in my house were staring directly into the sun in the afternoon. We live in a Southern State, where the sun can be quite fierce, even during the winter. After hanging darker curtains, my migraines ceased. Moral of the Story: When changing environments, check for potential triggers that weren't a problem before.

Q. I have read several studies, including one on your website, regarding the efficacy of a product called Mig-RL for the treatment of migraine headaches. However, doing a search for that product, or even the company which produces it, turns up nothing on the Internet. Can you tell me if Mig-RL is available for purchase in the United States?
   A. Mig-RL is a combination product of T. parthenium (feverfew) and Salix alba (white willow).

Q. As one whose experienced migraines since age 5 and have tried all sorts of natural remedies, I hope you keep tabs on the possible link between them and PFO (Science News issues April 7, 2007, and February 19, 2005) and the use of CGRP-receptor agonists in treating them (March 20, 2004). My migraine regimen (if interested): I currently use a loose protocol of OTC Excedrin Migraine taken with 1000mg Cal/500mg Mag at the first sign of a migraine. I also have a
ritual of taking a near-daily does of the ionic form of liquid mag and topical OTC USP progesterone cream. When I need to work during a migraine, sometimes OTC Gelstat (a sublingual form of feverfew and ginger) will temporarily suspend the migraine and/or ease the symptoms, but the effect only lasts a few hours. Both 5-HTP and a spritz of sublingual spray melatonin at night do not help. Both--esp. the melatonin--when taken after a very slight indication of an impending migraine--or after having experienced some migraine triggers--actually seem to hasten or trigger a migraine.

Q. I am a migraine patient for last many years. Zomitriptan 5 mg. works on my headache. I get major attacks if I eat fresh corn, corn starch, aged cheese, sour cream, cream cheese, banana, grapes, black raisins. My biggest attack was 6 weeks as I was unaware of it. I kept checking my eyes, teeth etc. I like banana milk shake so it was in my diet everyday.