What does a migraine headache feel like?
Everyone gets a headache from time to time, but migraine headaches are different. They are a lot more than just a bad headache. Migraine is a complex medical condition that has many different features. These headaches can occur repeatedly on a daily, weekly, or monthly basis. There may a pattern to the attacks--for example, teenage girls may tend to have a migraine headache at particular times in their monthly menstrual cycle.

In addition, migraine headaches generally have some of the following symptoms:

• A warning sign called an "aura" may start before the headache. These auras can include blurry vision, seeing zigzag lines, flashing lights, stars or colored spots, experiencing strange tastes, or numbness or tingling sensations in the arm or on the side of the face. This aura may begin hours or even days in advance of the headache. In teenagers and young adults, however, most migraine headaches develop suddenly without warning.
• The headache pain usually starts off only on one side of the head. This may vary from headache to headache. Less often the headache may start in the front or in both temples.
• The pain is throbbing and pounding rather than steady, and the pain can last for hours (or rarely for days).
• The pain is made worse by physical activity, such as running or climbing stairs. The discomfort is so severe that is difficult or even impossible for you to continue with your normal activities.
• Migraine headaches may be accompanied by nausea, stomach pain or vomiting.
• During a migraine headache, light appears much brighter than normal and sounds seem to be much louder than normal.
• You may become dizzy and develop a numb or tingling feeling in your fingers or toes.
• You may learn that other members of your family have had migraine headaches. An estimated three fourths of teens who have migraines have a family history for these headaches.

Why do I get migraine headaches?
Good question! Unfortunately, the exact cause of migraine is still unknown. The latest thinking is that if you suffer from migraine, the blood vessels of your brain and scalp are more sensitive to the chemicals that cause brain blood vessels to constrict (get smaller) and dilate (enlarge). When there are not enough of these chemicals in the brain, the blood vessels may constrict (cutting off the blood supply to that part of the brain, causing the "aura" symptoms) and then enlarge, producing severe pain from stretching. Because the brain controls its blood vessels in separate sections, most migraine sufferers experience pain only on the left or right side of the head. The pain is throbbing since the blood vessels pulsate with each heartbeat. Exciting developments for identifying the true cause of migraines are on the horizon.

What brings on my migraines?
Certain foods, beverages or situations may bring on a migraine headache. It is well worth trying to figure out what might trigger your particular headaches. Any of the following are thought to trigger some migraine headaches, but the specific triggers vary with each individual:

• Eating and drinking the wrong thing can provoke a migraine headache in susceptible teens. Food chemicals such as tyramine and nitrates are thought to be involved. The most common food offenders include cheese, nuts, chocolate, red wine, alcoholic beverages, hot dogs and luncheon meats, citrus fruits, strawberries, tomatoes, potatoes, homemade bread, pizza, some sea foods, fried foods, aspartame (NutraSweet), and saccharin. Another chemical to watch for is the additive MSG (found in Chinese food and salad bars).
• Missed meals
• Rapid changes in blood sugar level
• Fatigue or irregular sleep patterns
• Stress is a significant trigger for many adolescents
• Rapid changes in hormone levels
• Rapid changes in weather
• Head cold or sinus congestion
• Increased physical exertion
• Dehydration and fluid loss
• Excessive exposure to fluorescent lighting

What should I do if my headaches sound like migraine?
Tell your parents! Repeat: tell your parents! They probably already know that something is wrong because you probably have not been acting like yourself. Do not try to diagnosis migraine yourself since there are other causes of headaches and the treatment for each is different.

You should be checked by your doctor for any of the following:

• You feel it is the worst headache of your life
• Along with the headache, you have a fever and a stiff neck
• Your headaches begin after, or are caused by, head injury, exertion, coughing, or bending
• Your headache is worse the first thing in the morning
• The headache wakes you up from sleep
• You have vomiting along with your headache
• Your headache is so severe that you require bed rest
• Your headache pain doesn't go away within 48 hours
• Your headaches are becoming more frequent or more painful

Don't be worried if the doctor orders blood tests and head x-rays or has you go see a specialist (neurologist) for an examination. Your physician just wants to make sure that everything is okay!

How are migraine headaches treated?
There are two ways doctors treat migraine headaches. The first is to try to prevent the headache by asking you to become a medical detective who determines what might be triggering your headaches. The doctor will need your help and might ask you to keep a headache diary. You will write down when the headaches are occurring and what you were doing before it started. What were you eating? How much sleep are you getting? Are you under any unusual stress at school? Often, you and your doctor will be able to discover the cause, and by avoiding the triggers you can prevent the headaches. Then you will not have to take any medication. The second approach is medication to relieve the headache. Treatment can include various medicines both for the acute headache and also to prevent the headaches. Effective new medicines are available, but this decision is best left up to your doctor.

If you do suffer from migraines, remember not to skip meals and to get adequate rest and sleep. Drink plenty of non-caffeinated fluids. Learning to unwind and relax is very important in preventing attacks since tension and stress often trigger migraines. Plan and schedule your activities sensibly. Try to avoid overcrowded schedules and potentially upsetting situations. Eliminate those foods that seem to trigger the headache, but remember that everyone is different, so your triggers may be different from someone else. A regular daily schedule (get up at the same time, eat at the same time, exercise at the same time - even on weekends) is one of the most helpful things you can do.

The "bad" news is that migraine headaches can spoil your plans, cause you to miss school and take some of the fun out of being a teenager. The "good" news is that they are not life threatening and can be successfully treated, and often completely avoided, with today's therapies.