Migraine Diagnosis

Your doctor will ask about your health history and your symptoms. It may help if
you have a diary of your symptoms and any triggers you’ve noticed. Write down:

 What symptoms you have, including where it hurts

 How often you have them
 How long they last
 Any other family members who have migraines
 All the medicines and supplements you take, even over-the-counter ones
 Other medicines you remember taking in the past

Your doctor may order tests to rule out other things that could cause your
symptoms, including:

 Blood tests
 Imaging tests like MRI or CT scans
 Electroencephalogram (EEG)

Migraine Treatment and Home Remedies

There's no cure for migraine headaches. But many drugs can treat or even prevent
them. Common migraine treatments include:

 Pain relief. Over-the-counter (OTC) drugs often work well. The main

ingredients are acetaminophen, aspirin, caffeine, and ibuprofen. Never
give aspirin to anyone under the age of 19 because of the risk of Reye’s
syndrome. Be careful when you take OTC pain meds, because they might
also add to a headache. If you use them too much, you can get rebound
headaches or become dependent on them. If you take any OTC pain
relievers more than 2 days a week, talk to your doctor about prescription
drugs that may work better.
 Nausea medicine. Your doctor can prescribe medication if you get nausea
with your migraine.
 Triptans. These drugs balance the chemicals in your brain. You might get a
pill to swallow, tablets you dissolve on your tongue, a nasal spray, or a shot.
Examples
include almotriptan (Axert), eletriptan (Relpax), sumatriptan (Imitrex), rizat
riptan (Maxalt), and zolmitriptan (Zomig).
 Ergotamine. This also works on the chemicals in your brain.
 Lasmiditan (Reyvow). This drug eases pain, nausea, and sensitivity to light
or sound.
  CGRP receptor antagonists. Your doctor might give you rimegepant
(Nurtec) or ubrogepant (Ubrelvy) if other treatments don’t help.
 Preventive medicines. If other treatments don’t work and you have four or
more migraine days a month, your doctor may suggest these. You take them
regularly to make your headaches less severe or frequent. They
include seizure medicines, blood pressure medicines (like beta-blockers and
calcium channel blockers), some antidepressants, and shots of botulinum
toxin type A (Botox). CGRP antagonists such as eptinezumab (Vyepti),
erenumab (Aimovig), fremanezumab (Ajovy),
and galcanezumab (Emgality) can also prevent migraines.
 Transcranial magnetic stimulation (TMS). You place this device on the
back of your head at the start of a migraine with aura. It sends a pulse of
magnetic energy to part of your brain, which may stop or reduce pain.

Home remedies
You may ease migraine symptoms by:

 Resting with your eyes closed in a dark, quiet room

 Putting a cool compress or ice pack on your forehead
 Drinking plenty of liquids

Complementary and alternative treatments

Some people get relief with therapies they use in addition to or instead of
traditional medical treatment. These are called complementary or alternative
treatments. For migraine, they include:

 Biofeedback. This method helps you take note of stressful situations that

could trigger symptoms. If the headache begins slowly, biofeedback can
stop the attack before it becomes full-blown.
 Cognitive behavioral therapy (CBT). A specialist can teach you how
actions and thoughts affect how you sense pain.
 Supplements. Research has found that some vitamins, minerals, and herbs
can prevent or treat migraines. These include riboflavin, coenzyme Q10,
and melatonin. Butterbur may head off migraines, but it can also affect
your liver enzymes.
 Body work. Physical treatments
like chiropractic, massage, acupressure, acupuncture, and craniosacral
therapy might ease headache symptoms.

Talk to your doctor before trying any complementary or alternative treatments.

Migraine Prevention
Try these steps to prevent symptoms:

 Identify and avoid triggers. Keep track of your symptom patterns in a diary
so you can figure out what’s causing them.
 Manage stress. Relaxation techniques like meditation, yoga, and
mindful breathing can help.
 Eat on a regular schedule.
 Drink lots of fluids.
 Get plenty of rest.
 Get regular moderate exercise.
 Ask your doctor about preventive medicines if you get migraines around
your period or if lifestyle changes don’t help.

Some new devices can also prevent migraines. Cefaly is a headband-like gadget
that sends electrical pulses through the skin of your forehead. It affects your
trigeminal nerve, which is linked with migraine headaches. You use Cefaly once a
day for 20 minutes. When it's on, you'll feel a tingling or massaging sensation.
Another stimulator, gammaCore, sends out a mild electrical signal to the fibers of
the vagus nerve in your neck to relieve pain.