Dr. Manoj Khanal is one of the Best Migraine specialist in North Delhi

With an Experience of 15+ years, Dr. Khanal offers treatment for Parkinson, Epilepsy, Headache & Migraine, Trigeminal Neuralgia, Brain Stroke, Alzheimer’s, Bell’s Palsy, and other neurological disorders.

What is a migraine and how is migraine treated?

A migraine is a headache that can cause severe throbbing pain or a pulsing sensation, usually on one side of the head. It’s often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities. The right migraine treatment should be sought after if you have been diagnosed with migraine.

For some people, a warning symptom known as an aura occurs before or with the headache. An aura can include visual disturbances, such as flashes of light or blind spots, or other disturbances, such as tingling on one side of the face or in an arm or leg and difficulty speaking.

Medications can help prevent some migraines and make them less painful. The right medicines, combined with self-help remedies and lifestyle changes, might help.

What causes migraine attacks?

Researchers haven’t identified a definitive cause for migraine. But they still believe the condition is due to “abnormal” brain activity that affects nerve signaling, and chemicals and blood vessels in the brain. Right migraine treatment is essential to avoid any kind of migraine attacks.

There are also many migraine triggers that are continually reported, including:

bright lights
severe heat, or other extremes in weather
dehydration
changes in barometric pressure
hormone changes in people assigned female at birth, like estrogen and progesterone fluctuations during menstruation, pregnancy, or menopause
excess stress
loud sounds
intense physical activity
skipping meals
changes in sleep patterns
use of certain medications, like oral contraceptives or nitroglycerin
unusual smells
certain foods
smoking
alcohol use
traveling

If you experience a migraine attack, your doctor may ask you to keep a headache journal. Writing down what you were doing, what foods you ate, and what medications you took before your migraine attack began can help identify your triggers.

Migraine treatment

Migraine can’t be cured, but your doctor can help you manage migraine attacks by giving you the tools to treat symptoms when they occur, which may lead to fewer attacks in general. Treatment can also help make migraine less severe.

Your treatment plan depends on:

your age
how often you have migraines attacks
the type of migraine you have
how severe they are — based on how long they last, how much pain you have, and how often they keep you from going to school or work
whether they include nausea or vomiting, as well as other symptoms
other health conditions you may have and other medications you may take

Your treatment plan may include a combination of:

lifestyle adjustments, including stress management and avoiding migraine triggers
OTC pain or migraine medications, like Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen (Tylenol)
prescription migraine medications that you take every day to help prevent migraine headaches and reduce how often you have headaches
prescription migraine medications that you take as soon as an attack starts to keep it from becoming severe and to ease symptoms
prescription medications to help with nausea or vomiting
hormone therapy if migraines seem to occur in relation to your menstrual cycle
counseling
alternative care, which may include meditation, acupressure, or acupuncture

If you need help finding a primary care doctor, then check out our FindCare tool here.

Medication

Medications can be used to either prevent a migraine attack from happening or treat it once it occurs. You may be able to get relief with OTC medication. But if OTC medications aren’t effective, your doctor may decide to prescribe other medications.

The severity of your migraine and any other health conditions you have will determine which treatment is right for you.

Acute medications — taken as soon as you suspect a migraine attack is coming — include:

NSAIDs: These medications, like ibuprofen or aspirin, are typically used in mild-to-moderate attacks that don’t include nausea or vomiting.
Triptans: These medications, like sumatriptan, eletriptan, and rizatriptan, are typically the first line of defense for individuals who have nerve pain as a symptom of their migraine attacks.
Antiemetics: These medications, like metoclopramide, chlorpromazine, and prochlorperazine, are typically used with NSAIDs to help decrease nausea.
Ergot alkaloids: These medications, like Migranal and Ergomar, aren’t prescribed that often and are usually reserved for individuals who don’t respond to triptans or analgesics.

Preventative medications — prescribed to people whose migraine attacks can be debilitating or happen more than four times a month — are taken once a day, or every 3 months via injection. These medications include:

Antihypertensives: These drugs are prescribed for high blood pressure and can also help with migraine attacks. Beta-blockers and angiotensin receptor blockers (candesartan) are some examples of antihypertensive drugs used for migraine prevention.
Anticonvulsants: Certain anti-seizure medications may also be able to prevent migraine attacks.
Antidepressants: Some antidepressants, like amitriptyline and venlafaxine, may also be able to prevent migraine attacks.
Botox: Botox injections are administered to the head and neck muscles every 3 months.
Calcitonin gene-related peptide treatments: These treatments are administered either via injection or through an IV and work to prevent a migraine attack from developing.
Migraine triggers

While migraine attack triggers can be very personal, certain foods or food ingredients may be more likely to trigger an attack than others. These may include:

alcohol or caffeinated drinks food additives, like nitrates (a preservative in cured meats), aspartame (an artificial sugar), or monosodium glutamate (MSG) tyramine, which occurs naturally in some foods

Tyramine also increases when foods are fermented or aged. These include foods like some aged cheeses, sauerkraut, and soy sauce. But ongoing research is looking more closely at the role of tyramine in migraines, as it may not be as big of a trigger as previously thought.

Other migraine attack triggers can be varied and seem random:

hormone triggers in people assigned female at birth
stress
anxiety
excitement
poor sleep quality
strenuous exercise (if you don’t do it often)
bright lights
changes in climate
hormone replacement therapy drugs

Dr Manoj Khanal is considered as the best neurologist for migraine treatment.