About 18 percent of women [in the U.S.] and 6 percent of men have migraines. No one is exactly sure why. The brains of men and women are different in terms of hormonal exposures and probably that affects the wiring of the brain. So, partly it is because women have menstrual cycles, but in general, men's and women's brains are just a little different and that may contribute to why more women have migraines.
Migraines often start in women just before menstruation and can stop after menopause and can get better during pregnancy.
Do children have migraines?
Migraines have been recognized in children down to about age 3. They may not be recognized until they have been having them for some time because the child cannot articulate what is wrong. A child may not hold his head, he may just vomit or have a bellyache or be very sick. And when they hit 10 or 11 you realize, "Oh, they have been having migraines." Before adolescence, migraines are evenly divided between girls and boys.
When should you consult a doctor?
More than 90 percent of people who go to the doctor thinking that they have recurring tension headaches or sinusitis are wrong and have migraines.
There is no hard call, though, about who goes to the doctor: We have patients who tough it out, and we have patients who come after their first one.
If the headaches are of sufficient intensity or frequency, or if they are interfering with life, then go see a doctor.
You often hear about "auras" accompanying migraines. What is an aura?
About 25 percent of all patients have some neurological symptoms before a headache - most frequently, sparkling light, or patchy blind spots. Some patients will have creeping neurological symptoms across the skin. Rarely the symptoms will be scary such as a patient having trouble speaking or getting confused.
Some people get many auras, but few headaches. In some, every single aura comes with a headache.
How are migraines diagnosed?
There is no test for migraines, only tests for other things that cause headaches. If the patient meets the definition of [migraine] symptoms and the patient otherwise looks normal neurologically, then we say it is a migraine by definition.
How are migraines treated?
The treatment consists of three parts: Lifestyle modification, medication to be given before a headache, and medication that prevents the headaches.
