|Also Listed As:
Migraines are severe, recurrent headaches that are generally accompanied by
other symptoms such as visual disturbances or nausea. There are two types of
migraine - classic and common. A classic migraine has
an "aura" or warning associated with it that precedes the headache. The aura is
often a visual disturbance (like seeing stars or zigzag lines or a temporary
blind spot.) A common migraine does not have such a warning before the head pain
begins. The experience of migraines, which affect 6 out of 100 people, tend to
start between the ages of 10 and 46. More women than men have
|Signs and Symptoms|
The headache from a migraine, classic or common, has the following
- Throbbing, pounding, or pulsating pain
- Often, begins on one side of your head and may spread to both or stay
- Most intense pain is often concentrated around the temple(s) (side of
- Commonly lasts from 6 to 48 hours
Accompanying symptoms that may precede or occur at the same time as the
- Nausea and vomiting
- Dizziness described as lightheadedness or even vertigo (feeling like
the room is spinning)
- Loss of appetite
- Visual disturbances, like seeing flashing lights or zigzag lines,
temporary blind spots (for example, loss of your peripheral vision), or blurred
- Eye pain
- Extreme sensitivitity to light (called photophobia)
- Parts of your body may feel numb, weak, or tingly
- Light, noise, and movement—especially bending
over—make your head hurt worse; you want to lie down in
a dark, quiet room
Symptoms that may linger even after the migraine has
- Feeling mentally dull, like your thinking is not clear or sharp
- Increased need for sleep
- Neck pain
The symptoms of migraines occur as a result of changes in the diameter of
blood vessels to the brain and surrounding structures. Initially, the blood
vessles constrict (narrow), reducing blood flow to these areas and leading to
visual disturbances, difficulty speaking, weakness, numbness, or tingling
sensation in one area of the body, or other similar symptoms. When these
symptoms start before the actual headache (as in classical migraine), it is
called an aura. Minutes to hours later, the blood vessels dilate (enlarge)
leading to increased blood flow and a severe headache. Things that can trigger
migraine (that is, the change in the diameter of blood vessels) include the
- Low blood sugar from, for example, missing meals
- Certain foods such as those containing the amino acid tyramine (found
in red wine, aged cheese, smoked fish, chicken livers, figs, and some beans),
chocolate, nuts, peanut butter, some fruits (like avocado, banana, and citrus),
foods with monosodium glutamate (MSG - an additive in
many foods), onions, dairy products, meats containing nitrates (bacon, hot dogs,
salami, cured meats) fermented or pickled foods
- Fluctuations in hormones (for example, menstruation)
- Certain odors, such as perfume
- Allergic reaction
- Bright lights
- Loud noises
- Stress, physical or emotional (often, the headache occurs during the
period of relaxation just following a particularly stressful time)
- Sleeping too little or too much
- Smoking or exposure to tobacco smoke
- Prolonged muscle tension (for example, from a tension headache can
lead to a mixed migraine-tension headache)
- Women are more likely to get migraines than men
- Having other family members with migraine headaches
- Use of birth control pills, especially if you also smoke or have high
- Being under age 40; after that point, the likelihood of migraine
declines for both men and women
- Exposure and sensitivity to any of the potential triggers listed above
When you see your health care provider, he or she will take a detailed
history in order to distinguish migraine headaches from other types of
headaches, such as tension or sinus. Sometimes, headaches are a combination,
like mixed migraine and tension. Your health care provider will ask questions
about when your headaches occur, how long they last, how frequently they come
on, the location of the pain, and any symptoms that accompany or precede the
headaches. Sometimes it helps to keep a diary about your headaches prior to
seeing the doctor; this way, you'll have an accurate recording of how often they
happen and you won't forget the details related to your headaces. (See
Lifestyle section for what information to
include in a diary.)
When you do see your physician, the physical exam will include assessing your
head, neck, eyes, and sinuses as well as performance of a neurologic
examination. Don't be surprised if the doctor asks you some questions to test
your short term memory. On exam, the physician is likely to find nothing wrong.
Tests that your doctor may order, depending on your symptoms and exam,
- CT scan or MRI to look for a mass or other brain disorder or to check
- Xray of the neck to look for arthritis or spinal problems; xray of the
sinuses to look for sinusitis
- Electroencephalogram (EEG) - a brain wave
study , looking for any seizure activity
- Lumbar puncture
You should contact your physician right away if any of the following
- You have unusual neurologic symptoms that you have not experienced
before like speech disturbance, change in vision, loss of balance, or difficulty
moving a limb.
- Your headache pattern or intensity is different
- You are experiencing "the worst headache of your life"
- Your headache worsens when you are lying down
These may indicate a stroke, a bleed in the brain, or other serious condition
that warrants immediate attention and evaluation.
There is no specific cure for migraine headaches. The treatment is geared
toward preventing such symptoms by avoiding or altering triggers. Once migraine
symptoms begin, however, treatment is aimed at preventing the headache pain if
you have an aura (namely, associated symptoms that precede the headache) or
treating the head pain once it has set in. There are a number of ways to
accomplish all three of these - reduce the number and
intensity of your headaches, quickly abort the onset of a headache by treating
the migraine at the time of the aura, or successfully diminish the head pain
once you have it.
A combination of
medications for symptom relief together
lifestyle change and complementary
therapies to reduce recurrence can offer effective management of migraines.
Mind/Body Medicine) may help to
control the initial contraction of blood vessels and stress management may
reduce both the frequency and intensity of attacks. Whenever possible,
preventing migraines should be done without the use of medication. The treatment
of migraines when the symptoms set in almost always requires medication,
Keeping a headache diary, particularly when you first begin to experience
migraines, can help identify the triggers for your headaches and how to modify
your environment and habits to avoid them. When a migraine occurs, write down
the date and time it began. Note what you ate for the preceding 24 hours, how
long you slept the night before, what you were experiencing just before the
headache, any unusual stress in your life, how long the headache lasted, and
what you did to make it stop.
Other lifestyle measures that may reduce the number of your headaches
- Avoidance of smoking, caffeine, and alcohol
- Exercising regularly
- Getting adequate sleep each night
- Relaxing and reducing stress in your life or your negative bodily
responses to stress (see
Mind/Body Medicine section)
Once a headache or associated migraine symptoms begin, measures that are
- Rest in a quiet, darkened room
- Drink fluids to avoid dehydration (especially if you have vomited)
Medications for migraines serve two general purposes: prevent headaches
altogether or treat the symptoms once they have begun. The latter includes
trying to abort the headache before it starts if you have an aura (see earlier
explanation). Preventing headaches by taking a prescription medication every day
is generally reserved for those who have at least three headaches per month.
Drugs for Prevention
- Beta-blockers, such as propranolol or timolol
- Anti-depressants, including tricyclics (like amitriptyline), serotonin
re-uptake inhibitors or SSRIs (like fluoxetine, fluvoxamine, paroxetine, and
sertraline), nefazodone, and venlafaxine
- Anti-convulsants, such as valproic acid and divalproex sodium
- Calcium channel blockers, such as verapamil
Drugs for Treatment
Medications that are used if you have an aura, such as visual disturbances
with classical migraines, or very soon after the symptoms of a migraine begin
include those listed below. It is important to note that the intention of
several of these medications is to keep the blood vessels narrow, thereby
avoiding the headache that comes from the subsequent blood vessel widening.
Therefore, these drugs should not be used by anyone with a heart
- Ergots, including ergotamine and dihydroergotamine
- Serotonin agonists or triptans, including almotriptan, naratriptan,
sumatriptan, rizatriptan, and zolmitriptan
Other medications are used to treat the headache pain or associated
- Anti-emetics - that is, drugs (like
metoclopramide or prochlorperazine) to relieve nausea and vomiting; may be given
as a suppository if your vomiting is significant enough to not be able to keep
- Acetaminophen for pain
- Ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs)
- Narcotics (like propoxyphene)
- Barbiturates (like butalbital)
|Nutrition and Dietary Supplements|
Certain foods can trigger migraine headaches; these include:
- Monosodium glutamate (MSG), a flavor enhancer found most notably in
food from Chinese restaurants; you can always ask them to prepare the food
- Foods containing the amino acid tyramine (found in red wine, aged
cheese, smoked fish, chicken livers, figs, and some beans)
- Peanut butter
- Some fruits (like avocado, banana, and citrus)
- Dairy products
- Meats containing nitrates (bacon, hot dogs, salami, cured meats)
- Fermented or pickled foods
If you suspect that any of these foods contribute to how often you get
migraines, you could follow an elimination-rechallange diet. This involves
eliminating all of the items on this list and then reintroducing them one at a
time. During this process, you should keep track of the frequency of your
headaches (in a headache diary), paying close attention to when the number of
headaches increases relative to particular foods. Then you know the trigger
foods to avoid.
On the other hand, incorporating foods rich in omega-3 fatty acids, like
flaxseed, walnuts (which contain alpha-linolenic acid [ALA], an important
omega-3 fatty acid), and fish, into your diet may help stave off migraines. More
research in this area would be helpful.
5-hydroxytryptophan for migraine prevention. 5-hydroxytryptophan (5-HTP) is
an amino acid. The body makes 5-HTP from tryptophan (an amino acid that is
obtained from the diet) and converts it to an important brain chemical known as
serotonin. 5-HTP dietary supplements help raise serotonin levels in the brain,
which may have a positive effect on sleep, mood, anxiety, aggression, appetite,
temperature, sexual behavior, and pain sensation. Some studies suggest that
5-HTP supplements may be effective in children and adults with various types of
headaches including migraines.
Magnesium levels tend to be lower in those with migraine headaches, including
children and teenagers, when compared to those who do not get headaches. A few
studies suggest that taking a magnesium supplement may decrease the length of
time that a migraine headache lasts and reduce the amount of medication you need
to relieve the pain from a migraine.
Combining magnesium with the
herb feverfew along with vitamin B2
(riboflavin) may be particularly helpful when you have a headache. This is a
welcome alternative for many, especially if you have trouble taking medications
because of side effects.
However, if you have 3 or more headaches per month, magnesium does not seem
to work as well as prescription medications to prevent migraine headaches (that
is, reduce their frequency by taking the medication or supplement every day).
Unless, you are a woman and your migraines tend to happen around the time of
your menstrual period; then, magnesium can be an effective way to prevent such
Magnesium sulfate may even be administered intravenously in the hospital if
home remedies for the migraine symptoms are not working. The physician in the
emergency room will determine if this or another therapy is most appropriate.
In a preliminary study, SAMe decreased the frequency, intensity, and duration
of migraines for most of the 124 people included in this evaluation. In
addition, many reported an improved sense of well-being and use of fewer pain
Vitamin B2 (Riboflavin)
For many migraine sufferers, taking riboflavin regularly may help decrease
the frequency and shorten the duration of migraine headaches. It is not clear
how riboflavin compares to conventional medications used to prevent migraine
headaches, however. As mentioned above, often the combination of riboflavin,
magnesium, and feverfew is particularly helpful.
Early information and individual reports suggest that glucosamine (a
supplement often used for arthritis) and coenzyme Q10 (an antioxidant that helps
protect us from damage to cells in our bodies that can occur from normal
metabolic processes) may each help to reduce the frequency of migraine
The use of herbs is a time-honored approach to strengthen the body and treat
disease. Herbs, however, contain active substances that can trigger side effects
and interact with other herbs, supplements, or medications. For these reasons,
herbs should be taken with care and only under the supervision of a practitioner
knowledgeable in the field of herbal medicine.
Feverfew (Tanacetum parthenium)
Feverfew, traditionally used for headaches, is very popular for migraines. In
fact, a survey conducted in the 1980s of 270 migraine sufferers in Great Britain
revealed that more than 70% of individuals felt substantially better when taking
fresh feverfew leaves every day. Since then, several well-designed studies have
been conducted to evaluate the safety and effectiveness of feverfew for the
prevention and treatment of migraine headaches. Most, but not all, of these
studies have found beneficial results. For example, in a study of 76 migraine
sufferers, those who took feverfew capsules every day for 4 months experienced a
substantial drop in the number of attacks as well as far fewer symptoms that
often accompany migraines, such as nausea and vomiting, compared to those who
It is particularly important when using feverfew to do so with guidance from
a specialist because there is wide variability in the formulations of this herb
sold over the counter. This may explain why some studies show improvement in
migraines while others do not.
For now, some suggest that feverfew may be most appropriate for migraine
sufferers who have not gotten better using conventional therapies or cannot
tolerate standard medications due to side effects. Other specialists point out
that many prescription medications used for headaches do not have the strongest
data to support their use either. They go on to say that given that feverfew has
fewer side effects and greater tolerability, this herb is definitely an
important option for people with migraines.
Although studies are lacking, the following herbs have been used clinically
by herbal specialist to treat migraine and other types of
- Dong quai (Angelica sinensis)
- Devil's claw (Harpagophytum procumbens)
- Ginger (Zingiber officinale)
- Ginkgo biloba (Ginkgo biloba)
- Jamaica dogwood (Piscidia erythrina/Piscidia piscipula)
- Lavender (Lavandula angustifolia)
- Linden (Tilia cordata/platypus
- Peppermint (Mentha x piperita)
- Valerian (Valeriana officinalis)
- Willow bark (Salix
An acupuncturist diagnoses headaches not as migraine, tension, or sinus, but
rather as conditions deriving from "energetic" imbalances. Headaches are
commonly seen and often successfully treated by acupuncturists.
Acupuncture has been studied as a treatment for migraine headache for over 20
years, and the National Institutes of Health, as well as other groups of
experts, recommend acupuncture as a treatment for headache. While not all
studies have shown benefit with acupuncture, researchers do agree that
acupuncture appears to be safe and that headache patients who wish to try this
therapy should not be discouraged from doing so. Results from a study published
in 2003 suggest that receiving an acupuncture treatment when migraine symptoms
first begin is as effective as sumatriptan (one of the main medications used
during the early stages of a migraine); later on in the course of the symptoms,
however, the medication works better than acupuncture.
In addition to needling treatment, acupuncturists may recommend lifestyle
changes, such as suggestions for specific breathing techniques, qi gong
exercise, and dietary modifications.
Several well-designed trials support the effectiveness of spinal manipulation
therapy in the treatment of migraine headaches.
In one study, for example, including 127 people with migraine headaches, 22%
of those who received chiropractic manipulation reported more than a 90%
reduction of migraines and 49% reported a significant reduction of the intensity
of each episode.
In another study, 218 individuals with migraine headaches were randomly
assigned to receive spinal manipulation, a daily medication
(amitryptiline—a drug used to prevent pain in chronic
conditions such as migraine headache), or a combination of both. Spinal
manipulation was as effective as the medication and had fewer side effects.
There was no added benefit to combining the two therapies.
In addition, a review article evaluating nine studies that tested spinal
manipulative therapy for tension or migraine headaches concluded that this
chiropractic technique is comparable to medications used to try to prevent
either of these two types of headaches.
|Massage and Physical Therapy|
Reflexology, a technique involving massage of "reflex points" on the hands
and feet that correspond to areas throughout the body, helps you become more
aware of you own body signals. This may allow you to anticipate the onset of a
migraine sooner because of subtle symptoms that begin before the headache sets
in. Reflexology also helps improve general well-being and energy level.
One of the most common reasons people seek homeopathic care is to relieve the
pain associated with chronic headaches. Interestingly however, only one out of
four studies included in a recent review concluded that individually prescribed
homeopathic remedies significantly reduces the frequency, severity, and duration
of migraine symptoms. Some of these effective remedies are listed below.
Professional homeopaths may also recommend various treatments based on their
knowledge and clinical experience. Before prescribing a remedy, homeopaths take
into account the individual's constitutional type. In homeopathic terms, a
person's constitution is his or her physical, emotional, and intellectual
makeup. An experienced homeopath assesses all of these factors when determining
the most appropriate remedy for a particular individual.
The following are some of the remedies found to be effective in the
previously mentioned studies:
- Belladonna — for throbbing headaches that
come on suddenly; these types of headaches tend to worsen with motion and light,
but are partially relieved by pressure, standing, sitting, or leaning backwards
- Bryonia — for headaches with a steady, sharp
pain in the forehead that may radiate to the back of the head; these types of
headaches worsen with movement and light touch, but improve with firm pressure;
this remedy is most appropriate for individuals who are irritable and may also
experience nausea, vomiting, and constipation
- Gelsemium — for pain that extends around the
head and feels like a tight band of constriction; pain usually originates in the
back of the head and may be relieved following urination; this remedy is most
appropriate for individuals who feel extremely weak and have difficulty keeping
their eyes open
- Ignatia — for pain that may be described as a
feeling of something being driven into the skull; these types of headaches tend
to be triggered by emotion, including grief or anxiety, and the treatment is
appropriate for both children and adults
- Iris versicolor — for periodic migraines that
begin with blurred vision, especially after eating sweets; pain usually occurs
on one side of the head and may be partially relieved by gentle movement and/or
- Kali bichromicum — for aching and pressing
pains on the forehead (particularly between and behind the eyes); may be
accompanied by sinus congestion or nausea and vomiting; this remedy is most
appropriate for individuals who prefer to lie down in a dark room and who
experience relief from warmth and eating
- Lachesis — for migraines on the left side of
the head that are typically worse in the mornings and before menstruation; this
type of headache is aggravated by warmth and sunlight and relieved by open air
and firm pressure
- Natrum muriaticum — one of the most common
remedies used for migraine headaches, particularly those that are described as
"hammers beating the head;" pain is relieved when the individual is lying down,
alone, in a quiet dark room; these migraines may be associated with either
menstruation or a grieving experience and are worse in the middle of the day;
this remedy is most appropriate for children who look pale and feel nauseated,
nervous, and emotional
- Nux vomica — for headaches that are described
as a "nail being driving into the head;" often accompanied by nausea and/or
dizziness; this remedy is most appropriate for individuals who are constipated
- Sanguinaria — for right-sided headaches that
begin in the neck and move upwards, recur in a predictable pattern (such as
every seven days), and are accompanied by nausea and vomiting; pain is
aggravated by motion, light or sun exposure, odors, and noise; this remedy is
appropriate for children who may have a craving for spicy or acidic foods,
despite having a general aversion to eating due to the headache
- Sepia — for migraines that are accompanied by
nausea and are relieved when the individual is lying down; light and movement
tend to worsen symptoms; this remedy is most appropriate for individuals who are
moody and don't like being alone, but worry about being with others
Homeopaths may also prescribe the following remedies based on their knowledge
and clinical experience:
- Pulsatilla — for headaches triggered by
eating rich, fatty foods, particularly ice cream; pain tends to move but may be
concentrated in the forehead or on one side of the head; may be accompanied by
digestive problems or occur around the time of menstruation; children for whom
this remedy is appropriate often develop these symptoms while at school
- Spigelia — for migraines described as a
stinging, burning, or throbbing pain, often on the left side of the head;
symptoms tend to worsen with exposure to cold weather and with motion, but are
temporarily relieved by cold compresses and when the individual is lying on the
right side with the head propped up
Reducing and learning to cope with stress effectively are important for
trying to limit the number and intensity of your headaches. Techniques that can
- Joining a support group
- Relaxation techniques such as progressive muscle relaxation (a
practice that involves contracting and releasing muscles throughout your body),
meditation, and guided imagery
Many of the medications, herbs, and supplements used to prevent or treat
migraines should not be used during pregnancy. Please refer to monographs on the
individual substances discussed in this article. Talk to your doctor before
using any substance available over the counter or that you received by
prescription prior to becoming pregnant.
|Warnings and Precautions|
It is important to use medications only as directed. Rebound headaches may
occur from overuse of medications.
Call your health care provider if you experience a new headache, a change in
quality of a previous headache or previous headache pattern, or if you are
unable to manage your symptoms in the usual way (for example, a medication that
usually takes away the pain no longer works).
|Prognosis and Complications|
Migraine headaches generally represent no significant threat to your overall
health, although they can be chronic, recurrent, frustrating, and interfere with
your day to day life on occasion. Stroke is an extremely rare complication from
severe migraines. This may be due to prolonged constriction (narrowing) of blood
vessels, reducing the blood flow to parts of the brain.
For many, migraines go into remission (meaning that they stop for a long time
and happen only very infrequently) or even disappear altogether. This happens as
you age in particular; for women, this may be related to declining levels of
Annequin D, Tourniaire B, Massiou H. Migraine and headache in childhood and
adolescence. Pediatr Clin North Am. 2000;47(3):617-631.
Astin JA., Ernst E. The effectiveness of spinal manipulation for the
treatment of headache disorders: a systematic review of randomized clinical
trials. Cephalagia. 2002;22(8):617-623.
Baghdikian B, Lanhers M, Fleurentin J, et al. An analytical study,
anti-inflammatory and analgesic effects of Harpagophytum procumbens and
Harpagophytum zeyheri. Planta Med.
Barrows KA, Jacobs BP. Mind-body medicine: an introduction and review of the
literature. Med Clin North Am. 2002;86(1):11-31.
Bauman RJ. Behavioral treatment of migraine in children and adolescents.
Paediatr Drugs. 2002;499):555-561.
Birdsall TC. 5-Hydroxytryptophan: a clinically-effective serotonin precursor.
Alt Med Review. 1998;3(4):271-280.
Blumenthal M. The Complete German Commission E Monographs. Austin,
Tex: American Botanical Council. Boston: Integrative Medicine Communications;
Bronfort G, Assendelft WJ, Evans R, Haas M, Bouter L. Efficacy of spinal
manipulation for chronic headache: a systematic review. J Manipulative
Physiol Ther. 2001;24(7):457-466.
Cady RK, Schreiber CP. Sinus headache or migraine? Considerations in making a
differential diagnosis. Neurology. 2002;58(9 Suppl 6):S10-S14.
Cummings S, Ullman D. Everybody's Guide to Homeopathic Medicines. 3rd
ed. New York, NY: Penguin Putnam; 1997: 217-220, 343.
Dagenais S. Haldeman S. Chiropractic. Prim Care. 2002;29(2):419-437.
DeBenedittis G, Massei R. Serotonin precursors in chronic primary headache. A
double-blind cross-over study with L-5-hydroxytryptophan vs. placebo. J
Neurosurg Sci. 1985; 29:239-248.
DeGiorgis G, et al. Headache in association with sleep disorders in children:
a psychodiagnostic evaluation and controlled clinical
study—L-5-HTP versus placebo. Drugs Exp Clin
De Weerdt CJ, Bootsma HPR, Hendricks H. Herbal medicines in migraine
prevention. Randomized double-blind placebo controlled crossover trial of a
feverfew preparation. Phytomedicine. 1996;3:225-230.
Demirkaya S, Vural O, Dora B, Topcuoglu MA. Efficacy of intravenous magnesium
sulfate in the treatment of acute migraine attacks. Headache.
Diener HC, Kaube H, Limmroth V. A practical guide to the management and
prevention of migraine. Drugs. 1998;56(5):811-824.
Ernst, E. Homeopathic prophylaxis of headaches and migraine? A systematic
review. J Pain Symptom Manage. 1999;18(5):353-357.
Ernst E, Pittler MH. The efficacy and safety of feverfew (Tanacetum
parthenium L.): an update of a systematic review. [Review] Public Health
Facchinetti F, Sances G, Borella P, Genazzani AR, Nappi G. Magnesium
prophylaxis of menstrual migraine: effects on intracellular magnesium.
Gao S, Zhao D, Xie Y. A comparative study on the treatment of migraine
headache with combined distant and local acupuncture points versus conventional
drug therapy. Am J Acupuncture. 1999;27(1-2):27-30.
Gatto G, Caleri D, Michelacci S, Sicuteri F. Analgesizing effect of a methyl
donor (S-adenosylmethionine) in migraine: an open clinical trial. Int J Clin
Pharmacol Res. 1986;6:15-17.
Gobel H, Schmidt G, Soyka D. Effect of peppermint and eucalyptus oil
preparations on neurophysiological and experimental algesimetric headache
parameters. Cephalalgia. 1994;14(3):228-234.
Goslin RE, Gray RN, McCrory DC, Penzien D, Rains J, Hasselblad V. Evidence
report: Behavioral and physical treatments for migraine. Technical Review, 2.2,
February 1999. Prepared for the Agency for Health Care Policy and Research under
contract number. 290-94-2025. Available at:
Accessed on June 30, 2003.
Harel Z, Gascon G, Riggs S, Vaz R, Brown W, Exil G. Supplementation with
omega-3 polyunsaturated fatty acids in the management of recurrent migraines in
adolescents. J Adolesc Health. 2002;31(2):154-161.
Hesse J, Mogelvang B, Simonsen H. Acupuncture versus metoprolol in migraine
prophylaxis: a randomized trial of trigger point inactivation. J Intern
Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as
prophylactic treatment of migraine. Br Med J.
Launso L, Brendstrup E, Arnberg S. An exploratory study of reflexological
treatment for headache. Altern Ther Health Med. 1999;5(3):57-65.
Linde K, Melchart D, Fisher P et al. Acupuncture for idiopathic headache
(Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford:
Manias P, Tagaris G, Karageorgiou K. Acupuncture in headache: a critical
review. Clin J Pain. 2000;16(4):334-339.
Mauskop A. Alternative therapies in headache. Is there a role? [Review]
Med Clin North Am. 2001;85(4):1077-1084.
Mauskop A, Altura BM. Role of magnesium in the pathogenesis and treatment of
migraines. Clin Neurosci. 1998;5(1):24-27.
Mauskop A, Altura BT, Altura BM. Serum ionized magnesium levels and serum
ionized calcium/ionized magnesium ratios in women with menstrual migraine.
Melchart D, Linde K, Fischer P, et al. Acupuncture for recurrent headaches: a
systematic review of randomized controlled trials. Cephalalgia.
Melchart D, Thormaehlen J, Hager S, Liao J, Linde K, Weidenhammer W.
Acupuncture versus placebo versus sumatriptan for early treatment of migraine
attacks: a randomized controlled trial. J Intern Med.
Mueller L. Tension-type, the forgotten headache. How to recognize this common
but undertreated condition. Postgrad Med. 2002;111(4):25-26, 31-32,
Murphy JJ, Heptinsall S, Mitchell JRA. Randomised double-blind
placebo-controlled trial of feverfew in migraine prevention. Lancet.
Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. The
efficacy of manipulation, amitriptyline and the combination of both therapies
for the prophylaxis of migraine headache. J Manipulative Physiol Ther.
Newall C, Anderson L, Phillipson J. Herbal Medicines: A Guide for
Health-care Professionals. London, England: Pharmaceutical Press; 1996:
NIH Consensus Statement: Acupuncture. National Institutes of Health, Office
of the Director. 1997;15(5):1-34. Accessed at
on June 30, 2003.
Palevitch D, Earon G, Carasso R. Feverfew (Tanacetum parthenium) as a
prophylactic treatment for migraine: a double-blind controlled study.
Phytotherapy Res. 1997;11:508-511.
Peikart A, Wilimzig C, Kohne-Volland R. Prophylaxis of migraine with oral
magnesium: results from a prospective, multi-center, placebo-controlled and
double-blind randomized study. Cephalagia. 1996;16(4):257-263.
Penzien DB, Rains JC, Andrasik F. Behavioral management of recurrent
headache: three decades of experience and empiricism. Appl Psychophysiol
Pfaffenrath V, Diener HC, Fischer M, Friede M, Henneicke-von Zepelin HH;
Investigators. The efficacy and safety of Tanacetum parthenium (feverfew)
in migraine prophylaxis - a double-blind, multicentre,
randomized placebo-controlled dose-response study. Cephalagia.
Pfaffenrath V, Wessely P, Meyer C, et al. Magnesium in the prophylaxis of
migraine - a double-blind placebo-controlled study.
Pittler MH, Vogler BK, Ernst E. Feverfew for preventing migraine. [Review]
Cochrane Database Syst Rev. 2000;(3):CD002286.
Pryse-Phillips W. Guideline for the diagnosis and management of migraine in
clinical practice. Can Med Assoc J. 1997;156:1273-1287.
Pryse-Phillips WE, Dodick DW, Edmeads JG, et al. Guidelines for the
nonpharmacologic management of migraine in clinical practice. Canadian Headache
Society. Can Med Assoc J. 1998;159(1):47-54.
Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia,
PA: Hanley & Belfus, Inc; 2002:188-192.
Russell AL, McCarty MF. Glucosamine for migraine prophylaxis? Med
Savi L, Rainero I, Valfre W, Gentile S, Lo Giudice R, Pinessi L. A comparison
of patients with migraine and tension-type headache. Panminerva Med.
Schoenen J, Jacquy J, Lenaerts M. Effectiveness of high-dose riboflavin in
migraine prophylaxis. A randomized controlled trial. Neurology.
Silberstein SD, Goadsby PJ, Lipton RB. Management of migraine: an algorithmic
approach. [Review]. Neurology. 2000;55(9 Suppl 2):S46-52
Trauninger A, Pfund Z, Koszegi T, Czopf J. Oral magnesium load test in
patients with migraine. Headache. 2002;42(2):114-119.
Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of spinal
manipulative therapy for migraine. J Manipulative Physiol Ther.
Ullman D. Homeopathic Medicine for Children and Infants. New York, NY:
Penguin Putnam; 1992:91-94.
Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin
Putnam; 1995: 236-239.
Vogler BK, Pittler MH, Ernst E. Feverfew as a preventive treatment for
migraine: a systematic review. Cephalalgia. 1998;18(10):704-708.
Wagner W, Nootbaar-Wagner U. Prophylactic treatment of migraine with
gamma-linolenic and alpha-linolenic acids. Cephalalgia.
Walach H, Haeusler W, Lowes T et al. Classical homeopathic treatment of
chronic headaches. Cephalalgia. 1997;17:119-126.
Walach H, Lowes T, Mussbach D et al. The long-term effects of homeopathic
treatment of chronic headaches: 1 year follow up. Cephalalgia.
Walach H, Lowes T, Mussbach D et al. The long-term effects of homeopathic
treatment of chronic headaches: one year follow-up and single case time series
analysis. Br Homeopath J. 2001;90(2):63-72.
Welch KM. Pathogenesis of migraine. Semin Neurol.
White AR, Resch KL, Chan JC, et al. Acupuncture for episodic tension-type
headache: a multicentre randomized controlled trial. Cephalagia.
|Review Date: June 2003|
|Reviewed By: Participants in the review process include: Robert A. Anderson, MD,
President, American Board of Holistic Medicine, East Wenatchee, WA; Shiva
Barton, ND, Wellspace, Cambridge, MA; Gary Guebert, DC, DACBR, (Chiropractic
section October 2001) Login Chiropractic College, Maryland Heights, MO;
Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley
Hospital, Boston, Ma and Senior Medical Editor A.D.A.M., Inc.; Richard A.
Lippin, MD, President, The Lippin Group, Southampton, PA; Anne McClenon, ND,
Compass Family Health Center, Plymouth, MA; Joseph Trainor, DC, (Chiropractic
section October 2001) Integrative Therapeutics, Inc., Natick, MA; Marcellus
Walker, MD, LAc, (Acupuncture section October 2001) St. Vincent's Catholic
Medical Center, New York, NY; Ira Zunin, MD, MPH, MBA, (Acupuncture section
October 2001) President and Chairman, Hawaii State Consortium for Integrative
Medicine, Honolulu, HI.|
Copyright © 2004 A.D.A.M., Inc
The publisher does not accept any responsibility for the accuracy of
the information or the consequences arising from the application, use, or misuse
of any of the information contained herein, including any injury and/or damage
to any person or property as a matter of product liability, negligence, or
otherwise. No warranty, expressed or implied, is made in regard to the contents
of this material. No claims or endorsements are made for any drugs or compounds
currently marketed or in investigative use. This material is not intended as a
guide to self-medication. The reader is advised to discuss the information
provided here with a doctor, pharmacist, nurse, or other authorized healthcare
practitioner and to check product information (including package inserts)
regarding dosage, precautions, warnings, interactions, and contraindications
before administering any drug, herb, or supplement discussed