Migraine

Q Is it possible to cure migraine completely, or do I have to manage it for life?

A. Rather than complete disappearance, a realistic goal is to greatly reduce the frequency and intensity of attacks. Active early treatment can significantly improve quality of life, and some people see remission after long-term treatment.

Q My migraines are severe, and I also have anxiety and depression. Are they related?

A. Yes, migraine and anxiety/depression are comorbid conditions that share the serotonin pathway. Treating both together also improves migraine prevention.

Q How should I keep a migraine diary so I can find my triggers well?

A. Record the date and time of onset, the location and intensity of pain (0 to 10), duration, accompanying symptoms (nausea, light/sound sensitivity), medications taken, and that day's meals, sleep, menstrual cycle, and stress level. At least four weeks of records is recommended.

Q Can I exercise if I have migraines? I heard exercise can actually trigger a headache.

A. Avoid vigorous exercise during an attack, but regular aerobic exercise (3 to 5 times a week, 30 minutes) is effective for migraine prevention. A thorough warm-up can reduce exercise-triggered headaches.

Q I suddenly had an extreme headache unlike anything I've ever felt. Is it just a migraine, or an emergency?

A. The worst headache you've ever experienced (a thunderclap headache) can be a sign of a brain hemorrhage. Call emergency services immediately or go to the ER. Never just self-medicate and wait.

Q I was prescribed a triptan. How often can I take it? Is it okay to take it with herbal medicine?

A. Triptans should be limited to no more than 10 days a month to prevent medication-overuse headache. Interactions with herbal medicine are rare, but you must always tell your prescribing Korean Medicine doctor what medications you are taking.

Q My neurologist prescribed migraine preventive medication (topiramate, propranolol). Can I receive Korean Medicine treatment alongside it?

A. Yes, combining Korean Medicine treatment with preventive medication is generally possible. Acupuncture and herbal medicine can complement the effect of preventive drugs and help reduce their side effects (cognitive impairment, fatigue).

Q My migraines are becoming more frequent. If it turns into chronic migraine, is it hard to cure?

A. If headaches occur on 15 or more days a month for over 3 months, it is chronic migraine. Active early treatment can prevent it from becoming chronic or turn it back into the episodic form, so managing it now is important.

Q I heard migraines get better on their own with age. Is that true?

A. To some extent, yes. After their 40s and 50s, women tend to see migraines ease as post-menopausal estrogen fluctuations decrease. In men too, attack frequency often declines with age.

Q Why does a migraine throb on just one side of my head? Could something be wrong with my brain?

A. A migraine is not a structural brain problem but a neurovascular hypersensitivity reaction. A wave of cortical excitation stimulates the trigeminal nerve and triggers inflammation around the blood vessels, causing throbbing pain on one side of the head.

Q Before a migraine I see flashing lights and my hands and feet tingle. Is this migraine with aura?

A. Yes. Typical visual aura (lights, zigzag patterns, blind spots) and sensory aura (tingling in the hands and feet) are hallmark symptoms of migraine with aura. The aura usually lasts 5 to 60 minutes and is followed by the headache.

Q I get severe migraines around my period every month. Is there a connection between menstruation and migraine?

A. Yes. When estrogen drops sharply just before and after menstruation begins, it can trigger what is called menstrual migraine. More than half of women with migraine show a connection to their cycle.

Q Are there foods I should avoid if I have migraines? I heard red wine and cheese are risky.

A. The tyramine in red wine and cheese, the nitrites in smoked meats, MSG, artificial sweeteners (aspartame), and both excess caffeine and caffeine withdrawal are major dietary triggers. Because individual differences are large, keeping a headache diary to find your own triggers is the most accurate approach.

Q My migraines get worse when I'm stressed or don't sleep well. Is there a way to manage this?

A. Stress and lack of sleep are the two major migraine triggers. Regular sleep (7 to 8 hours), abdominal breathing, and mindfulness meditation can help reduce headache frequency.

Q How often do I need to visit the clinic for migraines? I work in Dongincheon.

A. For acute and chronic migraine, we recommend 2 to 3 times a week, reducing to once a week once stabilized. We set 4 to 6 weeks as the first treatment period, aiming for a 50% reduction in attack frequency.

Q What home first-aid measures can I take when a migraine attack starts?

A. Rest in a quiet, dark room, and take your prescribed triptan early in the attack for the best effect. A cold compress, pressing the temples, and drinking water also help with temporary relief.

Q Is acupuncture effective for migraine? Can it replace triptan medication?

A. Acupuncture has clinical evidence as a preventive treatment for migraine. Triptans work faster for acute pain relief, but acupuncture is effective for preventing recurrence and reducing attack frequency, so it is used alongside medication or to help reduce medication use.

Q Does herbal medicine help with migraine? What kinds of herbal medicine are used?

A. Herbal medicine is prescribed differently according to the migraine pattern type (Ascending Liver Yang, Blood Deficiency, Phlegm-Fluid, Blood Stasis). Brain-clearing decoctions containing Cheonma (Gastrodia) and Jogudeung (Uncaria) are used to reduce attack frequency.