Information for Patients
What are migraines?
Migraines are a recurring type of headache. They cause moderate to severe pain that is throbbing or pulsing. The pain is often on one side of your head. You may also have other symptoms, such as nausea and weakness. You may be sensitive to light and sound.
Who gets migraines?
About 12 percent of Americans get migraines. They can affect anyone, but you are more likely to have them if you
- Are a woman. Women are three times more likely than men to get migraines.
- Have a family history of migraines. Most people with migraines have family members who have migraines.
- Have other medical conditions, such as depression, anxiety, bipolar disorder, sleep disorders, and epilepsy.
What causes migraines?
Researchers believe that migraine has a genetic cause. There are also a number of factors that can trigger a migraine, including
- Hormonal changes in women
- Bright or flashing lights
- Loud noises
- Strong smells
- Too much or not enough sleep
- Sudden changes in weather or environment
- Overexertion (too much physical activity)
- Caffeine or caffeine withdrawal
- Skipped meals
- Medication overuse (taking medicine for migraines too often)
- Certain foods and food additives such as
- Aged cheeses
- Monosodium glutamate (MSG)
- Some fruits and nuts
- Fermented or pickled goods
- Cured or processed meats
What are the symptoms of migraines?
There are four different phases of migraines. You may not always go through every phase each time you have a migraine.
- Prodome. This phase starts up to 24 hours before you get the migraine. You have early signs and symptoms, such as food cravings, unexplained mood changes, uncontrollable yawning, fluid retention, and increased urination.
- Aura. If you have this phase, you might see flashing or bright lights or zig-zag lines. You may have muscle weakness or feel like you are being touched or grabbed. An aura can happen just before or during a migraine.
- Headache. A migraine usually starts gradually and then becomes more severe. It typically causes throbbing or pulsing pain, which is often on one side of your head. But sometimes you can have a migraine without a headache. Other migraine symptoms may include
- Increased sensitivity to light, noise, and odors
- Nausea and vomiting
- Worsened pain when you move, cough, or sneeze
- Postdrome (following the headache). You may feel exhausted, weak, and confused after a migraine. This can last up to a day.
Migraines are more common in the morning; people often wake up with them. Some people have migraines at predictable times, such as before menstruation or on weekends following a stressful week of work.
How are migraines diagnosed?
To make a diagnosis, your health care provider will
- Take your medical history
- Ask about your symptoms
- Do a physical and neurological exam
An important part of diagnosing migraines is to rule out other medical conditions which could be causing the symptoms. So you may also have blood tests, an MRI or CT scan, or other tests.
How are migraines treated?
There is no cure for migraines. Treatment focuses on relieving symptoms and preventing additional attacks.
There are different types of medicines to relieve symptoms. They include triptan drugs, ergotamine drugs, and pain relievers. The sooner you take the medicine, the more effective it is.
There are also other things you can do to feel better:
- Resting with your eyes closed in a quiet, darkened room
- Placing a cool cloth or ice pack on your forehead
- Drinking fluids
There are some lifestyle changes you can make to prevent migraines:
- Stress management strategies, such as exercise, relaxation techniques, and biofeedback, may reduce the number and severity of migraines. Biofeedback uses electronic devices to teach you to control certain body functions, such as your heartbeat, blood pressure, and muscle tension.
- Make a log of what seems to trigger your migraines. You can learn what you need to avoid, such as certain foods and medicines. It also help you figure out what you should do, such as establishing a consistent sleep schedule and eating regular meals.
- Hormone therapy may help some women whose migraines seem to be linked to their menstrual cycle
- If you have obesity, losing weight may also be helpful
If you have frequent or severe migraines, you may need to take medicines to prevent further attacks. Talk with your health care provider about which drug would be right for you.
Certain natural treatments, such as riboflavin (vitamin B2) and coenzyme Q10, may help prevent migraines. If your magnesium level is low, you can try taking magnesium. There is also an herb, butterbur, which some people take to prevent migraines. But butterbur may not be safe for long-term use. Always check with your health care provider before taking any supplements.
NIH: National Institute of Neurological Disorders and Stroke
- Managing migraines at home (Medical Encyclopedia)
- Migraine (Medical Encyclopedia)
General Equivalence Map Definitions
The ICD-10 and ICD-9 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.