Migraines affect nearly 30 million Americans and are the most common type of disabling headache. They are severe, pulsating headaches that affect half of the head and can last up to 72 hours.

Sufferers can’t tolerate bright lights or loud sounds. They may feel nauseous and light-headed, and their faces may swell.

The migraine is often preceded by an aura, which can be an alteration of vision, smell, hearing or a tingling of the face or arms. 

Gluten sensitivity often triggers migraine attacks. A variety of foods, bright lights, loud noises, monosodium glutamate and stress also may set off a migraine.

If you think you have a migraine, check with your doctor to make sure it is not a cluster or tension headache.

Many treatments are available. First, try simple analgesics such as Tylenol, Motrin or Advil. Tylenol and Motrin can be taken together. Do not drink alcohol with Tylenol. Excedrin migraine is a combination of aspirin, Tylenol and caffeine.

If these over-the-counter medicines don’t relieve the pain, triptans, such as sumatriptan, are the next choice. Some antidepressants, such as tricyclic antidepressants and selective serotonin uptake inhibitors, may help.

The medicinal herb, feverfew, may prevent attacks. Similar claims have been made for cannabis, but its use is illegal.

An anti-epileptic drug, topiramate, may prevent migraines and make the attacks less severe. And some patients had less pain when they held a special magnetic stimulator to their heads when their auras began.

While migraines are common and disabling, those who suffer should be aware of the multiple treatment options.

SLUCare physician John Morley is director of geriatrics at St. Louis University and a geriatrician at St. Louis VA Medical Center. E-mail him at . The Aging Successfully column for seniors rotates each week with XX Files, a women’s health column.

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