Is it a Migraine or a Medical Emergency?


A severe headache can make your day more difficult. It’s especially annoying when it comes on first thing in the morning and you have many things on your to-do list. Just the thought of dealing with those things while you have a throbbing pain in your head is enough to send you back to bed!

Fortunately, for most of us, a little over the counter pain relief comes to the rescue and that headache diminishes or even goes away completely. That’s especially true of a tension type headache, which is the most common type of headache among seniors[1].

But for about 10% of seniors[2], that headache is actually a migraine – and rather than make your day difficult, it can make it virtually impossible.

Why should you care about migraines if only one in ten seniors have them? Besides the fact that you could develop migraines in your later years, some other medical conditions can feel like migraines. Those conditions can be quite serious, such as stroke or a brain tumor.  And in some cases, migraines present in a way that might leave you wondering what is going on – for instance, you might have flashes of light and issues with your vision followed by no pain at all. If that happens, you want to be sure it’s a migraine and not some other medical issue.

Let’s dive into what a migraine is, what it feels like, what might trigger one, and what you should look for to determine whether it’s a migraine or a true medical emergency.

What is a Migraine?

According to the American Migraine Foundation, a migraine is “a disabling neurological disease with different symptoms and different treatment approaches compared to other headache disorders.” It’s believed that 39 million people in the United States deal with migraines, but since many people never get officially diagnosed, the number is likely much higher[3]. This might be especially true for the elderly, who often see physical ailments as an inevitable sign of aging and thus might not visit the doctor when they suffer from migraines.

A migraine can be one of the most severe headaches you’ve ever felt. It often shows up with intense, throbbing pain that centers on one side of the head. It might trigger other physical symptoms, such as nausea and vomiting. You might be extremely sensitive to light and sound – a shaft of sunlight coming through the window or the sound of a child’s laughter can be agonizing when you’re in the midst of a migraine. You might see unusual things, especially an aura around objects, flashes of light in your vision or blind spots. And even more frightening, you might experience tingling in an arm, leg, or face, and find it difficult to speak[4].

Migraines might last for a few hours or might stretch to a few days. The severity can be bad enough to keep you from your daily activities.

A migraine doesn’t often come on suddenly – there are usually warning signs. The Mayo Clinic identifies four stages of migraine, each with their own unique symptoms.

The Prodrome stage happens one or two days before a migraine and can include:

·         Mood changes

·         Food cravings

·         Frequent yawning

·         Fluid retention

·         Increased urination

·         Constipation

·         Stiffness in your neck

The second stage is known as the Aura. This doesn’t happen to everyone; only about 25% of those who suffer from migraines go through the Aura phase.

Auras are usually visual but might include other problems.

·         Visual changes, including flashes of light

·         Temporary blurry vision or blindness

·         Tingling sensation in an arm or leg (or both)

·         Difficulty speaking

·         Weakness or numbness, usually in the face or on one side of the body

These symptoms can begin gradually and build up over several minutes. They might last for up to an hour. They can be quite frightening, even if you have a history of migraines and know what is happening. In many cases, those who are over the age of 45 will have a migraine that includes visual disturbances but doesn’t progress to pain.

The Attack phase is the painful part of the migraine experience. Neurology Advisor says that for senior adults, only about half will move into the Attack phase. This part usually lasts between four and 72 hours, but prompt treatment might shorten the ordeal. This can include:

·         Throbbing or pulsing pain that is usually on one side of the head (though it can be present on both sides)

·         Strong sensitivity to light and sound

·         Nausea and vomiting

·         Occasionally, a strong sensitivity to touch or smell

The Post-Drome phase happens when the migraine is ending. The pain lessens but might come back if you move your head too quickly. You’ll likely feel very tired, drained, and maybe even confused as the pain decreases.

Keep in mind that some of the symptoms of a migraine, such as weakness and visual changes, can greatly increase your risk of falls. If you suffer from migraines, consider an affordable emergency response solution from Alert1. Reaching out for help by simply pressing a button on a medical alert pendant or watch can give you peace of mind. If you do suffer a fall or any type of emergency whatsoever, you can get help immediately.

When a Headache is More Serious Than a Migraine

You might read through some of these symptoms and recognize that many of them – including the throbbing pain and the weakness on one side of the body – can also describe other medical issues, especially a stroke.

If you notice these symptoms, it might not be a migraine. These should send you to the hospital immediately:

·         An abrupt, severe headache that comes on with no warning at all

·         A headache that is accompanied by fever and a stiff neck

·         Other physical symptoms in conjunction with the headache, including double vision, confusion, numbness or weakness in any part of the body, or seizures

·         Any headache after you bump your head

·         A headache that won’t go away no matter what you try

·         A headache that gets worse with coughing or exertion of some kind

·         Any new type of headache pain if you’re over the age of 50

If you experience these symptoms and you have medical alert technology at your fingertips, you have the advantage of pressing the emergency button alarm and getting help on the line immediately. This quick response can mean the difference between a bad outcome and a good one because every second counts. If you aren’t sure if what you’re experiencing is a migraine, always err on the side of caution and seek medical help.

What Causes Migraines?

No one knows for sure what causes migraines. Some experts believe there are both genetic and environmental factors involved. However, some triggers have been identified[5]:

·         Alcohol and caffeine. Wine seems to be the most common culprit when it comes to alcoholic beverages. Any caffeinated beverage, such as coffee or soda, could lead to a migraine.

·         Hormonal changes. If you are using hormone replacement therapy, you might have fluctuations in estrogen that can lead to migraines. This might happen before and during menopause as well.

·         Changes in the weather. A small shift in barometric pressure or temperature can be enough.

·         Foods and food additives. Skipping meals or eating certain things, such as processed foods, can be a problem. Artificial sweeteners and MSG are also known to cause migraines.

·         Sensory overload. Loud sounds, strong smells, and bright lights can trigger migraines.

·         Sleep issues. Not getting enough sleep – or getting far too much – can be a trigger. The National Institute on Aging recommends getting seven to nine hours of sleep each night, but that might need to be adjusted depending upon your physician’s advice.

·         Physical exertion. Strong and prolonged exercise might lead to migraines.

·         Medications. Some medications common for seniors, including vasodilators for high blood pressure or nitroglycerin for chest pain, can trigger migraines or make them worse.

·         Stress. When you’re under stress, your whole body is affected. Headaches could be common.

·         Overuse of painkillers. You might try anything to alleviate a migraine, including taking medications, either prescribed or over the counter. But the more medications you take, the more likely you are to experience a “rebound” headache. 

There are many risk factors that make you more likely to suffer from a migraine as a result of one of these triggers. Women are three times more likely to have migraines than men are. Hormonal changes can be a strong risk factor, as can a family history of migraines. And though migraines tend to peak in your 30s and gradually become less severe, sometimes they actually increase with age – especially for women, when hormonal shifts begin around menopause.

When to See the Doctor

Treatment for migraines can include a variety of over the counter medications as well as prescription drugs. Your doctor might start by recommending medications such as aspirin, acetaminophen or ibuprofen. If these common painkillers don’t work, migraine-specific drugs might be prescribed.

In addition to medications, lifestyle changes can help alleviate or lessen the severity of migraines and other headaches in general. These include addressing the triggers listed above that you can control, such as getting more sleep if you’re lacking in shut-eye or making sure not to skip meals.

See your doctor immediately if you experience the following:

·         A headache that feels different from any you’ve felt before

·         Headaches that are more frequent or intense than usual

·         A headache that leads to cognitive problems, such as confusion

·         Strange issues with the headache, such as ringing in the ears or double vision

If you are experiencing frequent headaches or migraines, it’s a good idea to keep a headache diary. Do this by simply writing down when you have a headache, what it feels like, what your symptoms were leading up to it, how long it lasts, and what you think might have triggered it. It can be helpful to include information on your sleeping schedule and what you ate that day. If you are suffering from frequent headaches or migraines, take that diary to your doctor to try to pinpoint things you can change.

While you and your doctor are figuring out the best treatment options for you, it’s good to have peace of mind that if something does go wrong, assistance is just a touch away. A medical alert wireless system for the elderly from Alert1 can give you a way to get help immediately whether it’s a migraine, something else, or any emergency situation.