45 96 Definition A throbbing head pain, usually asymmetrical, that spreads throughout the face and head. It can be severe and last for several days. Changes in serotonin levels in the body seem to play a role in migraine headaches. When serotonin levels are high, blood vessels constrict (shrink). When serotonin levels fall, the blood vessels dilate (swell). This swelling can cause pain or other problems. Characteristics It is estimated that 23 million people in the United States suffer from migraine, which affects approximately 18 million women and more than 5 million men. Migraine is a familial disor- der, with recurrent head pain that varies in intensity, duration, and frequency, with predis- posing factors identified as follows: Classical symptoms: Unilateral location, pulsating quality, aura, nausea, vomiting, photopho- bia, phonophobia, stiff or tender neck, tender scalp, and aggravation by physical activity. Precipitating or triggering factors: Changing hormone levels (e.g., menstruation, menopause) alcohol intake relaxation after emotional stress sleeping too much or too little weather changes altitude sleep patterns diet that includes such tyramine-containing foods as choco- late, cheese, vinegar, nitrites, caffeine, monosodium glutamate, and aspartame and such medications as contraceptive pills and certain hypertensive agents. A premonition may occur several hours to a day before the headache starts. Premonitions are feelings one gets that can signal a migraine is coming. These feelings can include intense energy, fatigue, food crav- ings, and mood changes. The most common types of migraine are classic migraine and common migraine. Classic migraines start with a warning sign, called an aura in which the individual may see flashing lights and colors or temporarily lose some vision, such as side vision. A strange prickly or burning sensation or muscle weakness may occur on one side of the body. Depression, irritability, and restlessness also may be present. Auras last about 15 to 30 minutes and may occur before or after head pain sometimes the pain and aura overlap or the pain never occurs. The head pain of classic migraines may occur on one side or on both sides. Common migraines don’t start with an aura. Common migraines may start more slowly than classic migraines, last longer, and interfere more with daily activities. The pain of common migraines may be on only one side of the head. Migraines may last from 4 to 72 hours. They may happen only once or twice a year or as often as daily. Women are more likely to have migraines than men. Policy Evaluate employee who presents with complaints of migraine in the occupational health unit. Include assessment for recent head trauma. If employee suffers from a migraine, pro- vide an environment conducive for treatment. Headache, Migraine