Rahul Sharma (Editor)

Mixed tension migraine

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Mixed tension migraines are also known as mixed migraines or mixed headaches. They combine characteristics of tension headaches and migraines.

Contents

A person may be thought to have mixed headaches when, in addition to experiencing muscle tension headaches, they begin to experience migraine symptoms as well, such as light sensitivity triggering an attack.

A person may also be thought to have this condition when they already experience migraines and then begin to experience chronic daily muscle tension headaches in addition to migraines.

Mixed tension migraines are classified as primary headaches and can be either episodic and chronic, or daily.

Affecting more than 80 percent of adult females and 65 percent of adult males, mixed tension migraines are commonly managed by medication and avoiding activities which may trigger the headaches. This migraine usually lasts between 4 to 72 hours and the level of pain can vary significantly.

Causes and Triggers

All migraines can be triggered by a variety of hormonal changes, dietary/environmental factors, stimulation, and stress. More specifically, triggers may include the following;

  • Menstrual cycle
  • Certain smells
  • Bright lights
  • Change in sleeping pattern
  • Alcohol and food
  • Use and/or withdrawal of medication
  • High, unmanaged stress levels
  • Poor posture

    • Symptoms

    Symptoms of mixed tension include, but are not limited to, the following;

  • Nausea and/or vomiting
  • Pain on one/both sides of the head
  • Neck pain
  • Irritability
  • Depression
  • Sensitivity to sound and/or light
  • Numbness and/or tingling sensation of the limbs

    • When to Seek Help

    Emergency medical care should be sought immediately if one or more of the following occur;

  • The pain is sudden and intense
  • The pain becomes increasingly worse
  • The appearance of a fever
  • Stiffness of the neck
  • Impaired neurological function such as loss of balance, speech disturbance or double vision
  • Seizures
  • Loss of consciousness
  • Patient experiences persistent nausea and/or vomiting

    • Diagnosis

    Due to the fact that there is no way to test for a mixed tension migraine, doctors diagnose patients through a process of elimination. Based on the symptoms a patient suffers from, physicians rule out other causes. This can be done through neurological examinations in order to rule out neurological disorders and stimulus response tests in order to check if the nervous system is functioning correctly. Other testing may include blood work, CT scans, and in some extreme cases, a lumbar puncture.

    Doctors also take into consideration the family history of a patient, as migraines are often genetic.

    Treatment

    Depending on a patient's symptoms, physicians will prescribe treatment for either a tension headache or a migraine.

    Medication

  • Tripitan: Causes the constriction of blood vessels and ease of migraines
  • Analgesics: Consists of ibuprofen and aspirin, commonly used to treat less severe migraines or tension headaches
  • Ergot Derivative Drugs: Aids in decreasing pain signals transmitted along the nerves
  • Non-Steroidal Anti-Inflammatory Drugs: Reduces inflammation

    • Complications

    Medication can be a great ease of pain for many individuals suffering from headaches and migraines. However, although perhaps initially effective, medication will most likely be unsuccessful with frequent use. It is also important to note that pain medication is only a quick fix, and will not eradicate any underlying health issue. Additionally, the overuse of many medications may in fact aggravate or cause further headaches.

    Upon the completion of drug therapy, patients may experience headaches worse than before for a short period of time.

    Nutrition and Life Style

    To aid medications in order to ease mixed tension migraines, the following steps can be taken;

  • Stay hydrated
  • Regular food intake
  • Meditation
  • Physical and/or massage therapy
  • Regular sleep
  • Light, daily exercise
  • Consumption of magnesium
  • Consumption of B2
  • Treatment of depression (where applicable)

    • Cognitive Behavioral Therapy (CBT)

    Many individuals suffer from these migraines due to high stress levels in their lives, and their inability to manage their stressors effectively. For this reason, many doctors suggest CBT, in order to assists patients in discovering and understanding their stressors. In this treatment method, therapists will work with patients in order to discern the main triggers of the headaches or migraines for that particular patient. Cognitive Behavioral Therapy is typically used in conjunction with other treatment methods, and does not generally stand alone as a method of treatment.

    Post-Treatment

    Usually, the aforementioned treatments will be successful in easing the pain or frequency of mixed tension migraines. If this is the case, no further treatment may be necessary. However, some patients do require additional drug and/or behavioral therapy.

    It is important for patients to monitor their headaches, and report any new or worsening symptoms to their doctor.

    Prevention

    In order to prevent a migraine, it is important to understand what causes them. These causes will differ from patient to patient, and so it is best to keep a record of any headaches that occur, and the activities and surroundings leading up to the pain. Patients should pay close attention to their sleep patterns prior to the headache, what food and drink was consumed recently, and what events were taking place in their lives during this time. Patients can then refer to their log in order to discern the triggers of their migraine.

    References

    Mixed tension migraine Wikipedia
    (Text) CC BY-SA