Nausea and vomiting are frequent companions of migraine. A family history and trigger pattern help make the diagnosis. Any pain that is always in the same location, awakens the patient from sleep, is caused by bending, coughing, straining at a bowel movement, or with other exertions, including sex, warrants a medical opinion. Also, if there is a sudden change in headache characteristics or frequency, let the doctor know. These symptoms may indicate the need for brain imaging.
Treatment is based on the individual.
For less than 4 headaches a month, the goal is to abort the headache or relieve the pain. First a careful analysis for triggers is undertaken. Removing the trigger, if identifiable, may be all that is necessary. Abortive medications work best if taken at the first twinge of migraine pain. Do not take medications that constrict blood vessels for the aura symptoms.