Migraine

What is a migraine headache?

A migraine headache is a type of headache that tends to recur in an individual and causes moderate to severe pain. The pain is often described as throbbing or pulsing and usually begins on one side of the head. Migraine headaches are worsened by physical activity, light, sound, or physical movement. The pain typically last from 4 hours up to 3 days. The person experiencing a migraine headache may be sensitive to light, sound and even smell. He or she may also experience nausea and/or vomiting.

Types of migraine

The types of migraine related to specific syndromes or triggers includes:

• Chronic migraine: This refers to any migraine that triggers attacks on over 15 days of the month.
• Menstrual migraine: This is when the attacks occur in a pattern connected to the menstrual cycle.
• Hemiplegic migraine: This causes weakness on one side of the body for a temporary period.
• Abdominal migraine: This is a syndrome that connects migraine attacks to irregular function in the gut and abdomen. It mainly occurs in children under 14 years of age,
• Migraine with brainstem aura: This is a rare type of migraine that can trigger severe neurological symptoms, such as affected speech.

Migraine symptoms

Migraines are often begin in childhood, adolescence or early adulthood. Not everyone who has migraines goes through all stages:

Prodrome

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

• Constipation
• Mood changes, from depression to euphoria
• Food cravings
• Neck stiffness
• Increased thirst and urination
• Frequent yawning

Aura

For some people, aura might occur before or during migraines. Auras are reversible symptoms of the nervous system. They're usually visual, but can also include other disturbances. Each symptom usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes.

Examples of migraine aura include:

• Visual phenomena, such as seeing various shapes, bright spots or flashes of light
• Vision loss
• Pins and needles sensations in an arm or leg
• Weakness or numbness in the face or one side of the body
• Difficulty speaking
• Hearing noises or music
• Uncontrollable jerking or other movements

Attack

A migraine usually lasts from four to 72 hours if untreated. How often migraines occur varies from person to person. Migraines might occur rarely or strike several times a month.

During a migraine, you might have:

• Pain usually on one side of your head, but often on both sides
• Pain that throbs or pulses
• Sensitivity to light, sound, and sometimes smell and touch
• Nausea and vomiting

Post- drome

After a migraine attack, you might feel drained, confused and washed out for up to a day. Some people report feeling elated. Sudden head movement might bring on the pain again briefly.

What causes a migraine?

Migraine headache pain results from signals interacting among the brain, blood vessels, and surrounding nerves. During a headache, specific nerves of the blood vessels are activated and send pain signals to the brain. It’s not clear, however, why these signals are activated in the first place.

There is a migraine “pain center,” or generator, in the mid-brain area. A migraine begins when overactive nerve cells send out impulses to the blood vessels. This causes the release of prostaglandins, serotonin, and other substances that cause swelling of the blood vessels in the vicinity of the nerve endings, resulting in pain.

What triggers a migraine?

• Emotional stress , worry: is one of the most common triggers of migraine headache. During stressful events, certain chemicals in the brain are released to combat the situation (known as the "flight or fight" response). The release of these chemicals can bring on a migraine. Other emotions such as anxiety, worry, and excitement can increase muscle tension and dilate blood vessels, which can make the migraine more severe.
• Sensitivity to specific chemicals and preservatives in foods: Certain foods and beverages, such as aged cheese, alcoholic beverages, chocolate, and food additives such as nitrates (in pepperoni, hot dogs, luncheon meats) and fermented or pickled foods may be responsible for triggering up to 30 percent of migraines.
• Caffeine: Having too much caffeine can cause headaches when the caffeine level abruptly drops. The blood vessels seem to become sensitized to caffeine, and when caffeine is not ingested, a headache may occur. Caffeine itself is often helpful in treating acute migraine attacks.
• Changing weather conditions such as storm fronts, barometric pressure changes, strong winds or changes in altitude.
• Bright light, fluorescent light, flashing lights, sunlight
• Tension, anxiety
• Being overly tired
• Overexertion
• Missing meals, dieting or not drinking enough liquids
• Changes in normal sleep pattern
• Loud noises
• Exposure to smoke, perfumes or other odors
• Certain medications that cause blood vessels to swell
• Hormonal changes in women (brought on by menstrual periods, birth control pills, hormone replacement therapy)

Migraine vs headache

It is important to know the difference between a migraine attack and a headache.

Headaches can vary a great deal in how long they last, how severe they are, and why they happen. They may not occur in a recognizable pattern as migraine attacks do.

Migraine attacks will present as moderate-to-severe headaches on one side of the head that occur with other symptoms, such as nausea and vomiting. Migraine and non-migraine headaches are different and can indicate different causes.

To help identify a migraine headache, it can be useful to keep a diary of symptoms noting the time of onset, any triggers, the duration of the headaches, any noticeable signs or auras leading up to a migraine attack, and any other symptoms.

A headache diary should ideally be used for a minimum of 8 weeks and record:

• The frequency, duration, and severity of headaches
• Any associated symptoms
• All prescribed and OTC medications taken to relieve headache symptoms
• Possible triggers
• The relationship of headaches to menstruation

The International Headache Society recommends the “5, 4, 3, 2, 1” criteria to diagnose migraines without aura.

This stands for:

• 5 or more attacks with a duration of 4 hours to 3 days
• At least two of the following qualities: Occurring on one side of the head, a pulsating quality, moderate-to-severe pain, and aggravation by routine physical activity
• At least one additional symptom, such as nausea, vomiting, sensitivity to light, or sensitivity to sound.

When to see a doctor

If you have multiple headaches a month that last for several hours or days. Make an appointment with our doctors' if your headaches start to affect your daily life.

Diagnosis

• MRI. An MRI scan uses a powerful magnetic field and radio waves to produce detailed images of the brain and blood vessels. MRI scans help doctors diagnose tumors, strokes, bleeding in the brain, infections, and other brain and nervous system (neurological) conditions.
• CT scan. A CT scan uses a series of X-rays to create detailed cross-sectional images of the brain. This helps doctors diagnose tumors, infections, brain damage, bleeding in the brain and other possible medical problems that may be causing headaches.

Treatment

Nontraditional therapies might help with chronic migraine pain.

Herbs, vitamins and minerals: There is some evidence that the herbs feverfew and butterbur might prevent migraines or reduce their severity, though study results are mixed. Butterbur isn't recommended because of safety concerns.

Acupuncture: Clinical trials have found that acupuncture may be helpful for headache pain. In this treatment, a practitioner inserts many thin, disposable needles into several areas of your skin at defined points.

Biofeedback: Biofeedback appears to be effective in relieving migraine pain. This relaxation technique uses special equipment to teach you how to monitor and control certain physical responses related to stress, such as muscle tension.

Cognitive behavioral therapy: Cognitive behavioral therapy may benefit some people with migraines. This type of psychotherapy teaches you how behaviors and thoughts affect how you perceive pain.

Migraine prevention

• Learn what triggers your migraines and avoid those things.
• Stay hydrated: Per day, Men should drink about 13 cups of fluids and women should drink 9 cups.
• Avoid skipping meals.
• Get quality sleep: A good night’s sleep is important for overall health.
• Quit smoking.
• Make it a priority to reduce stress in your life and learn to cope with it in helpful ways.
• Learn relaxation skills.
• Exercise regularly: Exercise may help you not only reduce stress but also lose weight. Experts believe obesity is linked to migraines. Be sure to start exercising slowly to warm up gradually. Starting too fast and intensely can trigger a migraine.

Recommendation

Migraine headaches can be severe, debilitating, and uncomfortable. Many treatment options are available, so be patient finding the one or combination that’s best for you. Keep track of your headaches and symptoms in order to identify migraine triggers. Knowing how to prevent migraines can often be the first step in managing them.