Migraine
Migraine is a neurological condition that
can cause multiple symptoms. It’s frequently characterized by intense,
debilitating headaches. Migraines often run in families and affect all ages. The
extreme pain that migraines cause can last for hours or even days.
Symptoms
Symptoms
of migraine can start a while before the headache, immediately before the
headache, during the headache, and after the headache. Although not all
migraines are the same, typical symptoms include:
·
moderate
to severe pain, usually confined to one side of the head but capable of
occurring on either side of the head
·
severe,
throbbing, or pulsing pain
·
increasing
pain during physical activity or when straining
·
inability
to perform regular activities due to pain
·
feeling
sick and physically vomiting
·
increased
sensitivity to light and sound, relieved by lying quietly in a darkened room
·
Some
people experience other symptoms such as sweating, temperature changes, stomach
ache, and diarrhea.
Fast facts on migraines:
·
Some
people who experience migraines can clearly identify triggers or factors that
cause the headaches, such as allergies, light, and stress.
·
Some
people get a warning symptom before the start of the migraine headache.
·
Many
people with migraine can prevent a full-blown attack by recognizing and acting
upon the warning signs.
·
Over-the-counter
(OTC) medications can eliminate or reduce pain, and specific medications can
help some people with migraine.
·
People
who have severe attacks can take preventive medicines.
Cause
The
specific cause of migraines is not known, but there may be fluctuations in
certain neurotransmitters, chemicals that send messages between brain cells.
These changes may predispose some people to develop migraine headaches.
Types
Migraine without
aura
A
migraine without aura is more than just a headache. The pain alone is enough to
stop you from carrying on your daily activities. And then there's the nausea,
maybe vomiting, and more.
Migraines with aura
Migraines
with aura account for about a quarter of all migraines. Even if you get auras,
you may not have one with every migraine. Some children and older adults may get
an aura without later pain.
Chronic migraine
Chronic
migraine is a distinct and relatively recently defined sub-type of Chronic
Daily Headache. The International Headache Society defines chronic migraine as
more than fifteen headache days per month over a three month period of which
more than eight are migrainous, in the absence of
medication over use. Episodic migraine is the other migraine sub-type, which is
defined as less than 15 headache days per month.
Menstrual migraines
Menstrual
migraines are primarily caused by estrogen, the female sex hormone that
specifically regulates the menstrual cycle fluctuations throughout the cycle.
When the levels of estrogen and progesterone change, women will be more
vulnerable to headaches. Because oral contraceptives influence estrogen levels,
women on birth control pills may experience more menstrual migraines.
Hemiplegic migraine
Hemiplegic
migraine is a rare and serious type of migraine headache. Many of its symptoms
mimic those common to stroke; for example, muscle weakness can be so extreme
that it causes a temporary paralysis on one side of your body, which doctors
call hemiplegia.
Migraine with
brainstem aura
Migraine
with brainstem aura (MBA) is a type of migraine headache with aura that is
associated with pain at the back of the head on both sides. An aura is a group
of symptoms that generally serve as a warning sign that a bad headache is
coming. Auras may consist of dizziness and vertigo, slurred speech, ataxia,
tinnitus, visual changes, and/or loss of balance. Although MBA can occur in men
and women of all ages, they are most common in adolescent girls. The exact
underlying cause of MBA is poorly understood. Migraines are likely complex
disorders that are influenced by multiple genes, in combination with lifestyle
and environmental factors.
Abdominal migraine
Abdominal
migraine is a form of migraine seen mainly in children. It is most common in
children ages five to nine years old, but can occur in adults as well.
Abdominal migraine consists primarily of abdominal pain, nausea and vomiting. It
is recognized as an episodic syndrome that may be associated with migraine, as
links have been made to other family members having migraines and children who
have this disorder often grow into adults with migraine. Most children who
experience abdominal migraine grow out of it by their teens and eventually
develop migraine headaches.
Cyclic vomiting
syndrome
Cyclic
vomiting syndrome (US English) or cyclical vomiting syndrome (UK English) (CVS)
is a chronic functional condition of unknown cause characterised
by recurring attacks of intense nausea, vomiting, and sometimes abdominal pain,
headaches, or migraines. CVS typically develops during childhood, usually
between ages 3 and 7; although it often remits during adolescence, it can
persist into adult life.
Risk factors
Several
factors make you more prone to having migraines, including:
Family
history. If you have a family member with
migraines, then you have a good chance of developing them too.
Age. Migraines can begin at any age,
though the first often occurs during adolescence. Migraines tend to peak during
your 30s, and gradually become less severe and less frequent in the following
decades.
Sex. Women are three times more likely
to have migraines. Headaches tend to affect boys more than girls during
childhood, but by the time of puberty and beyond, more girls are affected.
Hormonal
changes. If you are a woman who has
migraines, you may find that your headaches begin just before or shortly after
onset of menstruation. They may also change during pregnancy or menopause.
Migraines generally improve after menopause. Some women report that migraine
attacks begin during pregnancy, or their attacks worsen. For many, the attacks
improved or didn't occur during later stages in the pregnancy. Migraines often
return during the postpartum period.
Migraine tests
Doctors
diagnose migraines by listening to your symptoms, taking a thorough medical and
family history, and performing a physical exam to rule out other potential
causes. Imaging scans, such as a CT scan or MRI, can rule out other causes,
including:
·
tumors
·
abnormal
brain structures
·
stroke
Treatment
There
is currently no single cure for migraines. Treatment is aimed at preventing a
full-blown attack, and alleviating the symptoms that occur.
Lifestyle
alterations that might help reduce the frequency of migraines include:
·
getting
enough sleep
·
reducing
stress
·
drinking
plenty of water
·
avoiding
certain foods
·
regular
physical exercise
·
Some
people also find that special diets can help, such as gluten-free.
Consider
seeking further treatment if the above changes do not relieve the symptoms or
frequency of migraines. The treatment of migraine symptoms focuses on avoiding
triggers, controlling symptoms, and taking medicine.
Prevention
Until
recently, experts recommended avoiding common migraine triggers. Some triggers
can't be avoided, and avoidance isn't always effective. But some of these
lifestyle changes and coping strategies may help you reduce the number and
severity of your migraines:
Transcutaneous supraorbital nerve
stimulation (t-SNS).
This device (Cefaly), similar to a headband with
attached electrodes, was recently approved by the Food and Drug Administration
as a preventive therapy for migraines. In research, those that used the device
experienced fewer migraines.
Learn to cope. Recent research shows that a
strategy called learning to cope (LTC) may help prevent migraines. In this
practice, you are gradually exposed to headache triggers to help desensitize
you to them. LTC may also be combined with cognitive behavioral therapy. More
research is needed to better understand the effectiveness of LTC.
Create a consistent
daily schedule.
Establish a daily routine with regular sleep patterns and regular meals. In
addition, try to control stress.
Exercise regularly. Regular aerobic exercise reduces
tension and can help prevent migraines. If your doctor agrees, choose any
aerobic exercise you enjoy, including walking, swimming and cycling. Warm up
slowly, however, because sudden, intense exercise can cause headaches. Regular
exercise can also help you lose weight or maintain a healthy body weight, and
obesity is thought to be a factor in migraines.
Reduce the effects
of estrogen. If
you are a woman who has migraines and estrogen seems to trigger or make your
headaches worse, you may want to avoid or reduce the medications you take that
contain estrogen.