Migraine

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells.

Types of Migraines #

There are several types of migraines, and the same type may go by different names:

• Migraine with aura (complicated migraine): Around 15% to 20% of people with migraine headaches experience an aura.
• Migraine without aura (common migraine): This type of migraine headache strikes without the warning an aura may give you. The symptoms are the same, but that phase doesn’t happen.
• Migraine without head pain: Silent migraine or acephalgic migraine, as this type is also known as, includes the aura symptom but not the headache that typically follows.
• Hemiplegic migraine: You’ll have temporary paralysis (hemiplegia) or neurological or sensory changes on one side of your body. The onset of the headache may be associated with temporary numbness, extreme weakness on one side of your body, a tingling sensation, a loss of sensation and dizziness or vision changes. Sometimes it includes head pain and sometimes it doesn’t.

• Retinal migraine (ocular migraine): You may notice temporary, partial or complete loss of vision in one of your eyes, along with a dull ache behind the eye that may spread to the rest of your head. That vision loss may last a minute, or as long as months. You should always report a retinal migraine to a healthcare provider because it could be a sign of a more serious issue.
• Chronic migraine: A chronic migraine is when a migraine occurs at least 15 days per month. The symptoms may change frequently, and so may the severity of the pain. Those who get chronic migraines might be using headache pain medications more than 10 to 15 days a month and that, unfortunately, can lead to headaches that happen even more frequently.
• Migraine with brainstem aura: With this migraine, you’ll have vertigo, slurred speech, double vision or loss of balance, which occur before the headache. The headache pain may affect the back of your head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears and vomiting.
• Status migrainosus: This is a rare and severe type of migraine that can last longer than 72 hours. The headache pain and nausea can be extremely bad. Certain medications, or medication withdrawal, can cause you to have this type of migraine.

Phases of Migraine #

The phases are:

• Prodrome: The first stage lasts a few hours, or it can last days. You may or may not experience it as it may not happen every time. Some know it as the preheadache or premonitory phase.

• Aura: The aura phase can last as long as 60 minutes or as little as five. Most people don’t experience an aura, and some have both the aura and the headache at the same time

• Headache: About four hours to 72 hours is how long the headache lasts. The word ache doesn’t do the pain justice because sometimes it’s mild, but usually, it’s described as drilling, throbbing or you may feel the sensation of an icepick in your head. Typically it starts on one side of your head and then spreads to the other side.

• Postdrome: The postdrome stage goes on for a day or two. It’s often called a migraine hangover and 80% of those who have migraines experience it.

Risk factors of Migraine #

It’s difficult to predict who may get a migraine and who may not, but there are risk factors that may make you more vulnerable. These risk factors include:

• Genetics - Up to 80% of people who get migraine headaches have a first-degree relative with the disease.

• Gender - Migraine headaches happen to women more than men, especially women between the ages of 15 and 55. It’s likely more common in women because of the influence of hormones.

• Stress level - You may get migraines more often if you’re high-stress. Stress can trigger a migraine.

• Smoking.

Symptoms of Migraine #

Each phase of the migraine attack can come with different symptoms:

Prodrome symptoms #

• Problems concentrating.

• Irritability and/or depression.

• Difficulty speaking and reading.

• Difficulty sleeping. Yawning.

• Nausea.

• Fatigue.

• Sensitivity to light and sound.

• Food cravings.

• Increased urination.

• Muscle stiffness.

Aura symptoms #

• Numbness and tingling.

• Visual disturbances. You might be seeing the world as if through a kaleidoscope, have blurry spots or see sparkles or lines.

• Temporary loss of sight.

• Weakness on one side of the body.

• Speech changes.

Headache symptoms #

• Neck pain, stiffness.

• Depression, giddiness and/or anxiety.

• Sensitivity to light, smell and sound.

• Nasal congestion.

• Insomnia.

• Nausea and vomiting.

Postdrome symptoms #

• Inability to concentrate.

• Depressed mood.

• Fatigue.

• Lack of comprehension.

• Euphoric mood.

Causes of Migraine #

• The cause of migraine headaches is complicated and not fully understood.

• When you have a headache it’s because specific nerves in your blood vessels send pain signals to your brain.

• This releases inflammatory substances into the nerves and blood vessels of your head.

• It’s unclear why your nerves do that.

Diagnosis of Migraine #

Your healthcare provider may also order blood tests and imaging tests (such as a CT scan or a MRI) to make sure there are no other causes for your headache. An electroencephalogram (EEG) may be ordered to rule out seizures.

Treatment of Migraine #

Migraine headaches are chronic. They can’t be cured, but they can be managed and possibly improved. There are two main treatment approaches that use medications: abortive and preventive.

Abortive medications #

• These are most effective when you use them at the first sign of a migraine.

• Take them while the pain is mild.

• By possibly stopping the headache process, abortive medications help stop or decrease your migraine symptoms, including pain, nausea, light sensitivity, etc.

• Some abortive medications work by constricting your blood vessels, bringing them back to normal and relieving the throbbing pain.

Preventive (prophylactic) medications #

• They may be prescribed when your headaches are severe, occur more than four times a month and are significantly interfering with your normal activities.

• Preventive medications reduce the frequency and severity of the headaches.

• Medications are generally taken on a regular, daily basis to help prevent migraines.