One of the most nagging headaches, Migraine is episodic (occurs anywhere from once or twice a year to 1-4 times a month) in nature. It is associated with accompanying symptoms like vomiting, blurring of vision etc. Some patients may get headaches more frequently, almost daily.
Migraine is a condition which refers to severe headache that is commonly associated with signs like blind spots, nausea and/or vomiting. Migraine headaches are extremely painful and can last for hours or sometimes even for days together. Migraine headaches are often caused by certain genetic as well as environmental factors. Migraine can be prevented to a great extent by exercising and alternative therapies like acupuncture.
Depending on the signs and symptoms, migraines are classified into the Classic Migraine and Common Migraine.
Classic migraines start with an aura. The person may have trouble communicating, feel depressed, irritable and restless. The symptoms may last for 5 to 15 minutes or more. As these symptoms disappear, a throbbing headache begins on one side of the head along with symptoms like nausea, vomiting, and sensitivity to light and noise.
Common migraines don’t start with an aura and may start more slowly than classic migraines, last longer and interfere more with daily activities. The pain of common migraines may be on only one side of the head. Nausea, vomiting, and sensitivity to light and noise usually accompany the headache.
Though the exact causes of migraines are unknown, blood vessel contractions and other changes in the brain as well as inherited abnormalities in certain areas of the brain have been linked to it. A migraine pain center or generator is situated in the brain. A migraine begins when hyperactive nerve cells send out impulses to the blood vessels. This causes them to constrict, followed by expansion and the release of inflammatory substances like prostaglandins, serotonin etc. that cause the pulsation to be painful.
Migraines can begin at any age, but most develop them around adolescence or in their 20s. It occurs more often in women than men and most migraine sufferers have a family history of the disease.
A migraine attack could be triggered by certain factors like:
A Migraine headache usually starts as a dull ache and gets worse within minutes to hours. Patients usually complain of a throbbing, pounding or pulsating pain which is worse on one side of the head and lasts 6 to 48 hours.
This could be accompanied by –
Diagnosis is usually done by the symptoms and the pattern of headache, family history of migraine and the response to analgesics taken to stop the headache. Neurological tests are done to rule out diseases of the brain or nerves like epilepsy or multiple sclerosis that may also cause headaches and migraines. Patients are usually asked to maintain a headache diary which will help the doctor identify the triggers for the migraine episodes.
There are two approaches to treat migraine namely - Abortive and Preventive.
Abortive therapy: The treatment goal is to stop migraine as soon as a person experiences the pain.
Preventive therapy: The target of this treatment approach is to lessen the severity and frequency of migraine.
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