Migraines can be referred to as moderate to severe recurring pain in the head. The pain often affects just one side of the head which patients may describe as pulsing or throbbing. Sensitivity to light and sound are common during a migraine attack which may be accompanied by nausea and vomiting. When it comes to a migraine, it is found that the rate at which women are affected is much higher than men. An attack of a migraine can last from hours to days, and the pain can be so severe and unbearable. Some people get warning symptoms known as aura before the onset of the migraine. This can be in the form of temporary loss of vision, blind spots, flashing lights, tingling sensation on one side of the face, arm or leg, and zigzag lines.
Causes of Migraine Symptoms
As migraine causes are not fully understood, it appears genetics and environmental factors play a role. The cause of a migraine may be due to changes in the brainstem and its interactions with the major pathway which is the trigeminal nerve. Researchers who are still studying the role of serotonin in migraines believe that imbalances in chemicals like serotonin may play a role as it helps in the regulation of pain in the nervous system. Here are some known migraine triggers:
- Stress: It could be originated from either home or office, but this can cause a migraine
- Environmental Change: When the barometric pressure or the weather changes, this can trigger a migraine
- Hormonal Changes in Women: When estrogen fluctuates, it tends to cause a migraine in women. Female patients who present with a history of a migraine, usually notice headaches just before or during their periods, and this is when there is a remarkable fall in estrogen.
- Food Additives: Additives in food like sweetener aspartate and even the preservative called monosodium glutamate may lead to a migraine.
- Sensory Stimuli: Strong stimuli such as bright lights, sun glare, loud sounds, even strong smells like paints, second-hand smoke, perfumes and the rest of other strong smells.
- Drinks: Highly caffeinated beverages and alcoholic drinks especially wine can trigger a migraine attack.
- Wake-sleep Pattern Change: for people who change geographical locations with different time zone and experience jet lag which has been associated with a trigger of a migraine. Oversleeping or missing sleep can trigger an episode.
- Medications: some medications for treatment of another disease can lead to migraines like oral contraceptives and vasodilators.
- Physical Factors: Vigorous physical activity can trigger a migraine even sexual activities.
Most Common Symptoms of Migraine Headaches
Symptoms usually occur from childhood, adolescent or adulthood. There may be four stages of migraine progression.
- Prodromal: Patient may notice some changes that signal an imminent migraine, one or two days prior to These symptoms are stiffness of the neck, cravings for food, yawning more often, constipation, excessive thirst, and urination, change in mood ranging from depression to euphoria.
- Aura: Not all patients experience migraines with aura. For those who do, it may occur before or during an episode. Auras are merely manifestations of the nervous Usually, it is visual disturbances like flashes of light or zigzag vision. Sometimes auras can appear as a movement, speech disorders or touching sensations. The patient may experience muscle weakness or feeling of someone touching them. These symptoms start slowly and escalate over some minutes and last up to 20 to 60 minutes. Examples of migraine aura includes difficulty in speech, impaired vision, hearing of noises, sensation of pins and needles on the arms and legs, seeing of different shapes, light flashes or blind spots, feeling of weakness or numbness in face and sometimes one side of the body, jerking or movements that cannot be controlled.
- Attack: If untreated, migraine can last from three to 72 hours. Based on individuals, the frequency of migraines It could be very often within a month or occur rarely. Symptoms experienced during a migraine are vision blurriness, throbbing or pulsing pain, nausea, vomiting, lightheadedness that may be followed by fainting, photophobia, sensitivity to sounds smell even touch, pain experienced on either one side or both sides of the head.
- Post-drome: This is the final phase which happens after a migraine attack. Some people have a feeling of excitement while others may feel drained. Within the next twenty-four hours, the patient may experience dizziness, photophobia, and sensitivity to sound, confusion, and change in mood.
Treatment of Chronic Migraine
Many medications have been produced for the treatment of migraines. For the prevention and relief of migraines, some drugs that are used for other diseases can also be of great help. Choice of treatment depends on how often migraine occurs, its severity, how it limits activity and associated conditions. There are two groups of medications used to fight migraines, these are:
Firstly, medications for the relief of pain also referred to as acute treatment. They are administered during a migraine attack and aim to abort symptoms. This should be taken immediately the signs and symptom of a migraine appears for optimal result. The patient will also feel good if rest or sleep is done in a dark, quiet room after administration of medication. Here are pain-relieving medications:
- Pain Reliever: For mild migraines, acetaminophen, aspirin or ibuprofen can be used. Note that these drugs should not be taken for a long time as they can lead to some gastrointestinal disorders.
- Triptans: These medications help in constriction of the blood vessel and block the pain pathway in the brain.
Secondly, medication for prevention, this is recommended for daily use or when a trigger is presented for example menstruation is close. These medicines may not always completely stop a migraine and may even have side effects. Here are some common medications:
- Antidepressants: Tricyclic antidepressants have shown to be useful in the prevention of a migraine as it reduces the level of serotonin and other chemicals in the brain even if the patient has no history of depression.
- Cardiovascular drugs: the frequency and severity of a migraine can also be reduced by drugs used to treat high blood pressure and coronary heart disease known as Beta blockers.
- Anti-seizure drugs: Reduction in migraine frequency has been observed after the use of valproate and topiramate.
- OnabotulinumtoxinA (Botox): This is very effective for treatment of a chronic migraine in adults. This treatment needs to be administered every 12 weeks.
When to See a Neurologist
Once symptoms become too frequent, severe or there is a change in the pattern, one should visit a neurologist. Many times, migraine has been undiagnosed or untreated. Ensure to keep a record of episodes and how it was treated. Endeavor to make an appointment if different symptoms appear at once as it may be a sign of another disease.
References
Migraine – Symptoms and causes. (2018). Mayo Clinic. Retrieved 25 April 2018, from https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201
Migraine | MedlinePlus. (2018). Medlineplus.gov. Retrieved 25 April 2018, from https://medlineplus.gov/migraine.html