What is the migraine pain?
A migraine is a severe, painful headache that can be preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound. The excruciating pain that migraines bring can last for hours or even days.
Where does a migraine come from?
Migraine tends to affect people between 15-55 years of age. Some people who suffer from migraines can clearly identify triggers or factors that cause the headaches such as allergies, light and stress. Some people get a warning prodrome, preceding the onset of a migraine headache.
Where does it hurt when you have a migraine?
A migraine is usually an intense pounding headache that can last for hours or even days. The pounding or pulsing pain usually begins in the forehead, the side of the head or around the eyes. The headache gradually gets worse. Just about any movement, activity, bright lights or loud noises seem to make it hurt more.
How do you know if you have a migraine headache?
Symptoms associated with a migraine headache include:
» nausea.
» pain behind one eye or ear.
» pain in the temples.
» seeing spots or flashing lights.
» sensitivity to light and/or sound.
» temporary vision loss.
» vomiting.
Migraine Treatment
Migraine treatments can help stop symptoms and prevent future attacks.
Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:
Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.
Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.
Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you.
Signs and symptoms
Migraines typically present with self-limited, recurrent severe headache associated with autonomic symptoms. About 15–30% of people with migraines experience migraines with an aura and those who have migraines with aura also frequently have migraines without aura. The severity of the pain, duration of the headache, and frequency of attacks are variable. A migraine lasting longer than 72 hours is termed status migrainosus. There are four possible phases to a migraine, although not all the phases are necessarily experienced:
The prodrome, which occurs hours or days before the headache
The aura, which immediately precedes the headache
The pain phase, also known as headache phase
The postdrome, the effects experienced following the end of a migraine attack
Cause
The underlying causes of migraines are unknown. However, they are believed to be related to a mix of environmental and genetic factors. They run in families in about two-thirds of cases and rarely occur due to a single gene defect. While migraines were once believed to be more common in those of high intelligence, this does not appear to be true. A number of psychological conditions are associated, including depression, anxiety, and bipolar disorder, as are many biological events or triggers.
Pathophysiology
Migraines are believed to be a neurovascular disorder with evidence supporting its mechanisms starting within the brain and then spreading to the blood vessels. Some researchers believe neuronal mechanisms play a greater role, while others believe blood vessels play the key role. Others believe both are likely important. One theory is related to increased excitability of the cerebral cortex and abnormal control of pain neurons in the trigeminal nucleus of the brainstem. High levels of the neurotransmitter serotonin, also known as 5-hydroxytryptamine, are believed to be involved.
Diagnosis
The diagnosis of a migraine is based on signs and symptoms. Neuroimaging tests are not necessary to diagnose migraine, but may be used to find other causes of headaches in those whose examination and history do not confirm a migraine diagnosis. It is believed that a substantial number of people with the condition remain undiagnosed.
The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":
» Five or more attacks—for migraine with aura, two attacks are sufficient for diagnosis.
» Four hours to three days in duration
» Two or more of the following:
» Unilateral (affecting half the head);
» Pulsating;
» Moderate or severe pain intensity;
» Worsened by or causing avoidance of routine physical activity
If someone experiences two of the following: photophobia, nausea, or inability to work or study for a day, the diagnosis is more likely. In those with four out of five of the following: pulsating headache, duration of 4–72 hours, pain on one side of the head, nausea, or symptoms that interfere with the person's life, the probability that this is a migraine is 92%. In those with fewer than three of these symptoms the probability is 17%
