Migraine Headache

A migraine headache is a painful headache that is caused by a vascular condition. It is caused by an enlargement of the arteries and veins in the head that releases chemicals in and around the brain. The chemicals cause pain and inflammation of the arterial milieu. The pain can be very severe. Migraine headaches trigger the sympathetic nervous system to respond. This is the fight or flight response of the body so that there is an increase in diarrhoea, nausea and vomiting in attacks of the disease.

The sympathetic over activity triggers delayed emptying from the stomach, which results in delayed absorption of food and medications. Impaired absorption of medications means that oral medications don't work well for migraine headaches. The circulation of the feet is decreased so that the feet tend to be cold as well as the hands. There is a sensitivity to light and blurry vision due to the increased sympathetic activity.

Migraine headaches affect about 28 million people in the US with females having them slightly more commonly than men. It is a highly under diagnosed disease because it can seem just like a regular headache to some people.

The main symptoms of migraine headaches include recurrent attacks of intense, pounding or throbbing pain that usually occurs on one side of the head. In some cases, the pain is located in the forehead. The pain is bilateral about thirty percent of the time. It is made worse by doing daily activities and is associated with diarrhoea, nausea, vomiting, pale face, cold feet and cold hands. There is sensitivity to light and sound while the migraine headache is going on. The person needs to lie down in a dark and quiet room in order to feel better. The attacks can last between four and seventy-four hours.

About half of all migraine headaches have some kind of warning symptoms called premonitory symptoms. These can last for several hours or even days. Premonitory symptoms include irritability, tiredness or sleepiness, yawning, euphoria, depression or food cravings, particularly for salty or sweet foods.

An aura is different from a premonitory symptom. Only about twenty percent of migraine patients have an aura. This is a neurologic symptom such as the seeing of bright, flashing lights forming a zigzag pattern across the visual field, a hole in the visual field (blind spot), or other neurologic symptoms. Auras can be the only thing noticed in an elderly person. Less commonly, an aura can be the sensation of pins and needles down the mouth and nose on the same side of the body as the headache. Auditory hallucinations, abnormal tastes and smells can be part of an aura in unusual cases.

The diagnosis of a migraine headache is based upon a careful history and physical examination. If the headaches first start after the age of fifty, they are more likely to be another type of headache. There is often a family history of migraine headaches. Having an aura makes it easier to diagnose the condition. Sometimes, a CT scan or MRI scan of the brain is done in order to rule out a neurological cause for the headache, such as a brain tumour or aneurysm.

Migraines can be treated with or without medications. When treated without medications, patients use biofeedback, ice to the affected area and relaxation methods to stop an attack. Sleep helps diminish the feeling of a migraine headache. Patients should stop all triggers to migraines, including foods containing tyramine or sulphites and smoking cigarettes. Acupuncture can control some headaches.

Patients can use nonsteroidal anti-inflammatory medications or Tylenol for headaches, especially if they are mild. They cannot be taken if there is much nausea and vomiting going on as part of the headache. There are migraine-specific medications to stop severe migraines. These include triptans, which bind to serotonin receptors, allowing the arteries to constrict again. Sumatriptan is one anti-migraine medication which can be taken via several routes. Zomig also works in the same way and some come in a dissolving mouth lozenge. These medications can be used as first-line agents in the management of migraine headaches.

Ergot medications are also used for migraines. These can be combined with caffeine to shrink the arterial diameter. One ergot medication is called Cafergot. They are not as safe to take, however, than the triptans. Midrin is another anti-migraine medication that is used in both tension headaches and migraine headaches. They can abort a migraine headache if taken early enough.