Migraine is a disorder characterized by repeated attacks of severe headache.
A migraine headache is typically a pulsating or throbbing pain that ranges from moderate to severe. It can affect one or both sides of the head. It is worsened by physical activity, light, sounds, or odors and is accompanied by nausea, vomiting, and sensitivity to sounds, light, and/or odors.
· Migraines may be triggered by lack of sleep, changes in the weather, hunger, excessive stimulation of the senses, stress, or other factors.
· They are made worse by physical activity, light, sounds, or odors.
· Doctors base the diagnosis on typical symptoms.
· There is no cure for migraines, but drugs are used to stop the migraine as it is starting, to relieve pain, and to reduce the number and severity of migraines attacks.
Although migraines can start at any age, they usually begin during puberty or young adulthood. In most people, migraines recur periodically (fewer than 15 days a month). After age 50, headaches usually become significantly less severe or resolve entirely. Migraines are 3 times more common among women. In the United States, about 18% of women and 6% of men have a migraine at some time each year.
Migraines may become chronic. That is, they occur 15 or more days a month. Chronic migraines often develop in people who overuse drugs to treat migraines.
Migraines tend to run in families. More than half the people who have migraines have close relatives who also have them.
Types of Migraine:
Common Migraine
Also called a migraine without aura, common migraine is the most prevalent type of migraine, and it accounts for about 80 percent of patients. Auras are not associated with headaches in this type of migraine. Fatigue, mood changes, anxiety, and mental fuzziness are among the symptoms frequently experienced.
Classic Migraine
Also called migraine with aura, classic migraine occurs in about one-fifth of migraine sufferers. Visual or other sensory symptoms called auras most often occur before a headache but can also appear during or after a headache. Most commonly, sufferers see auras that are flashing lights, zigzag lines, or blind spots. Auras can also include feelings of numbness or tingling, speaking difficulty, ringing in the ears, smelling a strange odor, or having an odd taste in the mouth.
Menstrual Migraine
This type of migraine is related to fluctuating levels in estrogen during a woman's menstrual cycle. Around 60 to 70 percent of female migraine sufferers report a relationship between their migraine headaches and menstruation.
Abdominal Migraine
Abdominal migraine is an episode of moderate to severe abdominal pain, nausea, or vomiting that can last up to 72 hours. It is typically seen in children, especially those with a family history of migraine. Children who suffer from abdominal migraines usually suffer from classic migraine headaches as adults.
Retinal Migraine
Also known as ocular migraine, retinal migraine involves temporary partial or total loss of vision in one eye that can last an hour or less and is not always accompanied by headache.
Familial Hemiplegic Migraine
This is a very rare inherited condition caused by one of several chromosomes. In hemiplegic migraine, one side of the body may have some temporary motor paralysis or go numb during a migraine headache.
Basilar Artery Migraine
This type of migraine presents itself as a headache, usually in the back of the head, and is associated with an aura that includes dizziness, confusion, problems speaking, hearing changes, and visual disturbances. It is usually related to hormonal changes and most often affects young adults.
Ophthalmoplegic Migraine
This is a rare type of migraine that requires emergency treatment. Patients develop a partial or complete paralysis in nerves required for eye movement.
Status Migrainosus
This is a rare condition characterized by an extremely severe headache that lasts more than 72 hours. Hospitalization is often required to relieve symptoms.
Transformed or Chronic Migraine
This is a form of chronic daily headache. Transformed migraine occurs when, over time, a migraine becomes a continuous background headache with, occasionally, severe migraine symptoms. Sometimes called coexisting migraine and tension-type headache, it is challenging to treat.
Causes of migraine:
Migraines occur in people whose nervous system is more sensitive than that of other people. In these people, nerve cells in the brain are easily stimulated, producing electrical activity. As electrical activity spreads over the brain, various functions, such as vision, sensation, balance, muscle coordination, and speech are temporarily disturbed. These disturbances cause the symptoms that occur before the headache (called the aura). The headache occurs when the 5th cranial (trigeminal) nerve is stimulated. This nerve sends impulses (including pain impulses) from the eyes, scalp, forehead, upper eyelids, mouth, and jaw to the brain. When stimulated, the nerve may release substances that cause painful inflammation in the blood vessels of the brain (cerebral blood vessels) and the layers of tissues that cover the brain (meninges). The inflammation accounts for the throbbing headache, nausea, vomiting, and sensitivity to light and sound.
A rare subtype of migraine called familial hemiplegic migraine is associated with genetic defects on chromosome 1, 2, or 19. The role of genes in the more common forms of migraine is under study.
Estrogen, the main female hormone, appears to trigger migraines, possibly explaining why migraines are more common among women. Migraines can probably be triggered when estrogen levels increase or fluctuate. During puberty (when estrogen levels increase), migraines become much more common among girls than among boys. Some women have migraines just before, during, or just after menstrual periods. Migraines often occur less often and become less severe in the last two trimesters of pregnancy when estrogen levels are relatively stable, and they worsen after childbirth when estrogen levels decrease rapidly. As menopause approaches (when estrogen levels are fluctuating), migraines become particularly difficult to control. Oral contraceptives (which contain estrogen) and estrogen therapy may make migraines worse and may increase the risk of stroke in women who have migraines with an aura.
Other triggers include the following:
· Lack of sleep, including insomnia
· Changes in the weather, particularly barometric pressure
· Red wine
· Certain foods
· Hunger (as when meals are skipped)
· Excessive stimulation of the senses (for example, by flashing lights or strong odors)
· Stress
Head injuries, neck pain, or a problem with the joint of the jaw (temporomandibular joint disorder) sometimes trigger or worsen migraines.
Symptoms:
In a migraine, pulsating or throbbing pain is usually felt on one side of the head, but it may occur on both sides. The pain may be moderate but is often severe and incapacitating. Physical activity, bright light, loud noises, and certain odors may make the headache worse. This increased sensitivity makes many people retreat to a dark, quiet room, lie down, and sleep if possible. Migraines often subside during sleep. The headache is frequently accompanied by nausea, sometimes with vomiting and sensitivity to light, sounds, and/or odors. Severe attacks can be incapacitating, disrupting daily routines and work.
People often have sensations warning them that an attack is about to begin. These sensations, called the prodrome, may include mood changes, loss of appetite, and nausea.
In about 25% of people, migraines are preceded by an aura. The aura involves temporary, reversible disturbances in vision, sensation, balance, muscle coordination, or speech. People may see jagged, shimmering, or flashing lights or develop a blind spot with flickering edges. Less commonly, people experience tingling sensations, loss of balance, weakness in an arm or a leg, or difficulty talking. The aura lasts minutes to an hour before and may continue after the headache begins. Some people experience an aura but have only a mild or no headache. These mild headaches may be similar to tension-type headaches.
A migraine headache is typically a pulsating or throbbing pain that ranges from moderate to severe. It can affect one or both sides of the head. It is worsened by physical activity, light, sounds, or odors and is accompanied by nausea, vomiting, and sensitivity to sounds, light, and/or odors.
· Migraines may be triggered by lack of sleep, changes in the weather, hunger, excessive stimulation of the senses, stress, or other factors.
· They are made worse by physical activity, light, sounds, or odors.
· Doctors base the diagnosis on typical symptoms.
· There is no cure for migraines, but drugs are used to stop the migraine as it is starting, to relieve pain, and to reduce the number and severity of migraines attacks.
Although migraines can start at any age, they usually begin during puberty or young adulthood. In most people, migraines recur periodically (fewer than 15 days a month). After age 50, headaches usually become significantly less severe or resolve entirely. Migraines are 3 times more common among women. In the United States, about 18% of women and 6% of men have a migraine at some time each year.
Migraines may become chronic. That is, they occur 15 or more days a month. Chronic migraines often develop in people who overuse drugs to treat migraines.
Migraines tend to run in families. More than half the people who have migraines have close relatives who also have them.
Types of Migraine:
Common Migraine
Also called a migraine without aura, common migraine is the most prevalent type of migraine, and it accounts for about 80 percent of patients. Auras are not associated with headaches in this type of migraine. Fatigue, mood changes, anxiety, and mental fuzziness are among the symptoms frequently experienced.
Classic Migraine
Also called migraine with aura, classic migraine occurs in about one-fifth of migraine sufferers. Visual or other sensory symptoms called auras most often occur before a headache but can also appear during or after a headache. Most commonly, sufferers see auras that are flashing lights, zigzag lines, or blind spots. Auras can also include feelings of numbness or tingling, speaking difficulty, ringing in the ears, smelling a strange odor, or having an odd taste in the mouth.
Menstrual Migraine
This type of migraine is related to fluctuating levels in estrogen during a woman's menstrual cycle. Around 60 to 70 percent of female migraine sufferers report a relationship between their migraine headaches and menstruation.
Abdominal Migraine
Abdominal migraine is an episode of moderate to severe abdominal pain, nausea, or vomiting that can last up to 72 hours. It is typically seen in children, especially those with a family history of migraine. Children who suffer from abdominal migraines usually suffer from classic migraine headaches as adults.
Retinal Migraine
Also known as ocular migraine, retinal migraine involves temporary partial or total loss of vision in one eye that can last an hour or less and is not always accompanied by headache.
Familial Hemiplegic Migraine
This is a very rare inherited condition caused by one of several chromosomes. In hemiplegic migraine, one side of the body may have some temporary motor paralysis or go numb during a migraine headache.
Basilar Artery Migraine
This type of migraine presents itself as a headache, usually in the back of the head, and is associated with an aura that includes dizziness, confusion, problems speaking, hearing changes, and visual disturbances. It is usually related to hormonal changes and most often affects young adults.
Ophthalmoplegic Migraine
This is a rare type of migraine that requires emergency treatment. Patients develop a partial or complete paralysis in nerves required for eye movement.
Status Migrainosus
This is a rare condition characterized by an extremely severe headache that lasts more than 72 hours. Hospitalization is often required to relieve symptoms.
Transformed or Chronic Migraine
This is a form of chronic daily headache. Transformed migraine occurs when, over time, a migraine becomes a continuous background headache with, occasionally, severe migraine symptoms. Sometimes called coexisting migraine and tension-type headache, it is challenging to treat.
Causes of migraine:
Migraines occur in people whose nervous system is more sensitive than that of other people. In these people, nerve cells in the brain are easily stimulated, producing electrical activity. As electrical activity spreads over the brain, various functions, such as vision, sensation, balance, muscle coordination, and speech are temporarily disturbed. These disturbances cause the symptoms that occur before the headache (called the aura). The headache occurs when the 5th cranial (trigeminal) nerve is stimulated. This nerve sends impulses (including pain impulses) from the eyes, scalp, forehead, upper eyelids, mouth, and jaw to the brain. When stimulated, the nerve may release substances that cause painful inflammation in the blood vessels of the brain (cerebral blood vessels) and the layers of tissues that cover the brain (meninges). The inflammation accounts for the throbbing headache, nausea, vomiting, and sensitivity to light and sound.
A rare subtype of migraine called familial hemiplegic migraine is associated with genetic defects on chromosome 1, 2, or 19. The role of genes in the more common forms of migraine is under study.
Estrogen, the main female hormone, appears to trigger migraines, possibly explaining why migraines are more common among women. Migraines can probably be triggered when estrogen levels increase or fluctuate. During puberty (when estrogen levels increase), migraines become much more common among girls than among boys. Some women have migraines just before, during, or just after menstrual periods. Migraines often occur less often and become less severe in the last two trimesters of pregnancy when estrogen levels are relatively stable, and they worsen after childbirth when estrogen levels decrease rapidly. As menopause approaches (when estrogen levels are fluctuating), migraines become particularly difficult to control. Oral contraceptives (which contain estrogen) and estrogen therapy may make migraines worse and may increase the risk of stroke in women who have migraines with an aura.
Other triggers include the following:
· Lack of sleep, including insomnia
· Changes in the weather, particularly barometric pressure
· Red wine
· Certain foods
· Hunger (as when meals are skipped)
· Excessive stimulation of the senses (for example, by flashing lights or strong odors)
· Stress
Head injuries, neck pain, or a problem with the joint of the jaw (temporomandibular joint disorder) sometimes trigger or worsen migraines.
Symptoms:
In a migraine, pulsating or throbbing pain is usually felt on one side of the head, but it may occur on both sides. The pain may be moderate but is often severe and incapacitating. Physical activity, bright light, loud noises, and certain odors may make the headache worse. This increased sensitivity makes many people retreat to a dark, quiet room, lie down, and sleep if possible. Migraines often subside during sleep. The headache is frequently accompanied by nausea, sometimes with vomiting and sensitivity to light, sounds, and/or odors. Severe attacks can be incapacitating, disrupting daily routines and work.
People often have sensations warning them that an attack is about to begin. These sensations, called the prodrome, may include mood changes, loss of appetite, and nausea.
In about 25% of people, migraines are preceded by an aura. The aura involves temporary, reversible disturbances in vision, sensation, balance, muscle coordination, or speech. People may see jagged, shimmering, or flashing lights or develop a blind spot with flickering edges. Less commonly, people experience tingling sensations, loss of balance, weakness in an arm or a leg, or difficulty talking. The aura lasts minutes to an hour before and may continue after the headache begins. Some people experience an aura but have only a mild or no headache. These mild headaches may be similar to tension-type headaches.