Daily Medicos

Migraine Headache: Causes, Symptoms, Treatment

  • A primary headache disorder.
  • Migraine most often begins at puberty and most affects those aged between 35 and 45 years.
  • It is more common in women, usually by a factor of about 2:1, because of hormonal influences.
  • It is caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head.
  • Migraine is recurrent, often life-long, and characterized by recurring attacks.

Reference WHO

What is Migraine?

Migraine is a very common medical condition. It is a chronic headache disorder which affects one-half of the head. Headache is recurrent, throbbing and pulsatile in nature. In some people it follows an aura (perceptual disturbance/visual disturbance). Other associations include abdominal symptoms and sensitivities to sound and light. 

Who is more prone to suffer from migraine?

History of migraine dates back to 1500 BC. Each year it affects 15% of the population universally i.e. around 1 billion people. It is said that about 25% of the people will suffer from migraine at some point in their lives. Being slightly less common in African and Asian countries, it affects 6%-18% of the population in the United States and other Western countries. In Europe, 28% people suffer from migraine headache every year.

Age is also a key factor here as it starts between 15 to 24 years of age and typically occurs in 35 to 45 years of age. Before puberty, it is more common in males than females. But after adolescence it occurs more frequently in females than males with a ratio of about 3:1

What causes Migraine Headache?

A number of causes have been proposed but its exact underlying cause remains unknown. Following are a few possible triggers:

  • Genetic factors can be responsible here as migraine headaches run in families and about two-third of the cases are familial cases.
  • Environmental factors such as nature or quality of ambient sound and lighting 
  • Foods have also been reported as a cause by many people (e.g. following intake of monosodium glutamate, chocolate, dairy products, alcohol etc.)
  • Certain physiological processes like fatigue, stress, hunger, menopause, pregnancy etc.

How long does migraine last?

Duration varies. It may last from a few hours to 3 days.

What are the different kinds of Migraine?

Migraine headaches are of seven types. If you are a migraine sufferer, discern which kind of migraine you have.

  • Common Migraine: More common in females. Only headache, no aura.
  • Classic Migraine: More frequent in males. Headache followed by an aura.
  • Retinal Migraine: Headache associated with visual disturbance and sometimes even transient blindness of an eye.
  • Complication of Migraine: Associated with any brain lesion, unusually long and infrequent headache.
  • Abdominal Migraine: Cyclical vomiting, nausea, vertigo cause migraine headaches.
  • Probable Migraine: Headache present but absence of sufficient evidence to call it migraine.
  • Chronic Migraine: Headache lasts for a very long period ranging from 15 days to more than three months.

Symptoms of Migraine Headache:

The most common symptoms of migraine are:

  • Intense pulsating in half head
  • Blurred vision
  • Sensitivities to bright lights and loud noises
  • Numbness in hands and feet
  • Nausea
  • Vomiting

All these symptoms get worse after any physical activity.

Migraine headache occurs in episodes and has 4 phases. It’s not necessary that one will experience all four phases.

  • Prodrome: It occurs hours or even days before headache. During this phase you may have following symptoms:
  • Fatigue
  • Irritability
  • Constipation/Diarrhea 
  • Depression/Euphoria
  • Muscle stiffness
  • Altered mood
  • Aura: It occurs before or during headache and may last from minutes to about an hour. Its symptoms are:
  • Blurred vision
  • Transient blindness of one eye
  • Numbness
  • Tingling
  • Loss of position sense
  • Loss of a part of field of vision
  • Auditory hallucinations
  • Pain Phase: This is the headache phase. In children it lasts for an hour while in adults it lasts from 4 to 72 hours. Other symptoms during this phase are:
  • Blurred vision
  • Nausea
  • Sense of world spinning
  • Sensitivity to light and sound
  • Postdrome: It’s the hungover phase which occurs after a headache. You may experience weakness, depression or euphoria, abdominal symptoms etc.

How to treat and manage migraine headache?

Management and prevention includes lifestyle changes, dietary/nutritional supplements, medications and surgeries.

Our goal here is to reduce pain and other symptoms. The earlier you take medications the more effective they will be.

Medications include:

  • Aspirin, paracetamol, Ibuprofen, caffeine (Analgesics)
  • Sumatriptin (For pain and nausea)
  • Beta blockers are the first line treatment (propranolol, metoprolol)
  • Topiramate
  • Gabapentin
  • Pregabalin
  • Timolol
  • Amitriptyline
  • Eptinezumab, pertuzumab (Anti-calcitonin gene-related peptide)

For those who do not show any improvement after medication, migraine surgery is available. In this surgery nerves around the head and neck region are decompressed which improves the symptoms.

Botulinum toxin (Botox) has also been found to be as of a great benefit.

Effective household remedies to treat Migraine:

The following alternative remedies have proven to be effective in minimizing the symptoms of migraine headache. 

  • Acupuncture
  • Ginger
  • Yoga and massage
  • Essential oils (lavender) 
  • Magnesium supplements
  • Vitamin B complex intake
  • Biofeedback therapy
  • Herbs (Butterbur)
  • Adequate hydration
  • Good sleep
migraine

TAKE AWAY!

Though migraine is a benign condition it does affect the effectiveness and productivity of the sufferers. Hence by taking preventive measures such as regular sleep patterns, avoidance of triggers and proper medications you can prevent and minimize the frequency of headaches and live a true gleeful life.