MIGRAINE: MORE THAN WHAT YOU THINK!

Migraine is medical condition that involves recurrent severe form of headache and other symptoms. The headache in migraine is throbbing or pulsatile sensation limited to one side of the head (the entire head may be involved too). Symptoms may include sensitivity to light and sound, nausea, vomiting and difficulty speaking. Migraine pain most commonly affects the forehead area. It’s usually on one side of the head, but it can occur on both sides, or shift.

Most migraines last about 4 hours. If they’re not treated or don’t respond to treatment, they can last for as long as 72 hours to a week.

MIGRAINE SYMPTOMS

Symptoms in migraine are in stages. Stages which may not necessarily follow the sequential order are:

Stage 1: Prodromal stage

About 60% of those who have migraines notice some symptoms hours or days before the headache. These symptoms include: lack of appetite or food craving, mood change, severe thirst, bloating, constipation or diarrhea, being sensitive to light, sound or smell.

Stage 2: Aura stage

This stage involves visual sensation or feeling of impending doom. This stage is over a period of 5 – 20minutes and last less than an hour. One may see: flashes of light, wavy line, black dots, tunnel vision, not able to see at all, numbness on one side of the body, inability to speak clearly, having ringing sensation the ears, and changes in taste and smell.

Stage 3: Attack stage

A migraine headache usually starts as a dull ache and later becomes pulsatile or throbbing pain. The pain can move from one side of the head to another, can be in front of the head or can affect the entire head. About 80% of the patients experience nausea along with the headache while about 50% eventually vomit. Some may feel faint or pale and clammy. Most migraine headaches last 4 hours, but severe ones can go more than 72hours.

Stage 4: Postdromal stage

This stage is also called hangover stage. It is the last of fourth stage of migraine. It lasts for 24-48hours. It is characterized with depressed mood, euphoric mood, lack of concentration, weakness, muscle pain, feeling tired, or cranky.

DIAGNOSIS

The International Headache Society recommend the “5, 4, 3, 2, 1” criteria to diagnose migraine without aura. This number series stands for:

• having five or more attacks, each with a duration of 4 hours to 3 days
• the headache having at least two of the following qualities:
  – occurring on one side
  – pulsating
  – causing moderate-to-severe pain aggravated by activity
• having at least one additional symptom, such as:
  – nausea
  – vomiting
  – sensitivity to light
  – sensitivity to sound

The doctor may recommend imaging or other tests to exclude other causes of symptoms, such as a tumor.

 

CAUSES AND TRIGGERS OF MIGRAINE

The exact cause of migraine is unknown. However, it has been found to be associated with some trigger factors which include the following:

• positive family history of migraine: Some migraines trigger like bright like, change in weather, fatigue etc can be passed on from parents’ gene to their children. If one of the two parents have migraine headache, the chance of children having it is 50%, if the parents did, the chance increases to 70%.
• Sex: Migraine is commoner in women than men. This might be related to hormonal changes in women during ovulation, menstrual flow, pregnancy, contraceptives and hormone replacement therapy.
• Change in weather or altitude
• Skipping meal
• Foods: cheese and some food additives
• Loud noise, bright light and strong smell
• Stress
• Tobacco
• Change in sleeping pattern: Not getting adequate sleep or sleeping excessively
• Dehydration
• Anxiety

 

OTHER TYPES OF MIGRAINE

• Abdominal migraine: It is a recurrent cause of abdominal pain in children; can as well happen in adult. Children with abdominal migraine can be predicted to develop migraine headache in the future. It is common but less recognized. Abdominal migraine happens without headache but associated with other symptoms of migraine like photophobia, phonophobia, palour, anorexia, nausea and vomiting. The abdominal pain is central and severe enough to affect patient’s activities and last for more than one hour. In between episode, the individual is quite okay. Before your doctor will diagnose abdominal migraine, other possible cause of abdominal pain must be investigated.
• Vestibular migraine: It is a nervous problem in people with previous history of migraine symptoms. In vestibular migraine, the individual feels dizzy repeatedly with or without headache. This dizziness or vertigo last for about 5 minutes to 72 hours. Associated symptoms are nausea, vomiting, sensitivity to light, sensitivity to sound, or feeling unstable.
• Ophthalmic/ ocular migraine: There is sudden temporary visual loss which lasts for less than one minutes in one eye. It is caused by reduced blood flow in the retina.
• Hemiplegic migraine
• Acephalgic migraine

 

TREATMENT

Treatment of migraine include medication to either prevent or treat it. Consult your doctor if you notice any of the following:

• Having migraine headache for the first time.
• When Over-The-Counter medications are not improving your symptoms
• Unusual migraine headache.

 

FURTHER READING

https://www.yalemedicine.org/conditions/abdominal migraine

https://www.bmj.com/content/360/bmj.k179.full

https://www.healthline.com/health/migraine#takeaway

https://www.medicalnewstoday.com/articles/148373#types

https://www.webmd.com/migraines-headaches/migraines-headaches-migraines

IMAGE CREDIT: gettyimage