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Migraine

Migraine

What Is a Migraine?

A migraine is a severe headache that is often accompanied by nausea, vomiting, and light sensitivity. It could linger for hours or even days.

Symptoms

Everyone’s migraines are different. Many people experience them in phases. These stages could include the following:

Prodrome

About 60% of migraine sufferers detect symptoms like these hours or days before a headache:

  • Having a high sensitivity to light, sound, and scent
  • Fatigue
  • Cravings for food or a lack of appetite
  • Mood swings
  • Extreme thirst
  • Bloating
  • Diarrhoea or constipation

Aura

These symptoms are caused by your neurological system and frequently affect your vision. They normally begin slowly, over a 5- to 20-minute period, and continue no longer than an hour. You have the option to:

  • See black dots, wavy lines, light flashes, or objects that aren’t there? (hallucinations)
  • Tunnel vision?
  • Not being able to see anything at all
  • On one side of the body, tingling or numbness.
  • being unable to communicate clearly
  • Feeling heavy arms and legs?
  • Ringing in the ears?
  • Changes in scent, taste, or touch.

Attack

A migraine headache usually starts off as a dull ache that progresses into excruciating pain. It usually gets worse when you do something strenuous. The pain can travel from one side of your head to the other, be at the front of your head, or affect your entire head.

Around 80% of patients have nausea as well as a headache, and about half vomit. You may also feel faint or pale and clammy.

The majority of migraine headaches last 4 hours or less, although severe ones might last up to 3 days. Two to four headaches per month are not uncommon. Migraine headaches affect some people every few days, while others only get them once or twice a year.

Postdrome

After a headache, this stage can persist for up to a day. Among the signs and symptoms are:

  • Feeling fatigued, drained, or irritable
  • Feeling unusually energised or upbeat
  • Muscle weakness or discomfort
  • Cravings for food or a lack of appetite

Diagnosis

Your doctor will inquire about your medical history as well as your current symptoms. Keeping a diary of your symptoms and any triggers you’ve found may be beneficial. Make a list of:

  • What symptoms you’re experiencing, as well as where it aches
  • How frequently do you have them
  • How much time do they last
  • Does anyone else in your family that suffers from migraines
  • All of your medications and supplements, including over-the-counter ones
  • Other medications you may recall used in the past

Your doctor may prescribe tests to rule out other possibilities for your symptoms, such as:

  • Tests on the blood
  • MRI and CT scans are examples of imaging tests
  • EEG is an electroencephalogram

Causes

Migraine headaches are a symptom of migraine disorder. Doctors aren’t sure what causes migraine headaches, although they appear to be linked to changes in the brain and genes. Migraine causes including weariness, strong lights, and changing weather can even be passed down from your parents.

For many years, scientists believed that migraines were caused by alterations in brain blood flow. Most people now believe that while this can add to the pain, it is not the cause of it.

A migraine is thought to begin when overactive nerve cells send out signals that activate your trigeminal nerve, which controls sensation in your head and face. This triggers the release of hormones like serotonin and calcitonin gene-related peptides in your body (CGRP). CGRP causes the blood vessels in your brain’s lining to expand. Neurotransmitters then trigger inflammation and discomfort.

Complications

The NHS estimate that around 10 million people aged 15-69 in the UK suffer from migraines, While headaches are one of the most prevalent neurological causes for visiting A&E, they are also recognised as debilitating sickness.

Some factors may increase your chances of getting them:

  • Sex. Women are three times as likely as males to suffer from migraines.
  • Age. Migraine headaches affect the majority of adults between the ages of 10 and 40. However, many women find that their migraines improve or disappear around the age of 50.
  • Family history. Four out of every five migraine sufferers have a family member who also suffers from the condition. If one parent has had similar headaches before, their child has a 50% risk of getting them as well. The chance increases to 75% if both parents have them.
  • Other medical problems. Anxiety, depression, bipolar disorder, sleep difficulties, and epilepsy can all increase your chances.

Migraine Triggers

The following are some of the most prevalent migraine triggers:

  • Hormone imbalances. Many women experience headaches around their periods, throughout pregnancy, or when they are ovulating. Symptoms could also be linked to menopause, hormonal birth control, or hormone replacement medication.
  • Stress. When you’re anxious, your brain produces chemicals that can induce blood vessel alterations, which can result in a migraine.
  • Foods. In certain people, foods and beverages like aged cheese, wine, and food additives like nitrates (found in pepperoni, hot dogs, and lunchmeats) and monosodium glutamate (MSG) may be to blame.
  • Missing meals.
  • Caffeine. Headaches can be caused by either getting too much or not getting enough. Caffeine can be used to treat acute migraine attacks.
  • Weather changes. A migraine can be triggered by storm fronts, changes in barometric pressure, severe winds, or changes in altitude.
  • Senses. A migraine might be triggered by loud noises, bright lights, or strong odours.
  • Medications. They can be triggered by vasodilators, which expand your blood vessels.
  • Physical activity is important. This involves both physical activity and sexual activity.
  • Tobacco
  • Changes in your sleeping patterns. When you sleep too much or too little, you may experience headaches.

When to call a doctor

If your headache doesn’t go away or returns, see your doctor.

If you experience a headache with a stiff neck, fever, vomiting, numbness or weakness in the limbs, or difficulties speaking, see a doctor straight soon or go to the emergency department.

Migraine Types

Migraines come in a variety of forms. Migraine with aura (commonly known as a classic migraine) and migraine without aura are the most prevalent (or common migraine).

Among the others are:

  • Migraine during menstruation. This occurs when a woman’s period is linked to a headache.
  • Silent migraine. An acephalgic migraine is another name for this type of migraine. You don’t have a headache, but you have aura symptoms.
  • Vestibular migraine.  You experience issues with balance, vertigo, nausea, and vomiting, as well as a headache. People who have a history of motion sickness are more likely to experience this.
  • Migraine in the abdomen. This type is little understood by experts. It causes nausea, vomiting, and stomach pain. It most commonly affects children and can progress to classic migraine headaches over time.
  • Migraine with hemiplegia. On one side of your body, you have a brief episode of paralysis (hemiplegia) or weakness. You may also have numbness, disorientation, or changes in your vision. These symptoms could indicate a stroke, so seek medical attention immediately now.
  • Migraine with ophthalmic symptoms. An ocular or retinal migraine is another name for this condition. It produces a dull aching behind the eye that may spread to the rest of your head, as well as a short-term, partial, or entire loss of vision in one eye. If you notice any changes in your vision, seek medical attention straight once.
  • Migraine with aura in the brainstem. Before the headache, you may have dizziness, confusion, or a loss of balance. It’s possible that the discomfort will spread to the back of your head. These symptoms frequently appear out of nowhere, and they can include difficulty speaking, ringing in the ears, and vomiting. This form of migraine is primarily experienced by young adult women and is strongly associated with hormonal fluctuations. Get these symptoms checked out by a doctor as soon as possible.
  • Status migrainosus. This sort of severe migraine can linger for up to 72 hours. You may need to go to the hospital because the pain and nausea are so severe. Medicines or drug discontinuation might sometimes cause them.
  • Ophthalmoplegic migraine.  This produces pain in the area around your eye, as well as muscle paralysis. Because the symptoms can potentially be caused by pressure on the nerves behind the eye or an aneurysm, this is a medical emergency. A droopy eyelid, double vision, or other vision problems are some of the additional symptoms.

Treatment

Migraine headaches have no known remedy. However, several medications can be used to cure or even prevent them. Treatments for migraines include:

  • Pain relief. Over-the-counter (OTC) medications are frequently effective. Acetaminophen, aspirin, caffeine, and ibuprofen are the major components. Because of the risk of Reye’s syndrome, never administer aspirin to anyone under the age of 19. Take caution while taking over-the-counter pain relievers, as they may aggravate your headache. You can experience rebound headaches or grow reliant on them if you use them too often. If you use OTC pain medications more than twice a week, consult your doctor about prescription pain relievers that may be more effective. They may recommend prescription medications that may help to relieve your migraine headache. Your doctor will be able to inform you if these are appropriate for you.
  • Nausea medicine. If you experience nausea as a result of your migraine, your doctor may be able to prescribe medication.
  • Triptans. The chemicals in your brain are balanced with these medications. A pill, tablets that dissolve on the tongue, a nasal spray, or an injection may be given to you.
  • Ergotamine. This affects the chemicals in your brain as well.
  • Lasmiditan. This medication relieves pain, nausea, and light or sound sensitivity.
  • CGRP receptor antagonists. If other treatments fail, your doctor may prescribe rimegepant (Nurtec) or ubrogepant (Ubrelvy).
  • Preventive medication. Your doctor may recommend them if other therapies don’t work, your headaches are severe, or you have four or more migraine days per month. You take them on a daily basis to reduce the severity and frequency of your headaches. Seizure medications, blood pressure medications (such as beta-blockers and calcium channel blockers), antidepressants, and botulinum toxin type A shots are among them (Botox). Atogepant (Qulipta), eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality) are CGRP antagonists that can help avoid migraines.
  • Single-pulse transcranial magnetic stimulation (sTMS). At the start of migraine with aura, you place this gadget on the back of your head. It transmits a magnetic energy pulse to a portion of your brain, which may help to stop or lessen pain.
  • Neuromodulation devices. Other gadgets can relieve or prevent migraines by affecting the vagus nerve and the trigeminal nerve.

Home remedies

Migraine symptoms can be alleviated by:

  • Resting in a dark, quiet room with your eyes closed
  • Applying a cold compress or an ice pack to your brow and back of the neck
  • Keeping hydrated by drinking a lot of water

Complementary and alternative treatments

Some patients find relief from therapies that they utilise in conjunction with or instead of traditional medical care. Complementary or alternative treatments are what they’re termed. They include the following for migraines:

  • Biofeedback. This allows you to keep track of stressful circumstances that may cause symptoms. If the headache starts slowly, biofeedback can help you stop it before it becomes a full-fledged attack.
  • Cognitive behavioural therapy (CBT). An expert can show you how your actions and ideas influence your pain perception.
  • Supplements. Some vitamins, minerals, and plants have been shown in studies to help prevent or alleviate migraines. Riboflavin, coenzyme Q10, and melatonin are among them. Butterbur can help prevent migraines, but it can potentially cause liver enzyme imbalances.
  • Work on the body. Chiropractic, massage, acupressure, acupuncture, and craniosacral therapy are examples of physical treatments that may help with headache symptoms.

Before attempting any complementary or alternative therapy, consult your doctor.

Migraine Prevention

To avoid symptoms, take the following steps:

  • Recognize and avoid potential triggers. Keep a journal of your symptom patterns to help you figure out what’s causing them.
  • Take care of your tension. Meditation, yoga, and mindful breathing are all relaxation strategies that can help.
  • Maintain a regular eating schedule.
  • Drink plenty of water.
  • Make sure you get enough sleep.
  • Get moderate activity on a regular basis.
  • If you experience migraines around your period or if lifestyle modifications don’t help, talk to your doctor about taking preventive medications.

Some new gadgets can also help you avoid migraines. Cefaly is a headband-like device that transmits electrical pulses through your forehead skin. Your trigeminal nerve is affected, which is connected to migraine headaches. Cefaly is used once a day for 20 minutes. You’ll notice a tingling or massaging feeling when it’s turned on. GammaCore, another stimulator, transmits a modest electrical pulse to the vagus nerve fibres in your neck to ease pain and avoid migraines.

Outlook

There is currently no cure for migraines. Medications, on the other hand, can help prevent or stop them, as well as protect your symptoms from growing worse.

The majority of migraines do not have a long-term effect.

Migrainous infarction is a rare condition that might occur. This happens when you have a stroke while suffering from a migraine. However, there is no proof that migraines can cause a stroke.

Hemiplegic migraine can sometimes progress to a coma or other serious problems, however, this is extremely unusual.

A severe headache that appears out of nowhere could be an indication of something more catastrophic, such as a stroke or aneurysm. If this happens, get medical attention straight away.

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