Migraine is a disabling neurological condition that affects millions of people worldwide. It is listed as one of the most disabling conditions by the World Health Organization.
It is common among females, and out of 3 women, one can significantly affect the quality of life.
A migraine is a headache characterized by severe, often one-sided pain. It can accompany other symptoms such as nausea, vomiting, and sensitivity to light and sound. The diseases can last several hours or even days and are often debilitating.
What is the underlying cause of migraine?
The exact pathophysiology of migraines is not fully understood. But there are several theories to understand the cause.
- The vascular theory suggests that migraines are caused by changes in blood flow to the brain.
- The neurogenic inflammation theory proposes that the release of inflammatory substances from nerve fibres causes migraines.
- The cortical spreading depression theory suggests that migraines are caused by a wave of electrical and chemical activity that spreads across the brain’s surface.
- The genetics theory proposes that migraines may be caused by inherited genetic mutations that affect the brain’s ability to process pain.
- The serotonin theory suggests that changes in serotonin levels may play a role in triggering migraines.
What are the triggering factors of migraine?
Several known triggers can cause a migraine attack in some people. Some common triggers include:
- Hormonal changes: The disease is more common in women. Many women report that attack occurs during or around their menstrual period. Fluctuations in estrogen levels can also trigger the disease.
- Stress: Stress can cause an attack in some people. Stress can include emotional stress, such as the stress of a demanding job or relationship, and physical stress, such as lack of sleep or an injury.
- Diet: Certain foods and drinks can trigger an attack in some people. Common dietary triggers include chocolate, alcohol, aged cheeses, and processed foods. Skipping meals or fasting can also trigger an attack.
- Environmental factors: Bright lights, loud noise, and strong smells can trigger an attack. Weather changes, barometric pressure, humidity and temperatures can also be triggers for some people.
- Medications: Some medications, such as oral contraceptives and vasodilators, can cause the disease.
- Sleep: Poor quality sleep can trigger an attack. Disruptions in sleep patterns and jet lag can also trigger it.
It’s important to note that triggers differ from person to person, and not everyone with the disease will have the same triggers. A journal can help keep track of triggers. So that a headache specialist, neurologist, or primary care physician can help to identify triggers and plan a treatment to reduce symptoms and attacks.
What are the risk factors for migraine?
Several known risk factors can increase a person’s likelihood of developing migraine. Some of the most common risk factors include:
- Genetics: the disease tends to run in families, suggesting a genetic component to the disorder.
- Gender: Women are more likely to develop headaches than men. Hormonal changes during the menstrual cycle can trigger an attack in women.
- Age: the disease is most common in people between the ages of 25 and 55, but it can occur at any age.
- Medical history: People with a history of other types of headaches, such as tension headaches, are more likely to develop it.
- Lifestyle factors: People with certain lifestyle habits that increase their risk of developing the disease, such as smoking, consuming large amounts of alcohol, and eating a diet high in processed foods.
- Concurrent conditions: Other health conditions, such as depression, anxiety, and cardiovascular diseases, can increase the risk of developing the disease.
Signs and symptoms of Migraine
The signs and symptoms of a migraine can vary from person to person and can be different during each migraine attack. However, common symptoms of a migraine include,
- Headache is usually characterized by a severe, throbbing or pulsating pain often localized to one side of the head. The headache can last anywhere from a few hours to several days.
- Nausea and vomiting: Many people with the disease experience nausea and vomiting during an attack.
- Sensitivity to light, sound and smell: People with the disease often have a sensitivity to light, sound, and smell during an attack. This can make tolerating bright lights, loud noises, and strong odours difficult.
- Photophobia: Some people feel eye pain, photophobia (light sensitivity) or difficulty opening their eyes
- Aura: Some people experience visual disturbances before the headache begins. This is known as an aura. The aura can include seeing flashing lights, zigzag lines, or blind spots.
- Fatigue and drowsiness: Many people with the disease experience fatigue and drowsiness during an attack.
- Difficulty concentrating, dizziness or confusion: Some people may have difficulty concentrating or vertigo during an attack.
- Other symptoms: Some people with the disease experience symptoms such as tingling or numbness in the limbs, difficulty speaking, or weakness on one side of the body.
It’s worth noting that migraines can have different types, with various symptoms, and these symptoms can change over time. Consulting with a healthcare professional will help to get an accurate diagnosis and plan the best treatment for the person.
Phases of migraine headache
A migraine headache typically occurs in four distinct phases, although not all people with migraines experience all four stages.
Prodrome: This is the phase before the headache begins. Some people may experience fatigue, mood changes, or food cravings during the prodrome phase.
Aura: This is the phase during which some people experience visual or other neurological symptoms such as tingling or numbness in the limbs, difficulty speaking or weakness on one side of the body. These symptoms usually last a few minutes to an hour and are often followed by a headache.
Attack: This is the phase during which the headache occurs. This phase can last anywhere from a few hours to several days and is characterized by severe, pulsating pain, nausea, vomiting, sensitivity to light and sound, and fatigue.
Postdrome: This is the phase after the headache has subsided. Some people may continue to experience symptoms such as fatigue, confusion, and sensitivity to light and sound during this phase.
It’s important to note that not all with migraine will experience all four phases. For example, some people only experience the headache phase, while others may not have any aura symptoms.
How migraine is diagnosed
The disease diagnosis is based on a combination of factors, including the patient’s medical history, a physical examination, and a description of the headache symptoms.
- A healthcare professional will typically ask about the headache’s duration, frequency, and intensity. Also, they wanted to know any associated symptoms such as nausea, vomiting, and sensitivity to light and sound. Your doctor will also ask about any triggers, such as stress, dietary factors, or hormonal changes.
- A physical examination is usually performed to rule out any other underlying conditions causing the headache. The healthcare professional will also examine the eyes, ears, nose, and throat and may perform a neurological examination to check for any signs of weakness or changes in sensation.
- Diagnostic imaging, such as a CT scan or MRI, may be required to rule out any underlying structural problems causing the headaches.
- To confirm a diagnosis of migraine, a healthcare professional will use the International Headache Society (IHS) criteria.
It’s worth noting that not all migraines are the same. In addition, not everyone with migraines will experience all the symptoms or follow the IHS criteria, which is why a professional should be consulted for an accurate diagnosis and management of migraines.
What are the treatment options available?
There are various treatment options available, and the best treatment will depend on the frequency and severity of the attack. It also considers the individual’s preferences and comorbidities.
Medications: There are a number of medicines that can be used to treat migraines.
- Acute medications are medications taken during a migraine attack to reduce pain and other symptoms. These include NSAIDs such as ibuprofen and naproxen. Triptans such as sumatriptan and rizatriptan are also used.
- Preventive medications: These medications are taken daily to reduce the frequency and severity of the attack. These include beta-blockers, such as propranolol and metoprolol, and anticonvulsants, such as divalproex sodium and topiramate.
- Other medications may be prescribed depending on the specific symptoms and comorbidities, such as anti-nausea medications if there is vomiting or feeling of vomiting.
Self-care: Many self-care measures can be taken to reduce the pain and other symptoms, such as:
- Resting in a dark, quiet room
- Using a cold compress or ice pack on the affected area
- Drinking plenty of water
- Avoiding triggers, such as certain foods, drinks, and environmental factors
- Practising relaxation techniques, such as deep breathing and meditation
Complementary therapies: Several complementary therapies may be helpful for migraines, such as:
- Chiropractic care
- Massage therapy
- Yoga and other forms of exercise
Behavioural changes: there are lifestyle changes that can reduce the risk of migraines, such as:
- Adequate sleep, regular meals and hydration
- Regular exercise
- Avoiding triggers
- Managing stress through therapy or other stress management techniques
Not all treatment options will work for everyone, and it may take some time to find the best treatment for a specific person.
The Bottom Line
Although migraine can badly affect day-to-day life, understanding the disease pattern, causes, and triggers greatly help in controlling it and living a happy life.
Several ways to treat and control the disease are available, including taking painkillers for acute headaches and starting preventive medication if the headache is debilitating.
You also can try complementary therapies highlighted and practice self-care to control the disease.