Migraine

About

Migraine is a neurological disorder characterized by recurrent, moderate to severe headaches that can cause intense throbbing or pulsing pain on one side of the head. It is often accompanied by other symptoms such as nausea, vomiting, light and sound sensitivity, and aura. Although the exact cause of migraine is unknown, the risk may increase if there is a family history of migraine or if the individual is overweight or sleep-deprived. Treatments for migraine include medications, lifestyle changes, and alternative therapies such as acupuncture or relaxation techniques.

Symptoms

The primary symptoms of a migraine are a severe headache that is sometimes combined with other symptoms like nausea, vomiting, and sensitivity to light and sound. Other symptoms can include distorted vision, increased sweating, and a feeling of being overly tired. People may also experience mood changes before the onset of a migraine, such as depression, irritability, and anxiety.

Causes

The exact cause of migraine is not known, however, there are a few factors that may contribute to an increased risk of experiencing a migraine. These include genetics, hormones, environmental factors, certain foods or drinks, stress and changes in your normal routine. Other potential causes of migraine include changes in the weather, certain medications, fatigue, bright or flickering lights, strong odors and certain medical conditions such as high blood pressure or depression.

Risk factors

The exact cause of migraine is not known, however, there are a number of factors that can increase an individual’s risk of developing a migraine. These risk factors include:

Age: Migraines are more common in individuals between the ages of 25 and 55.
Gender: Women are three times more likely to experience migraines than men
Family History: Individuals with family members who suffer from migraines have a higher risk of developing them.
Stress: Stress can be a significant trigger for a migraine.
Sleep Patterns: Lack of sleep or getting too much sleep can trigger a migraine.
Changes in Weather: Changes in the weather such as humidity, temperature, and pressure can all be potential triggers for a migraine.
Alcohol & Caffeine: Consuming high amounts of alcohol or caffeine can increase an individual’s risk of developing a migraine.
Hormonal Changes: Hormonal changes such as those during puberty, menstrual cycles, and menopause can also be associated with an increased risk of migraines.

Diagnosis

A migraine is generally diagnosed by a doctor who will ask the patient about their symptoms, medical history, and any triggers they might have noticed. The doctor may also perform a physical exam, order blood tests, or order imaging tests to rule out other possible causes of the headache. A headache specialist may also be consulted to help diagnose and make treatment recommendations. This specialist will often ask a series of questions to determine the severity and duration of the headache, as well as the presence of any other symptoms, such as nausea, vomiting, or light sensitivity. In some cases, a physician may also use a physical test called the Autonomic Challenge Test to test the patient’s autonomic nervous system.

Sub-types

The four main subtypes of Migraine are:

Migraine with Aura (also known as classic Migraine): This type of Migraine begins with sensory changes (known as an aura) that can include visual disturbances such as seeing spots, flashing lights, or zigzag lines, or feeling numbness or pins and needles on one side of the body. The aura typically lasts about 30 minutes, and is then followed by a splitting headache, light and sound sensitivity, and nausea.
Migraine without Aura (also known as common Migraine): This type of Migraine does not begin with an aura, but consists of the same symptoms of Migraine with Aura: a splitting headache, light and sound sensitivity, and nausea.
Hemiplegic Migraine: This rare type of Migraine is similar to Migraine with Aura, but is accompanied by motor weakness, such as difficulty moving one side of the body or face. It typically lasts for 24 hours, and during its peak, a person can experience confusion, slurred speech, and numbness or tingling in the face and limbs.
Basilar-type Migraine: This type of Migraine is similar to Migraine with Aura and Hemiplegic Migraine, but is characterized by symptoms such as vertigo, double vision, slurred speech, and difficulty understanding what is being said. It typically lasts for 24 hours.

Treatments

The treatment options for migraine depend on a variety of factors such as the severity and frequency of the migraine, as well as a person’s individual triggers, response to medications, and other medical conditions.

The main goals of treating a migraine are to reduce the severity and duration of the headache and prevent future attacks. Treatment options may include medications, lifestyle modifications, and alternative and complementary treatments.

Medications used to treat migraine include:

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and aspirin
Triptans such as sumatriptan, rizatriptan, and naratriptan
Ergots such as dihydroergotamine
Antiemetics such as prochlorperazine, metoclopramide, and chlorpromazine
Botulinum toxin A
Corticosteroids
Beta-blockers
Calcium channel blockers
Antidepressants

Other treatments for migraine include lifestyle modifications such as avoiding triggers, identifying and managing stress, getting enough sleep, and eating a healthy diet. Alternative and complementary treatments such as acupuncture, biofeedback, massage therapy, and relaxation techniques may also be beneficial.

Prevention

There are several things that can be done to reduce the risk of migraine.

First, it is important to develop healthy sleep patterns. Sleep deprivation can be a major trigger for migraine, so it is important to ensure that you get adequate and consistent sleep.

Second, it is important to try to maintain a healthy diet that is rich in fruits and vegetables and low in processed foods. Eating foods with fewer additives may help to reduce triggers, as well as incorporating more complex carbohydrates such as whole grain bread and pasta.

Third, it is important to manage stress levels. Stress can be a major trigger for migraine, so it is important to find ways to manage stress, such as through relaxation techniques, meditation, or exercise.

Fourth, staying hydrated is important in order to reduce the risk of migraine. Consuming sufficient amounts of water throughout the day can help to reduce the risk of migraine.

Finally, avoiding potential triggers is important, such as avoiding certain foods, drinks, and overly bright or flickering lights.

Gender differences?

Yes, there are gender-specific differences in the presentation and management of Migraine. Studies have shown that women are affected by Migraine more frequently than men, with the rates of lifetime prevalence estimated to be 3 times higher in women than in men. Women also tend to suffer from more frequent and severe attacks, as well as more frequent aura episodes. Women are also more likely to experience reduced quality of life due to the impact of migraine on daily functioning, emotional wellbeing and relationships.

The gender differences in the presentation and management of Migraine can be explained in part by hormonal fluctuations; women’s fluctuating hormone levels are more likely to affect their Migraine than men’s more steady hormone levels. Additionally, many of the medications commonly used to treat Migraine, such as triptans, have FDA warnings for women of childbearing age. As such, women may be more likely to opt for alternative treatments that are less effective for the condition.

Finally, women also face unique psychological and social issues when it comes to the presentation and management of Migraine. Women are more likely to experience guilt and stigma for having Migraine, as well as feeling like their pain is not taken seriously or their condition is not believed. This can lead them to feel the need to hide their Migraine or to seek out ineffective treatments in order to avoid revealing their condition.

Overall, there are gender-specific differences in the presentation and management of Migraine that need to be taken into account when treating the condition. By recognizing and addressing these gender-specific differences, health care providers can ensure that women with Migraine are receiving the most appropriate and effective treatments.

Nutrition

Nutrition plays an essential role in the management of Migraine. A healthy, balanced diet consisting of fresh foods, mostly plant-based, can help reduce the frequency and intensity of Migraine attacks. Foods high in magnesium, such as dark green leafy vegetables, legumes, nuts and seeds, can help reduce the duration of Migraine attacks. Vitamin B-6, found in poultry, meat, fish, eggs, avocado and spinach, can also help reduce the severity of Migraine headaches. Additionally, avoiding common trigger foods such as alcohol, chocolate, caffeine, aged cheeses and processed meats may be beneficial. Although the specific connection between nutrition and Migraine isn’t fully understood, the evidence suggests that certain dietary changes may help reduce the frequency and intensity of Migraine attacks.

Physical Activity

Physical activity can have both positive and negative effects on migraine headaches. Regular physical activity has been found to reduce the frequency and severity of migraines, as well as providing other health benefits. Exercise can reduce stress, which is one of the common triggers of migraine. Exercise also increases endorphins, chemicals in the brain that act as natural painkillers. On the other hand, if you over-exert yourself and become too tired, it can trigger a migraine episode. Additionally, exercise can cause a drop in blood sugar levels, which can also lead to migraine attacks. It’s important for people with migraines to talk to their doctor about the best type, intensity, and duration of exercise for them and build a physical activity plan that takes into account their individual needs.