TIRED OF MIGRAINES? HERE IS A COMPLETE PERSPECTIVE THAT ACTUALLY HELPS

Are you worried about a migraine attack? You are certainly not alone. An estimated billion-plus people suffer from migraine globally. As per the World Health Organization (WHO), worldwide, the lifetime prevalence of migraine is estimated at 14%, with women at higher risk. The widespread prevalence and resultant disability present significant adverse effects on those affected and their families, coworkers, employers, and the community at large.

Read further to understand the phases, types, triggers, and treatment options.

What is a Migraine?

Migraine is a type of headache that usually presents on one side of the head, causing severe throbbing pain or a pulsing sensation. Migraines can persist from hours to days with severe pain that hampers daily activities.

Migraine usually has 4 phases:

1. Prodrome Phase

It marks the beginning of a headache, also known as pre-headache.

2. Aura Phase

Visual symptoms such as seeing various spots, shapes, or vision loss may be present in this phase. However, these symptoms of the nervous system are reversible. Other symptoms may include numbness and weakness of the face or one side of the body.

3. Headache Phase

 During this phase, the patient experiences a headache.

4. Postdrome Phase

The last phase of migraine; can linger on but typically wanes within a day after the headache has gone. It occurs in almost 80% of cases.

Types of Migraine

There are several types of migraine:

Migraine with aura

When the aura phase precedes headache, it is known as migraine with aura.

Migraine without aura

The most common type of migraine; occurs without any aura or warning signs.

Migraine aura without a headache

This type is also known as silent migraine – where an aura or some other migraine symptoms are present, but there is no headache.

Hemiplegic Migraine

If a patient develops weakness in one-half of the body and a "pins and needles" sensation or loss of feeling during the headache, it is likely a hemiplegic migraine. Headache may be of less severe intensity in this type and may not present in all cases, but the aura is always present. It goes away within hours to days.

Chronic Migraine

If a patient experiences a migraine for more than 15 days in a month, it is a case of chronic migraine. The severity of symptoms may vary throughout the month, and migraine may be mistaken as sinusitis or tension headache when the severity is low.

Retinal Migraine

When a headache results in temporary loss of vision, it is a retinal migraine. It usually occurs in females of childbearing age, with blindness persisting from a few minutes to months. It could signify a serious issue and necessitates a specialist's opinion.

Vestibular migraine

In this type, people may have dizziness, vertigo, balance problems, and other migraine symptoms. This type is also known as migrainous vertigo and migraine dizziness.

Abdominal Migraine

In this type, children complain of moderate to severe stomach pain that usually lasts from 2 to 72 hours. Children may vomit or experience nausea but feel normal in between episodes.

This condition relieves as the child grows but may develop into migraine headaches.

Menstrual migraine

Menstruation and the associated hormonal changes trigger this type of migraine, also known as "Hormone Headache."

Causes of Migraine

The causes of migraine are not completely clear, but there is a collective effect of genetic and environmental factors.

1. Research studies have identified 13 genes with variations related to changes that cause migraine.
2. Environmental factors like weather changes, stress, physical characteristics, and sensory stimuli may contribute to the cause.
3. The constriction and dilation of the brain's blood vessels may cause headaches. During an aura, brain cells become overexcited, and this increase in brain activity leads to blood vessel changes, which cause headaches. Sometimes, the migraine disorder is hereditary.

Triggers of Migraine

There are several migraine triggers, including:

• Hormonal changes in women: For instance, estrogen changes during menstruation, adulthood, or pregnancy.
• Stress: Stressful situations at work or home can trigger migraine.
• Drinks: Excessive intake of caffeine and alcohol.
• Physical factors: Intense physical effort, including sexual activity, might provoke migraines.
• Sensory stimuli: Bright lights and strong smells can stimulate migraine.
• Weather changes: A change of weather or barometric pressure can prompt a migraine.
• Change in sleep pattern: Not getting proper 6-8 hours of sleep can be a triggering factor.
• Medications: Vasodilators and oral contraceptives may aggravate migraine.
• Foods: Such as cheese and chocolate.
• Food additives: For instance, the sweetener aspartame and the preservative monosodium glutamate.

Treatment of Migraine

Before a migraine attack:

• Maintain a healthy lifestyle.
• Exercise regularly.
• Avoid alcohol if you are prone to migraine attacks.
• Take preventive measures when the weather changes.
• Eat nutritious and fresh foods.
• Get proper sleep for 6-8 hours.
• Consult your physician regularly if you are on any medication.
• Try to avoid sensory stimuli.

During an attack

Some people feel better while lying down in a quiet and darkened room or eating something.

Painkillers

Over-the-counter (OTC) medication is helpful in some patients, and this works well when taken at the onset of symptoms as it gets time to absorb into the blood.

Triptans

If ordinary painkillers are not helping with the migraine, a consultation with a specialist is necessary for a triptan prescription.

Anti-sickness medicines

Also known as anti-emetics, these may prove to be helpful in some patients.

Acupuncture

It is an alternative medicine practice proven to be effective in alleviating the symptoms in some patients. But, undoubtedly, the ultimate goal is to get rid of the migraine.

Transcranial magnetic stimulation

In 2014, the National Institute for Health and Care Excellence (NICE) approved transcranial magnetic stimulation (TMS) to treat and prevent migraines. Used during or between migraine attacks, the device delivers a magnetic pulse or pulses to the scalp, passing throughout the brain. It can stop or alleviate the severity of an attack or even prevent onset.

Devices Used to Treat or Prevent Migraine

Several devices that apply magnetic stimulation or electrical current to the head or body have received US Food and Drug Administration clearance for migraine treatment. These devices are associated with improvements in pain caused by acute migraine and a reduction of up to 2 migraine days per month in clinical trials.

Behavioral Therapies for Migraine Prevention

Behavioral therapy (mindfulness, biofeedback, and cognitive behavior therapy) may be combined with medications to prevent migraine. In one study, behavior therapy combined with preventive drugs reduced the number of migraines per month compared with medication or behavioral therapy alone.

Summary

A migraine should not be brushed aside as just a nasty headache. It can significantly impact daily life, making routine activities at work or life extremely taxing.

While preventing every attack may not be pragmatic, identifying and avoiding triggers can help reduce the frequency or severity of migraines.

Therefore, it is vital to see a healthcare professional for advice, medication, or other treatments to mitigate migraine symptoms.

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References

• https://americanmigrainefoundation.org/resource-library/what-type-of-headache-do-you-have/
• https://pubmed.ncbi.nlm.nih.gov/25496898/
• https://www.nhs.uk/conditions/migraine/
• https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201
• https://migrainetrust.org/understand-migraine/types-of-migraine/vesibular/
• https://n.neurology.org/content/neurology/79/18/e168.full.pdf
• https://jamanetwork.com/journals/jama/fullarticle/2787727

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