Migraine – Symptoms and Causes
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What is migraine?
Migraine is a condition where you experience a strong headache, usually on one side of the head. You tend to have other symptoms with the headache such as nausea, increased sensitivity to light or sound, etc.
The pain may last from several hours to an entire day, often disabling you. The pain tends to reoccur after several days to years.
Migraine may stay with you for life. You may need to manage it by taking medicines and avoiding triggering factors.
Symptoms of migraine
Apart from a severe headache, migraine has several other symptoms. It affects people differently, and not everyone develops the same symptoms. Thus, identifying migraine correctly can be a challenge.
Identifying features of migraine the following are the features that help you recognizing migraine:
1. Characteristic of headache:
• Location- headache in most people is restricted to one side of the head.
• Intensity of pain- usually moderate to severe in intensity.
• Nature of the pain- typically a throbbing or pulsating headache (pain that increases and decreases in severity like waves).
• Progress- often starts around the eye and temple region of the head. It gradually spreads to the back of the head and, in some people, may become generalized. It usually increases in severity over several hours.
2. Aura
The aura of migraine is the disturbances in your sense of perception- visual, hearing, or psychological functioning of your body.
You experience these symptoms just before or during an episode of headache.
Aura is seen in one-third of the people. They usually last between a few minutes to an hour.
Features:
• Visual- seeing spots, wavy lines, or flickering lights. Sometimes, partial/temporary loss of vision.
• Touch- numbness and tingling sensation on one side of the body especially face or hand.
• Speech- difficulty in speaking.
• Hearing- hearing of sounds/ ringing in the ear.
These symptoms may sometimes indicate a stroke or meningitis. Thus, if you experience these symptoms for the first time, it warrants medical attention.
The ICHD-3, has described certain features to differentiate between migraine aura and a transient stroke (TIA)
Thus, based on aura, migraine are of two types:
• Migraine with aura
• Migraine without aura
There is another entity where migraine aura occurs without a headache. If you have this, then you would experience an aura or other migraine symptoms without developing pain.
3. Nausea and vomiting
A feeling of nausea and vomiting commonly accompanies migraine.
4. Increased sensitivity to light and sound
In migraine, you may experience increased sensitivity to light and sound. The person feels comfortable sitting in a quiet, darkroom. Bright light and loud sound are also known to initiate pain of migraine.
5. Premonitory or Prodromal symptoms
Sometimes you may develop certain symptoms several hours to even a day before developing a migraine headache.
The symptoms are as follows:
• Feeling low
• Irritable
• Craving for food
• Constipation
• Stiff neck
Many people, because of severe pain,develop watery eyes, runny nose, or congestion, which may confuse with headache due to sinus inflammation.
How long the migraine pain lasts, and how frequently one can have migraine pain?
Migraine pain can last from a few hours to a day. In some people, if left untreated, it may last up to 3 days.
Migraine tends to be recurrent, with many people experiencing it lifelong. In some people, it frequently occurs, developing several times a week. Whereas in others, it may occur only occasionally with many years of attack-free period.
Who is more prone to develop migraine?
Women are 3 times more prone to have migraines than men. It usually affects teenagers to adults more often between 40-60 years of age.
What can cause or trigger a migraine?
In many people, migraine is triggered by certain personal or environmental factors. The triggers vary for different people, but a person tends to have the same set of triggers.
Common Migraine Triggers:
1. Physical factors: Fatigue, lack of sleep, sleep disturbance or oversleeping,
2. Hormonal factors: beginning of period, ovulation, or birth control pills.
3. Environmental factors:
• Change in weather like an increase in humidity, heat, exposure to sun, glare.
• Bright or flickering lights
• Loud sound
• Strong smell
4 . Emotional factors: stress, anxiety, anger.
5. Dietary factors:
• Skipping meal
• Drinking alcohol- usually red wine.
• Alteration in caffeine intake
• Food items like chocolate, old cheese,
• Food containing MSG- usually seen in Asian foods, cured meats, and fish-containing nitrates.
• Histamine containing or releasing food items.
What is the cause of migraine?
The exact cause of migraine is not clear till now. It is believed to develop due to temporary changes in the brain chemicals, blood flow, and activation of nerve cells in the head. The following factors play a role in the development of migraine.
Trigeminovascular system activation
Currently, it is said to occur due to the activation of the trigeminal nerve that supplies the meninges, causing its swelling. The swelling of meninges causes generation of pain.
Genetics
Approx. 70% of people with migraine have at least one close relative who has migraine. This association suggests that genes play a critical role in the development of migraine.
What are other medical conditions associated with migraine?
Migraine has been found to be related to the conditions of the heart and its blood vessels. It is also found associated with the issues of the brain and its vasculature.
Cardio-vascular conditions: hypertension, heart shunts, mitral valve prolapse, early onset of coronary heart disease.
Neuro-vascular condition: a person with migraine has a higher risk of stroke regardless of age and sex. The risk is highest in young females who have migraine with aura, especially who uses contraceptive pills or smoke.
A Harvard study involving approx. 20 thousand men found migraine to increase the risk of heart attacks by 42%
What is the treatment of migraine?
Supportive treatment
• Resting in a dark and quiet place- it makes many people comfortable and allows them to tackle the attack better.
• Other supportive measures- some people get help from:
o Eating food or drinking water
o Keeping an ice pack or cold cloth on the forehead.
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