Migraine: Definition, Types, Symptoms, Causes, Treatments and Prevention

Migraine causes severe throbbing pain or, in other words, a throbbing sensation, usually occurring on only one side of the head and often causing vomiting, nausea, and an intense sensitivity to light and any sound. The attacks can cause significant pain for hours or days and can be so severe that the pain is disabling.

Symptoms known as aura may be present before or after the headache; these may include blind spots, flashes of light, or tingling on one side of the face, arm, or leg.

Medicines can help prevent some migraines and make them less painful. Talk to your doctor about possible treatment options if you do not find relief; taking the proper medications combined with self-help remedies, in addition to making significant lifestyle changes, can help the problem.

What is a migraine?

Although many people use the term “migraine” to describe any severe headache, a migraine results from specific physiological changes that occur within the brain and lead to the characteristic pain and associated symptoms.

Migraine headaches are generally associated with sensitivity to light, sound, and smells. Some people suffer from nausea or vomiting, this type of symptom sometimes involves only one side of the head, but in some cases, it usually happens that patients can have bilateral pain or on both sides; it can be described as vibrations or bumps and can be worse with physical effort.

Not all headaches represent migraines, and it is not the only condition that can cause severe and debilitating headaches. For example, cluster headaches are severe headaches that regularly affect one side of the head (occurring in a “cluster” over time). The pain is sometimes described as “perforation” and can be worse than a migraine in some cases.

Migraine

Types of migraines

Migraine with aura

Also called classic or complicated migraine, in some cases, patients experience specific warning symptoms, or an aura, before the onset of their headache; these warning symptoms can range from flashing lights or a blind spot in one eye to numbness or weakness affecting one side of the body.

The aura can last for many minutes, and then as the headache starts, it can last until the headache resolves. For patients who have never experienced an atmosphere, the symptoms can be terrifying and can mimic the symptoms of a stroke.

Migraine without aura

Formerly called common migraine, this is the most common, where symptoms include a moderate to the severe throbbing headache that occurs without warning and is usually felt on one side of the head, nausea, confusion, mood swings, blurred vision, fatigue, and increased sensitivity to light, sound, or smells.

Attacks generally last 4 to 72 hours and recur several times a year several times a week (see Chronic migraine, below). What the movement does is make the attack worse. It is essential to know that this migraine without aura is the most likely to worsen with the frequent use of symptomatic medications.

Chronic migraine

It is characterized by headaches that occur 15 or more days a month for more than three months, which have the characteristics of the same in at least eight days a month, can be with or without aura, usually require preventive medications and behaviors to control, and they are often disabling.

After withdrawal from the drug, about half of the patients return to episodic migraine, and the other half do not.

Hemiplegic migraine

It is a subtype of migraine with aura; it is a rare but severe form that causes temporary paralysis, sometimes lasting several days, on one side of the body before or during a headache.

Symptoms such as vertigo, a stabbing sensation, and trouble speaking, seeing, or swallowing may start before the headache and usually go away soon after. When it runs in families, the disorder, although rare, at least three different genetic forms have been identified.

Menstrual migraine

It may be associated with falling estrogen levels. Studies have shown that it is most likely to occur in the two days before and the first three days of a period. There is no aura with this type, which can last longer than other types. It is believed that through studies, it affects less than 10% of women.

Abdominal migraine

It is an episodic syndrome associated with migraine; most cases are reported in young children, although it can occur in patients of all ages.

As children get older, about half of them “grow out” of abdominal migraine by 14 or 16. Seizures are reported mainly by two-thirds of children concurrently or in place during late adolescence and early adult life.

Migraine with brainstem aura

It is a rare subtype of migraine with aura, and studies investigating it are limited.

Symptoms of migraine

Often beginning in childhood, adolescence, or early adulthood, they can progress through four stages: prodrome, aura, headache, and post-drome, although you may not experience all stages.

Prodrome

A day or two before a migraine, you may notice subtle changes that warn of an upcoming migraine, including:

  • Constipation.
  • Very sudden mood swings, ranging from depression to euphoria.
  • Food cravings.
  • Neck stiffness.
  • We have increased thirst and urination.
  • Frequent yawning

Aura

The aura occurs before or during migraines—most of the people who suffer from this experience migraines without aura.

Auras are symptoms of the nervous system that are usually visual disturbances, such as flashing lights or wavy, zigzag vision. Sometimes auras can have contact with sensations (sensory), such as movement (motor) or speech (verbal). Muscles weaken, or you can feel someone touch you.

Each of the symptoms usually begins gradually so that it can build up over several minutes and lasts 20 to 60 minutes. Examples of aura include:

  • Visual phenomena include seeing bright spots or flashes of light and various shapes.
  • Sight loss.
  • Pins and needles sensations in an arm or leg.
  • Weakness on one side of the body or one side of the face.
  • Difficulty speaking
  • Listen to noises or music.
  • Uncontrollable movements or other movements.
  • Sometimes a migraine with aura is associated with limb weakness.

Attack

A migraine usually lasts four to 72 hours if left untreated; the frequency with which headaches occur varies from person to person, they can be rare or strike several times a month, and you can experience:

  • Pain on one side or both sides of the face or head.
  • Pain that feels throbbing or throbbing.
  • Sensitivity to light sounds and smells, and touch.
  • Nausea and vomiting
  • Blurry vision.
  • Fainting is sometimes followed by fainting.

Post-drome

The final phase, occurring after an attack, may feel drained and washed out, while some people feel euphoric. For about 24 hours, you can also experience:

  • Confusion.
  • Bad mood.
  • Dizziness.
  • Soft spot.
  • Sensitivity to light and sound.

Causes of migraine

The causes are not yet understood; environmental factors and genetics play an essential role since they can be caused by changes in the brainstem and its interactions with the trigeminal nerve, which is a central pathway for pain.

Triggers

Hormonal changes in women

Fluctuations in estrogen can cause headaches in some women. Women with a history of this pain sometimes report headaches before or during their menstrual cycles, when they significantly drop estrogen.

Others are more likely to develop migraines during pregnancy or menopause. Hormone medications, such as hormone replacement therapy, and oral contraceptives, can also worsen migraines. Some women, however, find that their migraines occur less frequently when taking these medications.

Food

Cheeses, very salty, and processed foods can trigger migraines. Not eating well or fasting can also trigger attacks.

Food Additives

The sweetener aspartame and the preservative monosodium glutamate are found in many foods.

Drinks

Alcohol, especially wine, and drinks that are high in caffeine.

Stress

The stress at home or work.

Sensory stimulus

Very bright lights and direct sun glare on the face can trigger migraines, as can loud sounds—strong odors, such as paint thinner, perfume, secondhand smoke, etc.

Changes in the wake-sleep pattern

Lack of sleep or oversleeping can trigger migraines in some people.

Physical factors

Intense physical exertion, including sexuality.

Changes in the environment

A change in weather or barometric pressure.

Medicines

Oral contraceptives and vasodilators can aggravate migraines.

Risk factors for migraine

Several factors make you more prone, including:

  • Family history. If you have a family member with migraines, you have a good chance of developing them.
  • Years.  They can be present at any age; although the first sometimes occurs in the middle of adolescence, it can peak during the 30 years of age, and they become less severe and frequent in the following decades.
  • Sex. Women are more likely, headaches tend to affect boys more than girls in infancy, but from puberty and beyond, more girls are affected.
  • Hormonal changes. If you are a woman with migraines, your headaches may start just before or shortly after the start of your period.

They can also change during pregnancy or menopause, generally improving after menopause.

Some women report that migraine attacks start during pregnancy or worsen their attacks. For many, the attacks improved or did not occur during later pregnancy, often returning during the postpartum period.

Treatment of migraine

There is currently no single cure; treatment aims to prevent a full-blown attack and alleviate the symptoms that occur.

Lifestyle alterations that can help reduce the frequency include:

  • Get enough sleep.
  • Reduce stress.
  • Drink a lot of water.
  • Avoid certain foods.
  • Regular physical exercise.

Some people also find that special diets can help, such as gluten-free.

Consider seeking additional treatment if the above changes do not relieve your migraine symptoms or frequency. Symptom treatment focuses on avoiding triggers, managing symptoms, and taking medications.

Surgery

The last decade has seen the development of new treatment approaches. A doctor can administer an injection of botulinum toxin, or Botox, to the extracranial sensory branches of the spinal trigeminal and cervical nerves. These are a group of nerves in the face and neck linked to migraine reactions.

Prevention of migraine

Until recently, experts on the subject recommended avoiding the most common triggers. Some of the triggers cannot be avoided, and avoiding them is not always practical; some changes in lifestyle and coping strategies can help reduce the number and severity:

Transcutaneous supraorbital nerve stimulation.

This device is similar to a headband with attached electrodes, recently approved by the Food and Drug Administration as a therapy for the prevention of migraines; in research, those who used the device experienced fewer migraines. Learn to Cope Recent research shows that a strategy called coping can help prevent migraines.

You can gradually expose yourself to headache triggers and help numb it in this practice. You can also combine it with cognitive behavioral therapy, but more research is needed to understand the effectiveness better.

Create a consistent daily schedule.

Establish a daily routine with regular and average sleeping and eating patterns and try hard to manage stress.

Get regular exercise.

Regular aerobic exercise reduces tension and can prevent migraines; if your doctor agrees, choose aerobic activities that you can enjoy, such as walking, swimming, and biking, but it is essential to warm up slowly because exercise suddenly with intensity can cause headaches. Regular exercise can help you lose weight or maintain a healthy and appropriate bodyweight because obesity is thought to be a factor in migraines.

Reduces the effects of estrogen.

If you are a woman and estrogens seem to trigger or worsen your headaches, you may want to avoid or reduce the estrogen medications you take. These medications include birth control pills and hormone replacement therapy; talk to your doctor about the alternatives or doses that are right for you.

Migraine vs. headache

It is essential to know the difference between a migraine attack and a headache.

Headaches can vary significantly in how long they last, how severe they are, and why they occur.

Migraine attacks will present as moderate to severe headaches on one side of the head that occur with other symptoms, such as nausea and vomiting. Migraine and non-migraine headaches are different and can indicate different causes.

To help identify a headache, it may be helpful to keep a symptom diary indicating the time of onset, any triggers, the duration of the headaches, any noticeable signs or aura leading to a migraine attack, and any other symptoms.

A headache diary should ideally be used for a minimum of 8 weeks and record:

  • The frequency, duration, and severity of the headaches.
  • Any associated symptoms.
  • All prescription and non-prescription medications are taken to relieve headache symptoms.
  • Possible triggers.
  • The relationship of headaches to menstruation.

During the initial diagnosis, the doctor may suggest a series of tests to rule out other causes of headaches. These may include EEG, CT and MRI scans, or a spinal tap.

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Hello, how are you? My name is Georgia Tarrant, and I am a clinical psychologist. In everyday life, professional obligations seem to predominate over our personal life. It's as if work takes up more and more of the time we'd love to devote to our love life, our family, or even a moment of leisure.