Migraine is one of the commonest types of headaches people come across. It not only lowers the quality of life but also interferes with day to day activities. Migraine affects both the genders, however, the ratio is higher in females than males
WHAT IS MIGRAINE?
Migraine is one of the neurological, vascular types of recurrent headache which varies from moderate to severe in intensity. It is a pulsating type of headache affecting one half of the skull or entire skull. Migraine pain is also radiated to the face and jaws. It is the debilitating type of headache with exact cause unknown. Globally migraine affects 1 billion people.
3MEDS- online pharmacy store in India provides detailed perception regarding migraines.
Beginning with the types of migraine:
Classic migraine: – it is associated with aura as a prodromal symptom. Aura is a neurological symptom associated with visual disturbances such as blind or colored spots, sparkles or stars, flashing lights, temporary blindness which lasts for less than 1 hour during or before the onset of headache.
Sub-types include:
· Hemiplegic migraine: – it involves temporary weakness or paralysis of half side of the body including face, feet, and hands. There is also speech and vision disturbances, and confusion. It is of 2 types:
Familial hemiplegic migraine- seen in individuals with a family history of migraine.
Sporadic hemiplegic migraine- seen in individuals without a family history of migraines.
· Migraine with Brain stem aura is also known as basilar migraine: – most common in young women. The symptoms are primarily neurologic and include aphasia (difficult to talk), temporary blindness, vertigo, confusion, and ataxia; may be accompanied by an occipital headache.
Common migraine: – migraine without prodromal aura is known as common migraine. Affecting almost 70-90% of individuals. It may last for 24 hours to 4 days. The patient presents irritability to light (photophobia) and noise (phonophobia).
Facial migraine: – it causes throbbing and/or stabbing pain in the neck and jaws. The pain is linked with the association of branches of the carotid artery (carotidynia) rather than cerebral vessels. Symptoms usually begin in individuals who are 30 to 50 years of age.
Menstrual migraine: -few women experience throbbing headache either 2 days before the onset of periods/menstrual cycle or during the menstruation up to 3 days after onset. Reasons attributed to this include; (1) falling levels of estrogen in the body, (2) increased level of prostaglandin hormone.
Vestibular migraine: – migraine associated with vertigo (spinning) or dizziness along with other symptoms of migraine. At least 5 episodes of a migraine attack with vertigo are required to diagnose it.
Chronic migraine: -headache lasting continuously for 15 days over a period of 3 months is termed as chronic migraine. It is the most debilitating due to fortnight-long headaches. Episodic migraine is a subtype that involves a headache for 15 days per month. The overuse of medication also causes this migraine.
Cyclical vomiting syndrome: – children presenting with recurrent episodes of vomiting without actual headache or any other infection constitutes cyclical vomiting syndrome. It is the main symptom for children below 6 years of age to confer migraine diagnosis.
CAUSES & TRIGGERING FACTORS FOR MIGRAINE;
The exact cause is still unknown. It is thought to be an amalgamation of genetic and environmental factors. Disturbance in chemical neurotransmitters like serotonin, calcitonin gene-related peptide. Brainstem changes associated with the trigeminal nerve. Psychological conditions like anxiety, depression. Genetic involvement in certain types of migraines is noticed.
Triggering factors are;
- Hormonal changes: reduced level of estrogen, increased level of prostaglandin during menstruation, menarche, pregnancy, menopause, and use of oral contraceptives or other hormonal therapy. However, migraine episodes disappear during the second and third trimester of pregnancy.
- Drinks: certain drinks rich in caffeine influence migraine attacks. Alcoholic drinks like wine is also a triggering factor.
- Certain foods: processed foods, aged cheese due to tyramine, food containing artificial additives aspartame and monosodium glutamate, certain meat containing nitrites or nitrates, citrus fruits, salty, spicy, chocolate containing caffeine and beta-phenyl ethylamine, frozen foods like ice-cream.
- Exercise: strenuous exercise, sports is thought to be a triggering factor among certain people.
- Stress: stress and fatigue are of the triggers for migraines. Stress from work or family can trigger migraines.
- Irregular sleep: too much sleep or lack of sleep or abnormal sleep triggers migraines.
- External stimuli: stimulus like bright light or sunshine, the loud noise of speakers or vehicles, certain perfumes, smoke, hunger, fasting.
SYMPTOMS OF MIGRAINE:
Divided into 4 phases:
Prodromal phase: preceding the onset of headache one can experience irritability, depression, euphoria, fatigue, sensitivity to light, noise, smell, constipation, excessive hunger and craving, stiffness of muscles.
Aura phase: associated with visual disturbances, aphasia, ataxia, vertigo, auditory disturbances, and hallucinations of bright light flashing to colorful spots. Not seen in all types of migraine.
Headache phase: severe throbbing or pulsating headache usually on one side of the cranium. Extreme sensitivity to trigger factors lasts for 24 hours to a few days if not treated. Associated with nausea and vomiting.
Post-normal phase: -this phase is followed by the headache phase. Feeling of weakness or energetic, sudden movement may cause pain again after the headache subsides.
TREATMENT:
3MEDS-best online medicine app in India recommends the following treatment strategies.
There is no permanent cure however, preventive measures and medications can reduce the number of episodes.
- Patients with migraine should consult doctors to identify potential triggering factors and take preventive measures to avoid the same.
- Consult a nutritionist to identify probable food triggers and avoid them and take supplements.
- Alteration of lifestyle habits and sleeping patterns. Relaxation therapy to minimize the stress of everyday living like yoga, biofeedback, massage, acupuncture.
. Drug therapy includes ergotamine, sumatriptan, beta-blockers like propranolol, verapamil, and tricyclic antidepressants, gabapentin. Frovatriptan for menstrual migraine, Ibuprofen.
- Surgery in extreme cases.
CONCLUSION:
Having a debilitating migraine is not a failure in life. With proper care and measures, one can overcome a number of episodes and achieve success. Do not overstress and live a happy life. Adopt healthy lifestyle practices. Make use of e-pharmacy like 3MEDS-online chemist shop and reduce sun exposure.