^^ Migraine ^^

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^^ Migraine ^^

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nurse
red rose

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^^ Migraine ^^

What is migraine?

Migraine is a long-term condition of the brain that can be characterized by recurring pain that comes in the form of severe, disabling headaches and other symptoms (migraine attack). The pain from a migraine headache (classified as moderate to severe), which is often only on one side of the head, can be described as intense, throbbing, or pulsing, and can last for 4 to 72 hours if not treated - sufferers must retreat from the world and wait in agony for the pain to recede. Other symptoms include nausea, vomiting, and extreme sensitivity to smells, sound, and light. Physical activity may make migraine pain worse, and similarly migraine pain may cause the sufferer to avoid physical activity. Currently, there is no cure for migraine; however, with the proper medication(s), the symptoms associated with a migraine attack can be controlled and sometimes even prevented.

Often, a migraine attack will follow a number of stages:

prodrome (before the headache)
aura
headache
postdrome (after the headache)

In the hours or days before the pain of a migraine headache hits, some people may experience one or more of the following: unusual thirst, drowsiness, irritability or depression, feelings of elation or high energy, and sugar cravings. These experiences, known as prodromes, can occur whether or not your migraine is accompanied by a group of strange sensations, known as an aura. You can think of a prodrome as an early warning signal.
One in five people with migraine experience a group of strange sensations called an aura, developing gradually anywhere from 5 to 20 minutes before the pain of a migraine headache starts and often lasting less than an hour. These may include vision disturbances (temporary blind spots, light flashes, and zigzag lines), tingling ("pins and needles") in the arms, legs, face or hands, and difficulty speaking. For some people, the aura can continue after the headache starts and sometimes, although rarely, they can occur after the headache begins. The headache itself causes an intense throbbing pain, usually on one side of the head. People may also experience nausea, vomiting, or sensitivity to sound or light (for more information, refer to the beginning of this section).
When the pain of a migraine headache is gone, some migraine sufferers may complain of other migraine symptoms that include tiredness, weakness, difficulty concentrating, and a "hangover" feeling. This type of experience is considered the postdrome stage of a migraine attack.
There are actually several terms used to describe the different types of migraine. Your doctor may describe yours as "migraine without aura" (previously known as common migraine) or "migraine with aura" (previously known as classic migraine). These are the two types seen most often.

05-29-2008 06:09 AM

nurse
red rose

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RE: Migraine...

There are many other kinds of headaches:

Tension headaches affect about 90% of all adults at some point in their lives. Often triggered by stress, tension headaches cause a temporary, steady ache on both sides of the head, unlike migraines, which are most commonly felt on only one side of the head.
Cluster headaches come in groups or clusters over weeks or a month. The pain is severe, but each headache typically lasts no more than 1 to 2 hours (usually shorter than a migraine), and the pain centres on one eye. Other symptoms include eye redness, tearing, and a runny nose. These symptoms sometimes help distinguish cluster headaches from migraine or other types of headaches. Alcohol is a known trigger. Cluster headaches are much less common than tension headaches, and affect approximately 1% of adults.
Medication-induced headaches (also called rebound headaches) mask themselves as frequent or chronic headaches. Headaches occur almost every day, causing a person to take pain relievers daily or almost daily. When the medication wears off, the headache comes back, leading to more medication use. The person takes more medication, and becomes trapped in a painful cycle. Medication-induced headaches often start off as migraine headaches. Once the proper diagnosis is made, the medications that are inducing the headaches are discontinued; this is key in treating medication-induced headaches.

05-29-2008 06:12 AM

nurse
red rose

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RE: Migraine...

What causes migraine attacks

No one knows exactly what happens in the body during a migraine attack, but there are several theories.
The most current theory proposes that migraine attacks occur because of a combination of changes in the nerves and the blood vessels that supply the brain. Individuals who suffer from migraines respond to certain triggers, such as a surge in hormones during the menstrual cycle, which activate specific nerves (the trigeminal nerve) in the brain, causing the release of chemicals called neuropeptides. These chemicals go on to cause a variety of reactions, including expanding of blood vessels and release of proteins and fluids, leading to inflammation. The neuropeptides are also thought to make parts of the trigeminal nerve more sensitive, which can make the migraine headache last longer. In addition, the activation of parts of the trigeminal nerve by the neuopeptides can also cause pain impulses to be transmitted in the brain.
Another theory proposes that a migraine attack starts with abnormal nerve activity that spreads in the brain. The brain reacts to this change in nerve activity by opening the blood vessels wider. As blood vessels expand, they press on nerves, causing pain. This theory also helps to explain why certain newer migraine-specific medications can be very helpful in treating migraine attacks.
Other theories suggest that abnormal genes that control certain brain cells are responsible, or that chemical signals between cells are interrupted, leading to migraine attacks.

05-29-2008 06:14 AM

nurse
red rose

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RE: Migraine...

Risk factors and causes of migraines

Migraines are caused by abnormal brain activity. This abnormal activity may be triggered by a number of factors. Although the exact process in which this occurs is unknown, the disorder appears to involve blood vessels, nerve pathways and chemicals in the brain.

Some researchers believe migraines are caused by imbalances in brain chemicals such as serotonin (a neurotransmitter that controls pain signals traveling through the trigeminal nerve) or changes in the trigeminal nerve, which carries sensory stimuli to the brain from the face, teeth and tongue. Others believe that migraines are due to central sensitization, which means that pain centers feel pain without any painful stimulus (allodynia).

Serotonin levels drop during a migraine. Many researchers think this triggers the trigeminal nerve to release substances known as neuropeptides. Once released, the neuropeptides travel to the brain’s surface, where they cause swelling and inflammation of blood vessels. This results in head pain. Low levels of magnesium, a mineral involved in nerve cell function, may also play a role.

Factors that may trigger a migraine include:

Sensory stimulus, such as bright lights, loud noises or certain odors
Stress (physical or emotional)
Depression
Changes in sleep patterns, including too little or too much sleep
Smoking or exposure to secondhand smoke
Skipping or delaying meals
Alcohol or caffeine
Intense physical activity
Tension headaches
Medications that cause the blood vessels to swell (vasodilators), including some blood pressure medications
Frequent use of pain medication (rebound withdrawal headaches)
Allergic reactions
Environmental changes, such as changes in weather, altitude level, barometric pressure or time zone
Hormonal changes, including those caused by menstruation, pregnancy, menopause, birth control pills or hormone replacement therapy

Although responses vary among individuals, certain foods can trigger migraines as well, including:

Chocolate
Peanut butter and nuts
Certain fruits (e.g., avocado, banana, citrus fruits)
Onions
Dairy products
Baked goods
Fermented foods
Pickled and marinated foods
Foods containing monosodium glutamate (MSG) or nitrates (hot dogs, bacon)
Foods containing the amino acid tyramine (e.g., red wine, aged cheese, smoked fish, chicken livers, figs and some beans)

A number of factors appear to make a person more likely to develop migraines. These risk factors include:

Age. According to the National Headache Foundation (NHF), migraines occur most often between the ages of 15 and 55.
Sex. The NHF estimates that women are affected with migraines three times as often as men.
Family history. Migraines are more likely to occur in people with migraine sufferers in their immediate family, such as a parent or sibling. According to the NHF, between 70 and 80 percent of migraine sufferers have a family history of migraines.

Some studies have found increased prevalence of migraines in people with certain conditions, including epilepsy, insulin resistance, obesity, fibromyalgia and certain cardiovascular conditions (see Ongoing research).

05-29-2008 06:17 AM

nurse
red rose

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RE: ^^ Migraine ^^

Signs and symptoms of migraines

The main symptom of a migraine is a throbbing, pounding or pulsating headache. The pain, which may be dull or severe, is typically worse on the sides of the forehead. It starts on one side of the head and typically remains contained there. However, it may spread to the other side. For many migraine sufferers, the headaches start on the same side each time.

Exertion often intensifies the pain. In addition, many patients experience pain behind the eye or in the back of the head or neck.

Migraines may be accompanied by a number of other symptoms including:

Nausea or vomiting
Sensitivity to light or sound
Loss of appetite
Fatigue
Allodynia
Numbness, weakness or tingling
Dizziness or vertigo (feeling that the room is spinning)
Chills
Increased urination
Increased sweating
Swelling of the face
Irritability

Some people who experience migraines have warning symptoms before the headache appears. Known as aura, these temporary visual disturbances are caused by transient changes in the activity of certain nerve cells. The changes may occur in one eye or in both. Aura most often occurs 20 minutes to one hour before a migraine. However, it can develop anywhere from a few minutes to 24 hours before the headache appears. Warning symptoms may include:

Visual hallucinations (e.g., flashing lights, zigzag lines, dots)
Blind spots
Tunnel vision
Sensitivity to bright light
Blurred vision
Eye pain

Most people, however, do not experience aura. According to the National Headache Foundation (NHF), only around one–fifth of migraine suffers experience aura. Some people also experience difficulty speaking, or a tingling sensation in their arm, leg or face.

Regardless of whether or not a patient has aura, there are a number of symptoms that may appear several hours to a day before a migraine occurs. Known as prodrome symptoms, these include: