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Introduction
The word "migraine" comes from words meaning "half the head", and sounds like
"demi-cranium", because migraine headaches often hurt on only the left or right
side of the head. However, many people with migraines always have pain on the
whole head.
A migraine headache is caused by hormonal fluctuations which cause blood vessels
in the head and neck to contract and then dilate. The first phase, or
contraction phase, may last minutes, hours, or days. During this phase,
symptoms can be spots in front of the eyes, difficulty concentrating, and cold
fingertips and hands. This is called an "aura". Many people recognize this
phase of their headaches; many others don't notice any symptoms at this time.
Some people who think they don't have an "aura" can learn to recognize it.
When the blood vessels dilate, the headache pain starts. Apparently the hormones
 over-react.
Instead of just going from a contracted state back to normal, the blood vessels
dilate much wider than normal, causing pain. Other things also happen about the
same time: swelling of the brain, release of certain chemicals, and perhaps
muscle tension. These things add to the pain.
What is Migraine?
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Migraine is one of the most common diseases of the nervous system. In developed
countries migraine affects about 10-15% of people.
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A migraine is a type of headache that usually happens in episodes or "attacks".
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It may feel like it is throbbing or pulsating and may be located on one side of
the head.
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The pain may be accompanied by nausea, vomiting, and sensitivity to light or
sound. It may be so severe that the patient has to lie down in a darkened room
and wait for it to pass.
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Some migraine sufferers have a warning 'aura', lasting up to 1 hour before the
headache starts, which often causes problems with eyesight; for example,
flashing lights, zig-zag lines and blank spots when trying to concentrate on
something. Such attacks preceded by an aura are called ‘classical’ and account
for about only 20% of migraines.
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Migraines without aura are called ‘common’ and account for about 80% of
migraine attacks.
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Some people also suffer from other warning symptoms, such as numbness or
tingling on one side of the face, around the mouth or down one arm.
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There are also other types of migraine that are less common than the ones
described above.
Causes of Migraine
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Migraine can be triggered by many different things, including stress, exercise,
certain foods, bright lights, flickering lights, loud noises, strong smells,
lack of sleep or too much sleep.
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In women, attacks may be triggered by hormonal changes, for example during
menstruation (periods).
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One theory of how migraine causes headache is that some of the nerves in the
head that provide sensation from the face become overactive, causing blood
vessels adjacent to the nerves to become slightly leaky and the lining of the
brain in the vicinity to become mildly inflamed. As the linings of the brain
are pain sensitive, headache occurs. After a while, the inflammation goes away
and the headache resolves.
Typical Symptoms of Migraine
Prior to a migraine, sufferers often notice warning signals that an episode is
on the way. About 40% of sufferers notice certain cravings or lethargy a day or
two in advance. They are then able to take action to try to head off the
attack. Other sufferers experience sensory symptoms – known as the ‘aura’ -
usually in the hour preceding the headache.
The aura
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Visual disturbances – wavy lines, flashing lights, blind spots (scotoma)
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Dizziness
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Numbness
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Slurred or muddled speech
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Nausea or vomiting
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Diarrhoea
The headache phase
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Thumping or throbbing headache
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Pain on one side (may swap sides)
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Pain in the sinuses or neck
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Dehydration, thirst
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Sensitivity to light (photophobia), noise (phonophobia) and smell (osmophobia)
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Cold sensation
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Pins and needles
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Temporary numbness on the affected side
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Inability to think clearly or perform normal activities
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Loss of concentration
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Lack of co-ordination
Post headache
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A feeling of being ‘washed-out’
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Fatigue
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Poor concentration
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Either lethargic or full of energy and revitalised
Acute (Symptomatic) Migraine Treatment
Many types of acute treatment are available for migraine. The choice of
treatment will generally depend on the severity and frequency of the headaches,
the degree of headache-related disability, associated symptoms, other
illnesses, the patient’s medication history and any personal preferences.
Listed below are the most common acute medications for migraine. This list is
not exhaustive and patients should always consult their physician to ensure
that they receive the most appropriate treatment for their migraine.
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Simple analgesics, combination analgesics and NSAIDs
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Analgesics reduce the perception of pain by raising the pain threshold. They do
not alter the cause of the pain, but simply mask the feeling of pain. Simple
analgesics, such as aspirin or paracetamol (acetaminophen), can be effective in
patients with mild-to-moderate and infrequent migraines. These agents are
thought to be most effective when taken early in the onset of migraine. Overuse
of these analgesics may lead to rebound headache.
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Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are also
often prescribed for the acute treatment of mild-to-moderate migraine attacks.
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When simple analgesics or NSAIDs fail to provide relief, doctors may choose to
prescribe certain combination products. Caffeine and codeine, for example, are
often combined with simple analgesics and/or NSAIDs.
Preventive (Prophylactic) Therapy
Prophylactic medications are taken daily to prevent or reduce the number of
migraine attacks. Prophylactic therapy may be recommended:-
1.When acute therapy alone has failed to control the symptoms;
2.In patients who experience three or more attacks per month; and
3.In patients whose migraines are predictable.
Patients with infrequent, but severely incapacitating headaches may also be
appropriate
candidates for prophylactic therapy, particularly if the headaches are poorly
controlled with symptomatic therapy.
Some of the more common types of medication used for preventive migraine
treatment include antidepressants, anticonvulsants, beta-blockers, calcium
channel blockers.
For Immediate Relief
Most of the treatments in this FAQ are used to prevent migraines from happening.
This section describes things you can do when you're in pain, to reduce the
pain.
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Have a bath or shower.
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Lie down to rest in a dark room.
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Avoid bright or flashing light.
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Put something cold on the back of your neck, such as a cold, wet cloth; or
alternate hot and cold cloths where the pain is.
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Put a cold compress on your forehead and your feet in a container of warm
water.
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Have a drink of water or natural juice, especially tomato juice.
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Have some food, or a nutritious drink, if you haven't eaten for a while.
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Massage your own face, head, neck and shoulders, or get someone else to do
those and your back. Relax your muscles.
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Press on two pressure points at the back of the neck. These points are about
two inches apart, just below the base of the skull. Press for a minute or two.
This releases endorphins that help against pain.
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Massage or press on the fleshy area between thumb and forefinger.
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Gently lean the head to left or right to stretch the neck muscles. Massage and
relax any tense muscles.
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Avoid sources of stress. Cancel activities so there's less to worry about.
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Avoid exercise during a headache if it makes throbbing pain in the head and
neck worse. On the other hand, generally exercise improves health, and it may
help you relax during a headache.
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Take some niacin (a form of vitamin B3). Taking enough niacin to cause a flush
(blood rushing to the skin) can provide relief from headache pain, but this
much niacin can also have side effects (flush, nausea, heartburn, liver damage,
etc.) Niacinamide doesn't have such bad side effects, but isn't as much use
against migraines, either. Smaller, safer amounts of niacin are also helpful.
Niacin can trigger a migraine, though.
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Take some vitamin C, vitamin B6, choline, tryptophan and niacin and/or
magnesium.
References:
http://www.patienthealthinternational.com
http://www.midas-migraine.net
http://www.migraine-advice.com
http://www.faqs.org
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