MIGRAINE- A COMPLEX HEADACHE

Migraine – A complex headache

What is migraine?

Migraine is a condition characterized by frequent episodes of headaches, associated with nausea or vomiting. Commonly, migraine headache is experienced on one side of the head around the temples and occasionally may shift from one side to the other. It arises from a combination of blood vessel enlargement and release of chemicals from nerves that are in close proximity to these blood vessels. During a migraine attack, the artery located just under the skin of the temple and outside the skull enlarges causing release of chemicals that cause an inflammation and further pain. This also triggers the sympathetic nervous system to react with feelings of nausea, vomiting and aversions to light, smell and sound.

Different types of Migraine:

In clinical practice, doctors see patients with two kinds of migraine viz migraine with aura and migraine without aura.

Migraine with aura: This is also known as classic migraine, and here the patients feel sensory symptoms (aura) 10-20 minutes prior to the attack. An aura is described as seeing hazy or flashing lines or blind spots in the centre of vision. Patients with classic migraine may also experience mental fuzziness and unclear speech. Almost 1 in 5 migraine sufferer experiences an aura.

Migraine without aura: This is the most common migraine and the patient in this case does not experience an aura although all other symptoms and factors for the attack are similar.

What triggers a migraine?

A migraine trigger is different for each migraineur and what acts as a trigger for one, may not start a headache in another. Some of the most common migraine triggers are –

• Changes in weather and especially summer heat
• Sensory disturbances such as strong smells, flashing or fluorescent lights, extreme and continuous loud noise

• Certain food items such as over fermented cheese, alcohol, red wine, nuts
• Stress and anxiety
• Sleep pattern disturbance
• Erratic meal timings and fasting 

What to do during a migraine episode?

For some patients it is difficult to differentiate between migraine and normal headache. Taking over-the-counter pain killers do not help relieve a migraine headache. If the headache is experienced on one side of the head along with nausea and vomiting, lasting 4 hours or more, then one needs to immediately consult a general physician. 

What are the treatment options available for migraine?

There are two levels of treatment options available for treating migraine.

Preventive treatment: Identifying and being aware of the triggers and trying to avoid them completely is one way to prevent migraine attacks. Maintaining a migraine diary and recording history helps tremendously to prevent a migraine attack.

Drugs for treating migraine: There are several classes of drugs that are used to treat a migraine headache. Although these are actually prescribed for other conditions such as depression, blood pressure, or allergy, experience shows that they can also halt a migraine headache.

What is the outcome in cases of Migraine?

Migraine attacks are at its peak in the age group of 25-55 years. Therefore as one grows older, the frequency of attacks gradually diminishes. For most patients, avoiding known triggers and following a therapeutic regimen works best to overcome migraine headache.