Migraine Chronicles: Decoding the Pain

Migraine is characterised by , hemicranial or unilateral throbbing headache and often associated with nausea, vomiting, and visual disturbances. Many patients, headache is bitemporal and generalised and there may not be any visual disturbances or focal neurological signs. It takes place in childhood, adolescent, and adult life. It is more common in females than males. Family history may be positive in 60% of patients.

It will likely get worse with physical activity, lights, noise, and smells.A migraine is a primary headache,  it doesn’t take place due to severe medical conditions . A secondary headache is a symptom of another health issue. 

Understanding the basics 

The symptoms of migraine are associated with changes in the cerebral blood flow secondary to changes in the vessel caliber , In migraine with aura ( Group of sensory , motor, and speech symptoms that acts like warning signals that headache will be begin soon ) the prodromal phase with neurological symptoms are due to arteriolar constriction of cerebral vessels. 

Dietary factors including chocolate, coffee, tea, cheese and alcohol; may precipitate attack. Some patients describe exposure to sunlight, exercise, tension, oral contraceptive, menstruation as increasing the frequency and the severity of attacks. Stress, pregnancy and anxiety may initiate the perpetuation of headache. About 50 % patients of it have an affected relative suggesting a genetic predisposition. 

Different Types Of Migraine 

• Migraine with aura – 15 – 20 % of people are affected by  it.
• Migraine without aura – It takes place without warning.
• Migraine without head pain – Includes the aura symptoms, but not the headache.
• Hemiplegic migraine – neurological or sensory changes on one side of your body.
• Retinal migraine – Pain with loss of vision in one eye. 
• Chronic migraine – when pain takes place at least for 15 days.

Unraveling the Clinical features 

The condition starts after puberty and continues until late middle life. Females suffer more than males. Episodes of headache occur at frequent intervals varying from days to weeks to months. Each attack lasts for hours to days. The headache is localised to the frontal region, spreads to one side of the head and sometimes becomes generalised. This is due to dilation of extra-cranial vessels. An attack of migraine can be separated into differential phases  : 

• Normal well being before an attack.
• Prodromal symptoms.
• Attacks of headache, photophobia, nausea, vomiting etc. 
•  Sleepy feeling.

Migraine Triggers 

Triggers vary from person to person. Some basic possible triggers are tiredness, poor posture, a lack of sleep, low blood sugar level, irregular mealtimes and dehydration. Triggers commonly include followings : 

• It may be emotional triggers, such as depression, stress, and excitement.
• Dietary habits like alcohol, caffeine, nuts, cheese, and citrus fruits.
• Hormonal changes, which are due to menstruation.
• Medications, such as sleeping pills and some birth control; pills.
• Environmental factors are the most common, which includes strong smells, loud noises, humidity and temperature changes.

Chronic Migraine 

Having a headache for at least 15 days per month is called chronic migraine. Chronic symptoms may include nausea, vomiting, striking pain and increased sensitivity to light, sounds and smells. Affecting factors of chronic headache may depend upon a number of medical conditions. These includes : 

• Anxiety

• Depression

• Pain conditions like fibromyalgia

• Sleep apnea

Chronic headaches have a huge impact on physical, social and official life. Patients with it report poor quality of life.It can be challenging to find an appropriate treatment, if you are struggling with chronic migraine. 

 Management

The first and the foremost aim of treatment is to find out precipitants and to avoid them. However known precipitants, dietary factors should be stopped immediately, if they are associated with attacks.Drugs like triptans and ergotamine, which will balance the chemicals of the brain.

Home remedies can also help to deal with migraines . Home remedies like resting with your eyes closed in a dark room, putting an ice pack on your head, and drinking plenty of water. Cognitive behavioural therapy which teaches you how actions and thoughts affect how you sense pain.

Physical treatments like massage, acupressure, acupuncture, and craniosacral therapy might ease its symptoms. If other treatments don’t work, your headaches are severe, or you have four or more headache days a month, your doctor may suggest preventive medicines too. They include seizure medicines, blood pressure medicines (like beta-blockers and calcium channel blockers), some antidepressants, and shots of botulinum toxin type A (Botox).