Migraine

A migraine is a severe headache usually felt as a throbbing pain at the front or on one side of the head.

Other symptoms such as nausea and sensitivity to light may be present.

A migraine headache is a form of vascular headache. Migraine headache is caused by vaso-dilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibers that coil around the large arteries of the brain. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.

Migraine attacks commonly activate the sympathetic nervous system in the body. The sympathetic nervous system is part of the nervous system that controls primitive responses to stress and pain, “fight or flight”response, and this activation causes many of the symptoms associated with migraine attacks;
for example, nausea , vomiting , and diarrhea when the activity is increased in intestines.

The increased sympathetic activity also contributes to the sensitivity to light (blurred vision)and
sound . There are two types of migraine:

Classical migraine— is when you have a warning sign, known as aura, before the migraine begins. About a third of people with migraine have this. Warning signs may include visual problems (such as flashing  lights) and stiffness in the neck, shoulders or limbs.

Common migraine— is when there is no aura

Symptoms
A migraine is an intense headache that usually occurs at the front or on
one side of the head. However, the area of pain can change position during an attack. The pain is usually a severe throbbing sensation that gets worse when patient move.

Symptoms of aura (i.e. symptoms just 15-45 minutes before headache)
These include:

  • Visual problems – Patient may see flashing light, zigzag patterns or blind spot.
  • Stiffness or a tingling sensation like pins and needles in his neck, shoulders or limbs
  • Problems with co-ordination – may feel disorientated or off-balance
  • Difficulty in speaking
  • Loss of consciousness – this only happens in very rare cases
  • Some people may experience aura with only a mild headache.

Symptoms accompanying a migraine

  • Nausea – patient may feel queasy and sick; this may be followed by vomiting
  • Increased sensitivity – patient may have
  1. photophobia (sensitivity to light)
  2. phonophobia (sensitivity to sound)
  3. osmophobia (sensitivity to smells)

which is why many people with a migraine want to rest in a quiet, dark room .
These often begin at the same time as the migraine and usually disappear once the headache eases.
Common symptoms(in common or classical migraines)

  • Poor concentration
  • Sweating
  • Feeling very hot or very cold
  • Abdominal pain (which can sometimes cause diarrhoea)
  • Frequent need to urinate

Not everyone experiences these symptoms when they have a migraine, and they do not usually all occur at once. The symptoms of a migraine can last anywhere between 4 hours -3 days. They will usually disappear when the headache goes. Patient may feel very tired for up to a week after a migraine attack.

Age During Occurence.-

A lot of people get migraines — about 11 out of 100. The headaches tend to first appear between the ages of 10 and 46.


Occasionally, migraines may occur later in life in a person with no history of such headaches. Migraines occur more often in women than men, and may run in families. Women may have fewer migraines when they are pregnant. Most women with such headaches have fewer attacks during the last two trimesters of pregnancy.

Triggers of Migraine–

  • Alcohol
  • Allergic reactions
  • Bright lights
  • Certain odors or perfumes
  • Changes in hormone levels (which can occur during a woman’s menstrual cycle or with the use of birth control pills)
  • Changes in sleep patterns
  • Exercise
  • Loud noises
  • Missed meals
  • Physical or emotional stress
  • Smoking or exposure to smoke
  • Food-related triggers may include:

  1. Any processed, fermented, pickled, or marinated foods
  2. Baked goods
  3. Chocolate
  4. Dairy products
  5. Foods containing monosodium glutamate (MSG)
  6. Foods containing tyramine, which includes red wine, aged cheese, smoked fish, chicken livers, figs, and
  7.  certain beans
  8. Fruits (avocado, banana, citrus fruit)
  9. Meats containing nitrates (bacon, hot dogs, salami, cured meats)
  10. Nuts
  11. Onions
  12. Peanut butter

This list may not be all-inclusive.

Tests & Diagnostics—

True migraine headaches are not a result of a brain tumor or other serious medical problem. However, only an experienced health care provider can determine whether your symptoms are due to a migraine or another condition. A complete physical & interrogative examination will be done to make sure that your headaches are not due to muscle tension, sinus problems, or a more serious underlying brain disorder or running in the families.
Tests are usually not needed if you have typical signs and symptoms of migraines.
However, a brain MRI or CT scan may be required to rule out other causes. If you have a migraine with unusual symptoms such as weakness, memory problems, or loss of alertness. An EEG may be needed to rule out seizures.
Rarely, a lumbar puncture (spinal tap) might be done.

Treatment–

 The goal of the treatment is to prevent symptoms by avoiding or changing your triggers.

  • Keep a record of the following—
  1. When your headaches occur
  2. How severe they are
  3. What you’ve eaten
  4. How much sleep you had
  5. Other symptoms
  6. Other possible factors (women should note where they are in their menstrual cycle)
  • Changing your sleep schedule may result in fewer migraine attacks
  • When you do get migraine symptoms, try to treat them right away. The headache may be less severe.
    When migraine symptoms begin
  •  Drink water to avoid dehydration, especially if you have vomited
  • Rest in a quiet, darkened room
  • Place a cool cloth on your head

Ayurvedic Medicines are used to:

  • Reduce the number of attacks
  • Stop the migraine once early symptoms occur
  • Treat the pain and other symptoms

If you have frequent migraines, your doctor may prescribe medicine to reduce the number of attacks. Such medicine needs to be taken every day for few weeks in order to be effective.

Ayurvedic medicines should be taken under the supervision of an Ayurvedic practitioner

Complications—

  • Stroke

Migraines are associated with a small increased risk of ischaemic strokes. An ischaemic stroke occurs when the blood supply to the brain is blocked by a blood clot or fatty material in the arteries. The reason why ischaemic strokes are linked to migraine is not entirely clear. An ischaemic stroke as a result of a migraine is very rare.
Another risk factor for ischaemic stroke is the use of the combined oral contraceptive pill. Medical professionals generally advise women who experience migraine with aura not to use the combined contraceptive pill.
Women who have migraine without aura can take the combined contraceptive pills. However, if you take the combined contraceptive pill and you have aura symptoms or your migraines become more frequent, see your doctor as soon as possible to discuss alternative forms of contraception.

  • Mental health problems

Migraine is associated with an increased risk of mental health problems

  1. depression
  2. manic depression
  3. anxiety disorder
  4. panic disorder.

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