Migraine : Causes-Symptoms-Diagnosis-Treatment

 What is Migraine?

A migraine is a strong headache that often comes with nausea,  vomiting, and sensitivity to light. It will last hours or days.A migraine is a common neurological disorder that causes a range of symptoms, most notably a throbbing, pulsing headache on one facet of your head. Your migraine can possibly intensify with physical activity, lights, sounds or smells.

Migraine

it should last a minimum of four hours or maybe days. 12% of American citizens have this genetic disorder. analysis shows that it’s the sixth most disabling disease within the world.There are over a hundred and fifty varieties of headaches, divided into 2 categories: primary headaches and secondary headaches. A cephalalgia may be a primary headache, that means that it isn’t caused by a unique medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no biopsy or imaging study to diagnose it. A secondary headache is a symptom of another health issue.

Medical terms

• A migraine is a headache that may cause severe throbbing pain or a pulsing sensation, sometimes on one facet of the head. It's often in the midst of nausea, vomiting, and extreme sensitivity to light and heat. Hemicrania attacks can last for hours to days, and therefore the pain is often so severe that it interferes with your daily activities. For a few people, a warning symptom called an aura happens before or with the headache. Associate in Nursing aura can embrace visual disturbances, resembling flashes of sunshine or blind spots, or alternative disturbances, such as tingling on one side of the face or in Associate in Nursing arm or leg and issue speaking. Medications will facilitate forestall some migraines and build them less painful. the correct medicines, combined with assistance remedies and mode changes, would possibly help. 
• Headaches Migraine headaches are the most common type of primary headache affecting approximately one in five women and one in twenty men The emotional impact of migraines can be severe with many sufferers experiencing significant disability For example some people have to give up work or school because they cannot carry out daily activities when they experience a migraine attack Because migraine attacks can last as long as 72 hours most people with this condition also require bed rest during an attack Migraines often run in families suggesting that both genetic and environmental factors play a role in developing the condition It is estimated that about half of all people.

Headache Symptoms Migraine headaches are intense and throbbing affecting one-fifth of the population Most migraine attacks last 24 to 72 hours and may be preceded by an aura or sensory symptoms; nausea and vomiting can be present as well Migraines typically occur on both sides of the head but not necessarily in the same spot each time Additionally people with migraines may experience sensitivity to light and sound facial pain fatigue and changes in their vision that include blurred vision double vision or blind spots.

Symptoms Migraine

How can you tell if your headache is actually a migraine? Symptoms vary from person to person. But if you agree with some or many of the statements below, your headache could be a migraine and you should consider seeing a doctor. Migraine, which affects children and adolescents as well as adults, can go through four stages: prodrome, aura, attack and postdrome. Not all migraine sufferers go through all stages.

Prodrome

One or two days before a migraine, you might notice subtle changes that warn of an upcoming migraine, including:

• Constipation

• Mood changes, from depression to euphoria

• Food cravings

• Neck stiffness

• Increased urination

• Fluid retention

• Frequent yawning

Aura

For some people, an aura would possibly occur before or throughout migraines. Auras are reversible symptoms of the nervous system. They're typically visual however may embody different disturbances. Every symptom usually begins gradually, builds up over many minutes and might last up to sixty minutes.

Examples of migraine auras include:

• Visual phenomena, such as seeing various shapes, bright spots or flashes of light

• Vision loss

• Pins and needles sensations in an arm or leg

• Weakness or numbness in the face or one side of the body

• Difficulty speaking

Attack

A sick headache sometimes lasts from four to seventy two hours if untreated. However, typically migraines vary from person to person. Migraines would possibly occur seldom or strike many times a month.

During a migraine, you might have:

• Pain usually on one side of your head, but often on both sides

• Pain that throbs or pulses

• Sensitivity to light, sound, and sometimes smell and touch

• Nausea and vomiting

Post-drome

After a sick headache attack, you would possibly feel drained, confused and washed out for up to a day. Some folks report feeling elated. explosive head movement might achieve the pain once more briefly.

When to see a doctor

Migraines are often unknown and untreated. If you frequently have signs and symptoms of migraine, keep a record of your attacks and the way you treated them. Then create an arrangement along with your doctor to debate your headaches. albeit you have got a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

See your doctor immediately or go to the emergency room if you have got any of the subsequent signs and symptoms, that may indicate a lot of serious medical problem: 

• An abrupt, severe headache like a thunderclap

• Headache with fever, stiff neck, confusion, seizures, double vision, numbness or weakness in any part of the body, which could be a sign of a stroke

• Headache after a head injury

• A chronic headache that is worse after coughing, exertion, straining or a sudden movement

• New headache pain after age 50

Causes Migraine

The reason behind sick headache headaches is sophisticated and not absolutely understood. After you have a headache it’s as a result of specific nerves in your blood vessels sending pain signals to your brain. This releases inflammatory substances into the nerves and blood vessels of your head. It’s unclear why your nerves do that.Though migraine causes aren't fully understood, genetic science and environmental factors seem to play a role. Changes within the neural structure and its interactions with the fifth cranial nerve nerve, a significant pain pathway, can be involved. thus may imbalances in brain chemicals — together with serotonin, that helps regulate pain in your nervous system. Researchers are learning the role of monoamine neurotransmitter in migraines. Different neurotransmitters play a role within the pain of migraine, together with thyrocalcitonin gene-related amide (CGRP).

Migraine triggers

There are a number of migraine triggers, including:

• Hormonal changes in women. Fluctuations in estrogen, adore before or throughout expelling periods, physiological condition and menopause, appear to trigger headaches in several women. secretion medications, such as oral contraceptives, can also worsen migraines. Some women, however, notice that their migraines occur less usually once taking these medications. 

• Drinks. These include alcohol, especially wine, and too much caffeine, such as coffee.

• Stress. Stress at work or home can cause migraines.

• Sensory stimuli. Bright or flashing lights will induce migraines, as can loud sounds. robust smells — corresponding to perfume, paint thinner, secondhand smoke et al. — trigger migraines in some people. 

• Sleep changes. Missing sleep or getting too much sleep can trigger migraines in some people.

• Physical factors. Intense physical exertion, including sexual activity, might provoke migraines.

• Weather changes. A change of weather or barometric pressure can prompt a migraine.

• Medications. Oral contraceptives and vasodilators, such as nitroglycerin, can aggravate migraines.

• Foods. Aged cheeses and salty and processed foods might trigger migraines. So I might skip meals.

• Food additives. These include the sweetener aspartame and the preservative monosodium glutamate (MSG), found in many foods.

Risk factors Migraine

Several factors make you more prone to having migraines, including:

• Family history. If you have a family member with migraines, then you have a good chance of developing them too.

• Age. Migraines will begin at any age, although the primary usually happens throughout adolescence. Migraines tend to peak during your 30s, and step by step dwindle severely and fewer frequent within the following decades. 

• Sex. Women are three times more likely than men to have migraines.

• Hormonal changes. For women who have migraines, headaches might begin simply before or shortly after the onset of menstruation. they may conjointly amendment throughout physiological state or menopause. Migraines usually improve after menopause. 

Complications Migraine

Taking painkillers too usually will trigger serious medication-overuse headaches. The chance appears to be highest with salicylate, Phenaphen and alkaloid combinations. Overuse headaches can also occur if you're taking aspirin or isobutylphenyl propionic acid (Advil, Motrin IB, others) for over fourteen days a month or triptans, sumatriptan (Imitrex, Tosyma) or rizatriptan (Maxalt, Maxalt-MLT) for additional than 9 days a month. Medication-overuse headaches occur once medications stop relieving pain and start to cause headaches. You then use more pain medication that continues the cycle.

Diagnosis Migraine

There’s no biopsy or scan (ultrasound, CT scan, or MRI) that may tell your doctor if your head pain is migraine. The only possible way for your doctor to understand is to speak to you. They have to urge data concerning the specifics of your head pain, your response to current and former treatments, your case history, and the way your head pain affects your daily functioning and quality of life. A radical assessment also will embody a general medical and medicine physical exam.If you have got migraines or a family history of migraines, a doctor trained in treating headaches (neurologist) will seemingly diagnose migraines supporting your medical history, symptoms, and a physical and medicine examination.

If your condition is unusual, complex or suddenly becomes severe, tests to rule out other causes for your pain might include:

• Magnetic resonance imaging (MRI). An imaging scan uses a strong magnetic flux and radio waves to supply careful pictures of the brain and blood vessels. MRI scans facilitate doctors diagnose tumors, strokes, injury within the brain, infections, and different brain and system (neurological) conditions 

• Computerized tomography (CT) scan. A CT scan uses a series of X-rays to make elaborate cross-sectional pictures of the brain. This helps doctors diagnose tumors, infections, brain damage, hemorrhage within the brain and alternative potential medical issues which will be inflicting headaches. 

Treatment Migraine

There are 2 primary kinds of treatments for sick headaches: acute ANd preventive treatment. there's acute medications patients use throughout an attack to alleviate pain and to prevent the migraine from progressing. Preventive treatment, on the opposite hand, aims to cut back the frequency, severity, and length of attacks. Acute treatments are taken once you are experiencing an attack and are designed to stop it before it gets worse. These embody over-the-counter pain relievers, prescription medications, or devices that stop the pain. Preventive treatments are designed to reduce the frequency, severity, and period of attacks before they occur. These treatment choices will be medical, reminiscent of medications or procedures, and non-medical, such as devices, fashion changes, trigger avoidance, behavioral therapy, or physical therapy. analysis has shown that behavioral treatment, such as stress management and biofeedback, can help scale back attack frequency and severity. behavioral treatment is a crucial tool for managing the sickness and might even work abroad alternative treatments to assist patients reach their treatment goals.Migraine treatment is aimed toward stopping symptoms and preventing future attacks.

Many medications have been designed to treat migraines. Medications used to combat migraines fall into two broad categories:

• Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.

• Preventive medications. These forms of medicine are taken regularly, usually daily, to cut back the severity or frequency of migraines. Your treatment decisions depend upon the frequency and severity of your headaches, whether or not you've got nausea and instinctive reflex along with your headaches, however disabling your headaches are, and different medical conditions you have. 

Medications for relief

Medications that relieve headache pain work best once taken at the primary sign of an oncoming migraine — as long as signs and symptoms of a migraine begin. Medications which will be used to treat it include:

• Pain relievers. These over-the-counter or prescription pain relievers embody Bayer or isobutylphenyl propionic acid (Advil, Motrin IB, others). Once taken too long, these presumably} cause medication-overuse headaches, and possibly ulcers and hurt within the gi tract. megrim relief medications that mix caffeine, aspirin and Anacin III (Excedrin Migraine) is also helpful, however typically solely against delicate migraine pain. 

• Triptans. Prescription drugs comparable to sumatriptan (Imitrex, Tosyma) and rizatriptan (Maxalt, Maxalt-MLT) are wont to treat sick headaches as a result of they block pain pathways within the brain. Taken as pills, shots or nasal sprays, they will relieve several symptoms of migraine. they could not be safe for those in danger of a stroke or heart attack. 

• Dihydroergotamine (D.H.E. 45, Migranal). Available as a nasal spray or injection, this drug is only once taken shortly after the beginning of headache symptoms for migraines that tend to last longer than twenty four hours. facet effects will embody worsening of migraine-related emesis and nausea. individuals with arteria coronaria disease, high blood pressure, or excretory organ or disease ought to avoid dihydroergotamine. 

• Lasmiditan (Reyvow). This newer oral pill is approved for the treatment of headache with or while not aura. In drug trials, lasmiditan considerably improved headache pain. Lasmiditan will have a sedative impact and cause dizziness, therefore folks taking it are suggested to not drive or operate machinery for a minimum of eight hours. 

• Ubrogepant (Ubrelvy). This oral thyroid hormone gene-related amide receptor antagonist is approved for the treatment of acute headache with or while not aura in adults. It's the primary drug of this sort approved for migraine treatment. In drug trials, ubrogepant was simpler than placebo in relieving pain and alternative migraine symptoms comparable to nausea and sensitivity to lightweight and sound 2 hours when taking it. Common facet effects embrace dry mouth, nausea and excessive sleepiness. Ubrogepant mustn't be in love with sturdy CYP3A4 substance drugs. 

• CGRP antagonists. Ubrogepant (Ubrelvy) and rimegepant (Nurtec ODT) are oral CGRP antagonists recently approved for the treatment of acute cephalalgia with or while not aura in adults. In drug trials, medication from this category was simpler than placebo in relieving pain and different migraine symptoms akin to nausea and sensitivity to light-weight and sound 2 hours when taking it. Common aspect effects embrace dry mouth, nausea and excessive sleepiness. Ubrogepant and rimegepant mustn't be infatuated with robust CYP3A4 matter drugs. 

• Opioid medications. For those that can't take different cephalalgia medications, narcotic opioid medications would possibly help. as a result they will be extremely addictive, these are typically used provided that no other treatments are effective. 

• Anti-nausea drugs. These will facilitate if your cephalalgia with aura is in the course of nausea and vomiting. Anti-nausea medicine embraces chlorpromazine, metoclopramide (Reglan) or major tranquilizers (Compro). These are typically loving pain medications. a number of these medications aren't safe to require throughout pregnancy. If you're pregnant or making an attempt to induce pregnancy, don't use any of those medications while not initially talking together with your doctor. 

Preventive medications

Medications will facilitate stopping frequent migraines. Your doctor would possibly advocate preventive medications if you have got frequent, lasting or severe headaches that don't respond well to treatment. Preventive medication is aimed toward reducing how typically you get a migraine, how severe the attacks are and the way long they last. choices include:

• Blood pressure-lowering medications. These embrace beta blockers akin to propranolol (Inderal, InnoPran XL, others) and beta blocker salt (Lopressor). Metal channel blockers such as Calan (Verelan) may be useful in preventing migraines with aura. 

• Antidepressants. An antidepressant drug (amitriptyline) will forestall migraines. due to the facet effects of amitriptyline, reminiscent of sleepiness, different antidepressants could be prescribed instead. 

• Anti-seizure drugs. Valproate and topiramate (Topamax, Qudexy XR, others) may facilitate if you've got less frequent migraines, however will cause side effects like dizziness, weight changes, nausea and more. These medications don't seem to be suggested for pregnant ladies or women making an attempt to induce pregnancy. 

• Botox injections. Injections of onabotulinumtoxinA (Botox) about every 12 weeks help prevent migraines in some adults.

• CGRP monoclonal antibodies. Erenumab-aooe (Aimovig), fremanezumab-vfrm (Ajovy), galcanezumab-gnlm (Emgality), and eptinezumab-jjmr (Vyepti) are newer medication approved by the Food and Drug Administration to treat migraines. They're given monthly or quarterly by injection. The foremost common aspect result could be a reaction at the injection site. raise your doctor if these medications are right for you. a number of these medications don't seem to be safe to require throughout pregnancy. If you're pregnant or attempting to be pregnant, don't use any of those medications while not 1st talking together with your doctor. 

More Information

• Migraine medications and antidepressants

• Migraine treatment: Can antidepressants help?

• Occipital nerve stimulation: Effective migraine treatment?

• Acupuncture

• Biofeedback

• Botox injections

• Chiropractic adjustment

• Massage therapy

• Infographic: Migraine Treatments: Botox & Nerve Blocking

Lifestyle and home remedies

When symptoms of megrim start, strive heading to a quiet, darkened room. shut your eyes and rest or take a nap. Place a cool artifact or ice pack wrapped during a towel or cloth on your forehead and drink innumerable water.

These practices might also soothe migraine pain:

• Try relaxation techniques. Biofeedback and different kinds of relaxation coaching teach you ways in which to contend with nerve-racking situations, which could facilitate cutting back the amount of migraines you have. 

• Develop a sleeping and eating routine. Don't sleep too much or too little. Set and follow a consistent sleep and wake schedule daily. Try to eat meals at the same time every day.

• Drink plenty of fluids. Staying hydrated, particularly with water, might help.

• Keep a headache diary. Recording your symptoms in an exceedingly headache diary will assist you learn a lot concerning what triggers your migraines and what treatment is most effective. it'll additionally facilitate your doctor diagnose your condition and track your progress in between visits. 

• Exercise regularly. Regular aerobics reduces tension and may facilitate stopping a migraine. If your doctor agrees, select aerobic activities you enjoy, reminiscent of walking, swimming and cycling. heat up slowly, however, as a result of sudden, intense exercise can cause headaches. Regular exercise can even assist you slim down or maintain a healthy body weight, and blubber is believed to be an element in migraines. 

Alternative medicine

Nontraditional therapies might help with chronic migraine pain.

• Acupuncture. Clinical trials have found that stylostixis could also be useful for headache pain. During this treatment, a practitioner inserts several thin, disposable needles into many areas of your skin at outlined points. 

• Biofeedback. Biofeedback seems to be effective in relieving hemicrania pain. This relaxation technique uses special instrumentality to show you ways to observe and manage bound physical responses regarding stress, corresponding to muscle tension. 

• Cognitive behavioral therapy. Cognitive activity medical care could profit some folks with migraines. This kind of psychotherapy teaches you the way behaviors and thoughts have an effect on how you understand pain. 

• Meditation and yoga. Meditation may relieve stress, which is a known trigger of migraines. Done on a regular basis, yoga may reduce the frequency and duration of migraines.

• Herbs, vitamins and minerals. There is some proof that the herbs Chrysanthemum parthenium and Petasites vulgaris would possibly forestall migraines or scale back their severity, although study results are mixed. Petasites vulgaris isn't suggested owing to safety concerns. A high dose of vitamin B complex (vitamin B-2) may reduce the frequency and severity of headaches. molecule Q10 supplements might decrease the frequency of migraines, however larger studies are needed. atomic number 12 supplements are wont to treat migraines, but with mixed results. raise your doctor if these treatments are right for you. If you're pregnant, don't use any of those treatments while not 1st talking with your doctor. 

Preparing for your appointment

You'll most likely 1st see a medical care provider, who may then refer you to a doctor trained in evaluating and treating headaches (neurologist). Here's some info to assist you make preparations for your appointment.

What you can do

• Keep track of your symptoms. Keep a headache diary by writing an outline of every incident of visual disturbances or uncommon sensations, as well as once they occurred, however long they lasted and what triggered them. A headache diary will facilitate your doctor diagnosing your condition. 

• Write down key personal information, including major stresses or recent life changes.

• Make a list of all medications, vitamins or supplements you take, as well as doses. It's notably necessary to list all medications you've accustomed to treat your headaches. 

• Write down questions to ask your doctor.

Take a family member or friend along, if possible, to help you remember the information you receive.

For migraines, questions to ask your doctor include:

• What is likely triggering my migraines?

• Are there other possible causes for my migraine symptoms?

• What tests do I need?

• Are my migraines likely temporary or chronic?

• What is the best course of action?

• What are the alternatives to the primary approach that you're suggesting?

• What changes to my lifestyle or diet do you suggest I make?

• I have these other health conditions. How can I best manage them together?

• Are there printed materials you can give me? What websites do you recommend?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

• How often do your headaches occur?

• How severe are your symptoms?

• What, if anything, seems to improve your symptoms?

• What, if anything, appears to worsen your symptoms?

• Does anyone else in your family have migraines?

General summary

1. Migraines are very painful but there are steps you can take to relieve the pain. Some of these treatments involve medications while others don't. You should consult your doctor if you have migraines that often or if you aren't seeing improvement with natural measures.
2. The main treatment for migraine is a drug called a triptan It reduces the intensity of pain and helps to relieve other symptoms such as nausea vomiting sensitivity to light blurred vision or sound sensitivity A combination of acetaminophen (Tylenol) or ibuprofen (Advil) with caffeine is also helpful in relieving headache pain Another option may be magnesium supplements which have been shown to reduce frequency and severity of some types of migraines.
3. A migraine is diagnosed when a person has experienced severe throbbing pain on one side of their head without the presence of an underlying medical condition Migraines are often accompanied by nausea and sensitivity to light and sound Below are some ways to stop you from feeling miserable in the hopes that your migraine will vanish.
4. Women are three times more likely to get migraines than men Scientists aren't exactly sure why this is the case but they do think that female hormones play a role Women who suffer from severe menstrual migraines may be taking birth control pills which can trigger headaches or suffering from premenstrual syndrome (PMS) Others may experience migraine attacks during their childbearing years because of hormonal changes related to pregnancy and childbirth.

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