Migraine headaches are a very serious and disabling condition. In fact, the World Health Organization identifies it as the 6th most disabling illness globally. Most patients with this condition may experience one or two migraine headaches a month, with about 4 million people having chronic migraine headaches that occur at least 15 times a month. As a result, an estimated 90 percent of patients with the condition are unable to fulfill daily tasks during a migraine attack. In this article, we explain what is a migraine, as well as its causes, stages, treatment, and prevention methods.
What is a migraine?
A migraine is a primary headache disorder that presents as a recurrent, life-long headache. The onset of this condition typically occurs during puberty, but primarily affects patients aged 35-45 years. Migraine headaches can also develop in patients with anxiety, depression, bipolar disorder, sleep disorders, and epilepsy.
Causes of a migraine
Migraines are triggered by the release of pain-producing inflammatory substances in the brain that affects the nerves and blood vessels of the head. Previous theories speculated a vascular etiology for this condition; however, more recent research points to mechanisms in the brain as a more plausible explanation for this condition. Specific causes that may lead to the development of migraines include:
Certain patients may experience migraines due to certain triggers, including alcohol, aged cheese, certain fruits and nuts, yeast, cured/processed meats, and fermented foods.
Stages of a migraine
This particular type of headache presents as a pulsating pain on one side of the head, which can be moderate to severe. Physical activity, coughing, or sneezing can aggravate the condition, which may last for hours to approximately 2-3 days.
Migraines typically undergo five phases, though not all phases may be present in all patients:
Phase 1 (Prodrome/ Premonitory). Begins 24 hours prior to the onset of a migraine headache. In this phase, patients may experience food cravings, mood changes, fluid retention or increased urination, and uncontrollable yawning.
Phase 2 (Aura). This phase is characterized by seeing flashing, bright lights or zig-zag lines. Patients at this phase may also experience muscle weakness. This may occur immediately prior to the onset of a migraine.
Phase 3 (Headache). This phase includes a moderate to severe headache that gradually increases in severity.
Phase 4 (Resolution). Refers to the point where the headache either gradually or suddenly stops.
Phase 5 (Recovery/ Postdrome). This is the phase post-headache. Here, patients may feel exhausted, confused, and weak for as long as a day.
Some patients may not experience a headache but have a migraine with symptoms like photophobia (an increased sensitivity to light), hyperacusis (increased sensitivity to noise), hyperosmia (increased sensitivity to smells), nausea, and vomiting.
Diagnosis & Treatment
Migraines are typically diagnosed clinically through medical history and physical examination (neurological exam). Physicians may order laboratory and imaging tests to rule out other possible conditions.
To this day, there is no known “cure” for migraines. Instead, treatment focuses on symptomatic relief and prevention of future attacks. Certain medications may provide relief from symptoms, such as ergotamine, triptans, and other pain relievers. Patients may also rest by closing their eyes in a dark room, drink fluids (without caffeine or alcohol), and placing a cold compress on their foreheads.
If symptoms of migraines recur or do not resolve, patients should seek medical consultation. The doctor may prescribe medication and rule out other potential causes for the headaches.
Prevention
Patients can undergo stress management through exercise, relaxation/breathing techniques, and biofeedback, which may prevent or reduce the severity of migraines. For patients with recurrent migraines, determining what triggers their headaches is important. If the migraine is related to weight issues, then a doctor may suggest weight loss as a method of prevention.
Learn more about Headaches here.
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