Migraine (also called a "sick headache") is a severe headache, which can last anywhere from two hours to two days. This headache is accompanied by disturbances of vision and/or nausea, extreme pain and vomiting.
Migraines affect over 23 million people, with roughly 75 percent of them being women. Migraines begin with the release of serotonin; a biochemical substance stored in the blood platelets produced naturally in the body. When serotonin is released, the blood vessels constrict (narrow). As serotonin is expelled by the kidneys, its level in the brain is depleted, causing the blood vessels to dilate (expand). This dilation causes pain in the surrounding nerves, which can lead to migraines. There are two predominant types of migraines - common migraine and classic migraine. The common migraine develops slowly and may be preceded by tiredness, cravings, yawning, depression, irritability and anxiousness. The common migraine usually occurs on one side of the head. The classic migraine develops in four stages - prodrome, aura, headache and postheadache. During the prodrome stage, the person may feel fatigued, irritable, have decreased concentration or experience depression. This stage will develop about 24 hours prior to the aura stage. The aura stage is a slowly expanding area of blindness surrounded by a sparkling edge that increases to involve up to one half of the field of vision of each eye. In addition to the aura, the migraine sufferer may see flashing lights, colors or zig-zags of light, experience a prickly or burning sensation and/or muscle weakness on one side of the body. The third stage is the headache itself, which is usually a severe throbbing pain on one side of the head that is often exaggerated by bright light or noise and may be accompanied by nausea and vomiting. The fourth stage is postheadache, which is characterized by exhaustion and fatigue. The classic migraine may occur on one or both sides of the head. The other types of migraines are: hemiplegic migraine, which involves muscle weakness or partial paralysis lasting less than an hour; ophthalmoplegic migraine, which involves temporary eye inconveniences, such as droopy eyelid and pupillary changes, lasting from several days to weeks; basilar artery migraine, which involves neurological spasm lasting for about six to eight hours; and status migraine; which involves a severe migraine attack, lasting longer than 24 hours.
Serotonin release, resulting in a migraine, can be triggered by a number of factors. These factors can be stress-related (such as anger, depression, shock, excitement or changes in routine), food-related (such as chocolate, cheese, red wine or fried foods), or sensory-related (such as bright lights, strong odors or loud noises). Additionally, migraines can be medication-related (medicines including nitroglycerin, lithium and certain anti-hypertensive, anti-inflammatory and bronchodilating drugs), or hormone-related (such as menstrual periods, hormonal treatments or birth control pills). Patients often have a family history of migraine.
The symptoms of a migraine may include:
No tests are available to reliably diagnose a migraine. The doctor will make a determination, based on a physical examination and a thorough medical history, including triggers, symptoms and family history.
Treatment of migraines is directed at preventing attacks (prophylactic or preventive therapy) and alleviating them when they occur (abortive therapy). Prophylactic Therapy Prophylactic therapy includes:
What type of migraine is it? Is this a symptom of another condition(s)? What can be done to prevent a reoccurrence? What medications can be taken to relieve the pain? What are the side effects of the medication? Should I keep a supply of migraine medication at home? How long before the pain subsides? Are there things that should be avoided (such as food, bright lights, exercise, etc.)?