What is migraine?

Migraine is a sensory processing disorder, a complex neurological disease. Migraine in incurable, however in most cases it can be managed. It is an invisible disability and is not a temporary condition.

Migraine is a common neurological condition where the brain is hyper excitable and affects around 1-10 people. Studies show that migraine is more common in women than men, which is thought to be due to hormonal factors. It is a genetic disorder, migraine often runs in families and can affect all ages.

A migraine brain works faster and can overreact when exposed to too much stimulation. Migraine is very disabling for some and can have a huge impact that affects everyday life, while others get occasional migraine attacks. Some people may have several migraine days every month and others have chronic migraine. Migraine is considered chronic if you have 15 or more days a month over a period of at least three months.

WHAT CAUSES MIGRAINE?

The cause of migraine in unclear. Research suggests that migraine is caused by swelling of the blood vessels in the scalp and tissues around the brain. Changes in brain activity, chemicals, genetics and environmental factors appear to play a role.

WHAT ARE SYMPTOMS OF MIGRAINE?

Migraine is typically felt on one side of the head however it can be on both sides or even switch from side to side. The sensation may be felt as; throbbing, pulsating, pounding debilitating pain. The pain may feel sever, dull or ache. It is very often accompanied by additional symptoms:

WHAT IS A MIGRAINE ATTACK?

Migraine attacks can last for hours to days, and the pain can be so sever that it interferes with daily tasks and activities. Everyone with migraine has their own experience and unique combination of symptoms. There are many different types of migraine, a number of which do not have significant head pain as a symptom.

Those who live with migraine respond to treatments differently and each have their own list of things that are more likely to set off a migraine attack, which are called triggers.

MIGRAINE TRIGGERS

• Excess daily stress levels can be a major contributing factor to migraine it is important to learn relaxation techniques such as mediation, yoga or engage in light exercise.
• Sensory stimuli Bright or flashing lights, sound sounds, strong smells like perfume,
• Second hand smoke, paint, fuel, cleaning chemicals and much more.
• Physical activity intense exercise, strenuous physical effort even sexual activity.
• Extreme weather conditions such as heat or change in barometric pressure even can induce a migraine.
• Sleep patterns - getting too much sleep or not enough sleep can trigger a migraine it is all about finding the right balance and maintaining a consistent sleep schedule.
• Food some foods have been reported to trigger migraine include chocolate, aged cheese, processed meats, food additives monosodium glutamate MSG, artificial sweeteners. It is a good idea to develop an eating routine avoid skipping meals and try to eat meals at the same time everyday.
• Drinks alcohol, wine or too much caffeine such as tea or coffee.
• Dehydration may cause head pain and lead to migraine which then provokes dizziness or even confusion.
• Hormonal changes women's estrogen levels fluctuate during menstrual cycle, throughout
• Pregnancy and around menopause these changes seem to trigger migraine for some people.

WHAT ARE THE FOUR STAGES OF MIGRAINE?

Prodrome Marks the beginning of a migraine. One or two days before a migraine, a person may experience a change in bowel habits constipation or diarrhea. A mood change depression, anxiety or irritability. Food cravings, increased thirst and frequent urination. Neck stiffness, frequent yawning, sensitivity to light (photophobia) and sensitivity to sound (phonophobia).

Aura Not every migraine has aura. Aura includes a wide range of neurological symptoms that include;

• Visual disturbance flashing lights, stars, zig zag lines and spots
• Numbness pins and needles
• Weakness
• Dizziness vertigo
• Change in speech

Attack Head Pain This stage has moderate to sever pain, the headache is usually throbbing and is made worse by movement. The pain is typically on one side of the head however you can get pain on both sides or all over the head. Nausea and vomiting can happen at this stage and can also feel sensitive to light, sound, smell and movement.

Postdrome Recovery This is the final stage of an attack and is also known as a migraine hangover, it can take hours or days for a drained, fatigued feeling to disappear. Symptoms can be similar to those of the first stage these include;

• Dehydration
• Fatigue
• Body aches
• Depression
• Euphoric mood
• Difficulty concentrating
• Mental fogginess

TYPES OF MIGRAINE

Migraine with aura Commonly the first sign of getting migraine with aura are the symptoms that affect you sight, you may see blind spots or see flashing lights. Aura with usually happen before a headache, this could be severe or mild and in some people the headache may not even occur. Aura is generally to do with your sight however speech may be affected. Some people can feel disoriented, confused or even faint.

• Seeing zig zags
• Seeing flashing or flickering lights
• Seeing colours spots or lines
• Blind spots
• Temporary blindness
• Some other aaa symptoms can include;
• Feeling dizzy or off balance
• Muscle weakness
• Numbness or tingling like pins and needles

Migraine without aura The most common type of migraine is migraine without aura. Usually this type go migraine will last between four hours and three days. Symptoms include a headache that is usually on one side of the head, often throbbing pain that gets worse when you move. The head pain is so sever that it can means you find it difficult to undertake daily tasks. Nausea, vomiting and sensitivity to light, sound and smell.

Vestibular migraine Is a type of migraine where people experience a combination of vertigo, dizziness or balance problems with other migraine symptoms. These symptoms are usually associated alongside headache, nausea, vomiting, sensitivity to light (photophobia), sensitivity to sound (phonophobia) sensitivity to movement. Also sensation of movement vertigo, sensitivity to smells (osmophobia). Light causing pain not just sensitivity (photicallodynia) and sensitivity to touch on the head or face (cranial allodynia).

Chronic migraine Is defined as having a migraine on at least 15 days per month, with eight of these having migraine symptoms, for at least three months. People who have fewer headache days with migraine symptoms have episodic migraine. Chronic migraine symptoms include;

• Frequent headaches
• Increased light, sound and smell sensitivity
• Nausea
• Vomiting
• Visual disturbances
• Numbness, tingling like pins and needles
• Dizziness
• Vertigo
• Aphasis (problems with speech)

Migraine with brainstem aura Migraine with brainstem aura should be distinguished from hemiplegic migraine. Hemiplegic migraine causes temporary weakness on one side of the body, usually in the face and arms but may also affect the legs.

• Slurring of speech.
• Vertigo
• Ringing in the ears (tinnitus)
• Double vision
• Unsteadiness when walking ataxia
• Temporary decreased consciousness
• Pins and needles and /or numbness affecting both arms or legs
• Changes in eyesight in both eyes such as patterns or flashing lights

Abdominal migraine Is a common condition that affects children and also some adults. Children usually stop getting abdominal migraine by the time they grow up, but often develop migraine later in life. Abdominal migraine consists of regular attacks from moderate to severe stomach pain that last from 2-72 hours, feeling sick and vomiting during attacks, no headache during attacks and feeling normal between attacks.

Hemiplegic migraine Someone who lives with hemiplegic migraine will experience temporary weakness on one side of their body as part of they migraine attack. It can be a frightening experience as the symptoms are similar to a stroke. In addition they may experience weakness and also common aura symptoms as well;

• Visual disturbance zig zags, sparkles, spots
• Communication difficulties can affect reading, writing, speaking and listening
• Speech difficulties not being able to speak clearly perhaps sluring words
• Additionally some experience dizziness, vertigo, ringing in the ears, confusion. This typically lasts from one hour to several days. Head pain may follow or not at all.

Mensural migraine Affects more women than men, and there is a known link between migraine and hormonal changes throughout a woman’s life. More than half of women with migraine report menstruation as a trigger for their migraine attacks.

Medication overuse headaches Is a headache that results from the frequent use of acute medicines or painkillers. It develops in people with a primary headache disorder, such as migraine usually with headache on 15 or more days per month. The medicine itself causes more headaches, which are sometimes referred to as ‘rebound headaches’. The use of painkillers on a regular basis increases the risk of medication overuse headaches and a vicious cycle can develop. If this happens pain returns as each dose of medicine wears off and even if the medicine is stopped, withdrawal symptoms are common. The need to relieve these withdrawal symptoms, and still treat the pain, leads to further use of painkillers and a cycle of medicine overuse starts. After a while the painkillers stop helping the original pain and start causing more pain.

MIGRAINE TREATMENT AND MANAGEMENT

Migraine treatment is aimed at stopping symptoms and prevent future attacks. There are two categories used to combat migraine;

Pain relieving medications Also known as acute or abortive treatment, these types of medications are taken at the first sign of an oncoming migraine or during a migraine attack and are designed to stop symptoms.

Preventive medications These types of drugs are taken regularly, usually daily, to reduce the severity or frequency of migraine attacks. Your treatment choices depend on the frequency and severity of your headaches, whether you have nausea and vomiting with your headaches, how disabling your headaches are, and other medical conditions you have.

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