Migraine – Causes, Pathophysiology, and Treatment.

Description

A migraine is a neurological condition that causes a severe or a moderate headache on one side of the head with a throbbing pain. This headache may radiate towards forehead or temple, eyes and makes a person to develop nausea, vomiting, vision problems, and sensitivity to normal light or mild exertion.

People describe migraine pain as:

  • Pulsating
  • Throbbing
  • Perforating
  • Pounding
  • Debilitating

“Classic” migraines begin with an aura such as seeing visual field changes (dots, wavy lines, blurriness) about an hour or less before the pain begins.

Pathophysiology

A migraine is a brain disorder which involves an altered regulation and control of afferents, with a particular focus on the cranium. The once popular vascular theory of a migraine, which suggested that a migraine headache was caused by the dilatation of blood vessels, while the aura of a migraine resulted from vasoconstriction, is no longer considered viable. Vasodilatation, if it occurs at all during spontaneous migraine attacks, is probably an epiphenomenon resulting from instability in the central neurovascular control mechanism.

Types of a migraine

  • A migraine with aura – where there are specific warning signs just before a migraine begins, such as seeing flashing lights.
  • A migraine without aura – It is the most common type, where a migraine occurs without the specific warning signs.
  • Migraine aura without a headache, also known as a silent migraine – where an aura or other migraine symptoms are experienced, but a headache doesn’t develop.

Causes

The exact causes of a migraine are still unknown.

  • Migraines may be caused by changes in the brainstem and its interactions with the trigeminal nerve, a major pain pathway.
  • Imbalances in brain chemicals such as serotonin that regulates pain in the nervous system. But still, research is going on to study the actual role of serotonin during migraines.
  • Generally, serotonin levels drop during migraine attacks. This may cause your trigeminal nerve to release substances called neuropeptides, which travel to your brain’s outer covering (meninges). The result is migraine pain. Other neurotransmitters play a role in the pain of a migraine, including calcitonin gene-related peptide (CGRP).

Risk factors

  • Changes in the weather
  • Changes in your daily schedule
  • Skipping a meal
  • Change in your sleeping pattern
  • Strong light
  • Smells which stimulate
  • Strong noises
  • Menstruation
  • Ovulation
  • Pill-free days if you take the pill.

Risk factors of a migraine from food

  • Wine
  • Chianti
  • Derivatives of red wine
  • Champagne
  • Sherry
  • Beer and white wine

Symptoms

  • Eye pain
  • Sensitivity to light or sound
  • Nausea
  • Vomiting
  • Severe pain
  • Food cravings
  • Depression
  • Fatigue or low energy
  • Frequent yawning
  • Hyperactivity
  • Irritability
  • Neck stiffness

Complications

  • Extensive deterioration in the quality of life.
  • Significant disability, affecting home life, work, and social activities.

Diagnosis and Test

Doctors diagnose migraines by listening to your symptoms, taking a thorough medical and family history, and performing a physical exam to rule out other potential causes. Imaging scans, such as a CT scan or MRI, can rule out other causes, including:

  • Tumors
  • Abnormal brain structures
  • Stroke

Treatment and medication

Migraines can’t be cured, but your doctor can help you manage them. Your treatment plan depends on your age, frequency of a migraine, type, and symptoms. Treatment pattern includes the combination of the following steps:

  • Self-care migraine remedies
  • Lifestyle adjustments, including stress management and avoiding migraine triggers.
  • OTC pain or migraine medications, such as NSAIDs or acetaminophen (Tylenol)
  • Painkillers – including over-the-counter medications such as paracetamol and ibuprofen
  • Triptans – medications that can help reverse the changes in the brain that may cause migraines
  • Anti-emetics – medications often used to reduce nausea and vomiting
  • Counseling
  • Alternative care, which may include biofeedback, meditation, acupressure, or acupuncture

Prevention

  • Sleep Smart: Sleep is a critical trigger. Too long or too little of sleep can bring on a migraine. Therefore it is much important to have your sleep time constant.
  • Do not skip your meals. When your blood sugar level drops brain is the first organ which feels it. Hunger is the common cause of headaches.
  • Be conscious of your caffeine level.
  • Sometimes drastic exercise activity can spark a migraine. Following moderate activity will give your overall health a boost and help you stay headache-free.
  • Even dehydration can cause a migraine and so it is must to drink too much water when you are roaming under the sunlight.
  • Hours in front of a computer or TV can strain your eyes. Eyestrain leads to head pain. Take breaks often. Stretch, close your eyes and get up to get your blood flowing.
  • Sometimes tooth pain can also trigger you a migraine thus it is advised to take care of your teeth health.

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43 comments

  1. aaah what is the Rx of that condition

  2. what is particularly allopathy drug to give?

  3. what is the incidence

    • Migraine episodes may occur at any age, the incidence of migraine peaks during adolescence. One population-based study conducted in the US found that incidence of a migraine with aura peaked between 12 and 13 years of age and migraine without aura between 14 and 17 years of age.

  4. what is the nursing diagnosis for it

  5. changing of life style.
    incause of emergency should b given i.v metclopermid or dexamethasone.

  6. should given i.v dexamethasone or metclopermid .

  7. what are self migraine remedies

    • Drink a caffeinated beverage. In small amounts, caffeine alone can relieve migraine pain in the early stages or enhance the pain-reducing effects of acetaminophen (Tylenol, others) and aspirin.

  8. thanks for this, it wld help me a long way,I really suffer from this but always just buy roadside drugs to calm it down,didn’t know its a serious thing,really as they say”ignorance is a disease” thanks again

  9. Thank you very much for your accurate analysis on your feed.
    Just to be honest you have mentioned everything that was happening to me for years, I really struggled with migraine headaches.
    I later adjusted almost everything thing around me, from eating, sleeping, smells around me, waking up time, food stuffs, you name it. I love gardening a lot so my times are now changed. Realy working.
    I am now on a high blood treatment.

  10. what are those effective medicines of migraine?

  11. hope migraine is not communicable? if it is, how can someone contact it?

  12. Adjei Ransford

    Hi, my friend is having such symptoms on half of her head sometimes now, so what do we do now please

  13. I use to have a severe half headache.
    But I don’t feel it again for some few months now.
    Do I have to consult a doctor still, please?

  14. take tab mild headache PARAMET FOR 3 DAYS OR ACUTE HEADACHE MIGRIL. IT WILL BE CURE.

  15. Ad eyemi Fadipe

    l am patient of immigrants pain tablet cannot cure it what next can be u

  16. Dr Shabbir Malik

    what will you say about the use of
    1.Naproxen sodium
    2.carbamezipin
    as a treatment of migrain.

  17. Rachel D Griffin-Morken

    I have a Chronic pain disorder from Auto Incidents; injuries to the CNS in the Spine & Head.
    Whiplash; rear-ended @a 4way Stop lights/Hwy 100 in ’93/’94-benign tumor removed from Stomach wall. In ’98/head impact on Windshield broke the glass. Both Airbags did NOT deploy/Dodge Daytona-Paasenger!
    In ’03;Frozen water pipe gushing out water/Bsmt/80% fnsh’d turned into a Lake!
    Farmer’s Ins, Umbrella Policy DENIED 125% Extended Coverage!
    Gov’t Grants/Housing Rehab:Didn’t remove toxins; They’d kept $!

  18. exactly correct

  19. i am suffering from maigrain almost 8 years and taking too much painkillers to releive it…i am a girl and 24 aged.isnt the pain killer bad for my health?

  20. .im 27years old…breastfeed of 1 @1/2yr old bby….i think in a week 2-3times i suffered headache..lalo pag mainit ang panahon
    then blur eyesight……i cannot sleep well at night

  21. i also have migrain send me simple treatment of this pain occur on the front of eye

  22. Sometimes I will be feeling itching on my forehead then dizziness follows with heavy vomiting with my eyes closed once I opened my eyes vomiting continued I will be staggering for some days like a drunk

  23. thanks for your good work God blessing open u

  24. thanks

  25. Ebenezer BarnesYour Name

    Have been experiencing severe sensation headache on forehead and on top of my skull ( head). Is like there’s fire set on my head. l sometimes get confuse in the mind. Is it a symptom of migraine.

  26. what do you say about this drug called Vasograin ?Am a 37 year old lady and have been experiencing this headache for some years now especially during my monthly periods,attending occasions,strong smells and light so l was advised to take the above mentioned drug.

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