Migraine: Signs and Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Prevention and Outlook

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women suffering from Migraine

 

1Overview

There are many types of headaches, and all of them lead to feelings of discomfort and pain. A migraine headache can cause severe throbbing pain, and it’s considered the most debilitating type of a headache.

If you’re suffering from a migraine, you are not alone. An estimated 12 percent of the U.S. population has a migraine and these recurring attacks of moderate to severe pain can affect daily activities. The pain is throbbing or pulsing, and often felt on one side of the head.

More than 37 million people suffer from migraines. Of these number, 2 to 3 million people who suffer from migraines are chronic, which means they suffer from the condition repeatedly for years. Migraines tend to occur in women, people between the ages 35 and 55 years old, those in the lowest income groups and Caucasian people.

Women suffer from a migraine three times more than men. A migraine is a severe headache that is sometimes accompanied by visual warning signs or auras.

Migraine Facts

  • Some individuals who have a migraine can determine factors or triggers that cause their headache bouts – allergies, stress, light, and some foods
  • Many migraine sufferers feel when a migraine attack is about to happen, they get a warning symptom before the start of a headache.
  • Many of those affected by a migraine can prevent an attack by recognizing the warning signs and taking due medicines for relief
  • People who have severe attacks can take preventive drugs

2Signs and Symptoms

The signs and symptoms of a migraine depend on what stage it’s in. It is often hard to predict when a migraine about is going to happen. However, you can predict the pattern and the different stages. There are various signs and symptoms migraine sufferers have, depending on the attack’s stage and status.

Prodrome

Prodrome is a phase of a migraine that occurs at about one to two days before the bout. You may notice that you’re experiencing a wide range signs and symptoms. These subtle signs include:

  • Constipation
  • Mood swings, from depression to aura
  • Neck stiffness
  • Food cravings
  • Frequent yawning
  • Increased thirst and urination 

Aura

An aura is a sensory warning sign that can indicate an impending migraine attack. An aura may occur before or during migraines. Not everyone will have a headache with an aura. Most people experience no auras at all, while others benefit from this nervous system sign because it identifies a possible attack.

A migraine with aura shows that aura comes in wide forms and sizes. They are usually visual disturbances such as flashes of light, dark spots in the visual field and zigzag vision. Auras can be touching sensations (sensory), speech or verbal disturbances and movements or motor problems.

  • Visual phenomena like seeing bright spots, flashes of light or seeing shapes.
  • Vision loss
  • Pins and needle sensations in the upper and lower extremities.
  • Difficulty speaking
  • Hearing loud music
  • Weakness in the face or one side of the body.

Attack

A migraine usually lasts from four to up to 72 hours if it’s not treated. The frequency of the migraine attacks varies from one person to another. During the attack, there are many symptoms like:

  • Pain on one side or sometimes, both side of the head
  • Sensitivity to sounds, light and sometimes even smells and touch
  • Blurred vision
  • Nausea and vomiting
  • Lightheadedness

Post-drome

The last phase, called post-drome, happens after an attack. The patient may still feel some discomfort like feeling drained while others might feel ecstatic. Other symptoms include confusion, moodiness, sensitivity to light and sound, dizziness, and weakness.

3Causes

Many factors can trigger a migraine attack. The exact cause of a migraine is still unclear, genetics and environmental factors may play a role. Migraines happen when there are changes in the brainstem and their effects on the trigeminal nerve, a primary pain pathway.

Another cause of a migraine is the imbalance in neurotransmitters or brain chemicals like serotonin. This neurotransmitter regulates pain in the nervous system. However, scientists are still studying the role of brain chemicals in migraines.

They have found that the levels of serotonin decrease during migraine attacks, leading to the excretion of substances called neuropeptides by the trigeminal nerve. These neuropeptides can travel to the brain’s outer covering called meninges. As a result, pain is felt.

Migraine triggers

Lack of sleep, alcohol, dehydration, exposure to extremely bright light, stress and hunger may all trigger a migraine attack.

Aside from these, there are other triggers of a migraine attack:

Hormonal Changes in Women

The reason why women are more likely to suffer a migraine attack is that of the variations in estrogen. Many women report having migraines before and after their periods, where there is a major drop in estrogen levels.

Women who are taking hormone replacement therapy or contraceptive pills may worsen a headache.

Food

There is some food that are known triggers for a migraine attack. Aged cheese, processed foods, salty foods may trigger attacks. Skipping meals or getting too hungry may induce a migraine.

Food Additives

Aspartame, an artificial sweeter and monosodium glutamate (MSG), found in many foods, trigger migraines.

Stress

People who are stressed at work, home or school can cause migraines.

Drinks

Alcohol, especially red wine and other types of wine, can trigger migraines. Highly caffeinated drinks may also cause migraines.

Sensory Stimuli

Extreme bright lights and the sun’s glare can trigger migraines. Loud sounds and strong smells can also induce migraine headaches in some people.

Lack of Sleep

Changes in the wake-sleep pattern like getting too much sleep or missing sleep may cause this type of a headache.

Medications

Some medications like vasodilators can aggravate migraines. Oral contraceptives are culprits too.

4Risk Factors

Risk factors increase a person’s likelihood of suffering from migraines.

  • Obesity
  • Chronic daily headaches
  • Women (75 percent of people who have migraines are women)
  • Hereditary or family history of migraines
  • Medical diseases – anxiety, depression, stroke, irritable bowel syndrome, epilepsy, and hypertension.

5Complications

Migraines, aside from being debilitating for most people who suffer from them, may have complications.

Status Migrainous

This is a rare and severe complication of a migraine. In this condition, the aura lasts for more than 72 hours, and because of this, some people may even need hospitalization because of the intense pain.

Status Infarction

When a migraine is associated with stroke, it’s called migrainous infarction. This type of a migraine headache that has an aura that lasts more than one hour. Sometimes, the aura is still present even if a headache disappears. This may be a sign of bleeding in the brain, which is life-threatening.

Persistent Aura without Infarction

When an aura lasts for more than a week even after a migraine has ended, it’s called persistent aura without infarction. However, this is less dangerous because there’s no bleeding in the brain.

Migralepsy

Migralepsy is a condition where a migraine triggers an epileptic seizure.

Stroke

A stroke happens when the blood supply to the brain is impeded or blocked. People with migraines have twice the risk of having a stroke.

Mental Health Conditions

Individuals who suffer from migraines have a higher risk of developing major depression, general anxiety disorder (GAD), panic disorder, bipolar disorder and post-traumatic stress disorder (PTSD).

6Diagnosis

A neurologist will diagnose a migraine as a result of his or her evaluation of your medical history, symptoms and medical examination.

There are some tests that the doctor will require like:

Blood tests

To check for blood vessel problems, infections, and toxins in the system.

Magnetic Resonance Imaging (MRI) and CT scan

To detect tumors, bleeding in the brain, infections, strokes, and other neurological conditions.

Spinal Tap

Also called lumbar puncture, it helps detect infections in the spinal cord, bleeding in the brain and another underlying condition.

7Treatment

Migraine treatments can aid curb symptoms and prevent future attacks.

Medications

Pain Relievers

The primary treatment for migraine attacks is pain medications. These types of drugs are taken during an acute attack to stop the symptoms, especially severe pain.

Preventive Medicines

These types of drugs are taken regularly as oral prophylaxis. This means that the drugs prevent the severity and frequency of migraines.

8Prevention

Lifestyle changes and home remedies can help treat and prevent headaches.

  • Get enough sleep but don’t oversleep
  • Rest and relax, especially if you’re stressed and tired
  • Keep a headache diary
  • Avoid foods that are considered triggers
  • Avoid extremely bright lights

9Outlook

For many people, migraines eventually go into remission. Sometimes, they might even completely disappear. However, in menopausal women, the drop in estrogen levels have been seen as the main reason why they have remission.