Migraine: Just Headache or Something else

Migraine is often known for frequent headache, but it is a neurological disorder which causes headache and dysfunction of the autonomic nervous system. Autonomic activities like digestion and breathing also get disturbed due to recurrent attacks of migraine.

In the beginning most of the migraine sufferers wrongly assume that they can deal with their headache on their own and use over-the counter drugs, which is generally overused. Most of the sufferers keep denying themselves and think that its just a headache which will go away on its own, and thus they wait too long to initiate the correct treatment and make it worst. During the migraine pain our brain amplifies the pain signals and other sensory stimulus. It creates  body-wide effects. For example the sound and light signals are amplified, and the sufferer find hard to tolerate smells, noise, light or even touch.
Women are three times more prone to migraine and your genes play an important role as a risk factor for migraine.
People often take leave from work due to migraine pain , but condition become more unproductive when a person with migraine pain comes to work and can't concentrate or work properly. In a survey Japanese Headache Society found that productivity of one in every five employee is decreased due to migraine, which costs Fujitsu, an IT company, $350 million per year.

Stages of Migraine

Migraine often starts in early childhood, adolescence or early adulthood. There are four stages of migraine, but not everyone goes through all of them. These stages are prodrome, aura, attack and post-drome.
  • Prodrome: This stage occurs two day before actual migraine and often not realized as symptom of migraine. The symptoms of this stage are mood changes (or depression), food cravings, neck stiffness, constipation, increased thirst/urination and frequent yawning.
  • Aura: It occurs only in some migraine patients where some reversible symptoms occur for 20 to 60 minutes that are related to our nervous system. Some of such symptoms are pins/needles sensation in arms/legs, numbness in face or one side of body, difficulty in speaking, hearing amplified noise, bright flashes of light, vision loss, uncontrollable jerking and hallucinations.
  • Attack: Migraine Attack can occur rarely or even a few time per month and can't be predicted. Duration of this attack can last from 4 to 72 hour if remains untreated. Symptoms of migraine attack are pain on one side of head (both sides in some cases), pain that pulses, sensitivity to light, sound, smell and touch and feeling of vomiting.
  • Post-drome: It is the post attack stage which may last up to 24 hours, during which you feel drained and confused. Sudden head movement can trigger pain for few minutes. 

Causes of Migraine

Causes of Migraine are not fully understood but researchers believe that genetics and environmental factors play an important role in it. Some recently understood causes of migraine which are being researched more are listed here.
  • Some researchers believe that when major changes occur in our pain pathway which includes brainstem and trigeminal nerve interaction, then it triggers migraine.
  • Some believe that imbalances in brain chemicals, such as serotonin, that regulate pain in our nervous system, is responsible for migraine pain.
  • Neurotransmitters, including calcitonin gene-related peptide (CGRP) may also be responsible for migraine.
  • Patent foramen ovale (PFO) is a hole in the heart which is present in more than 20% population. These people are four times more prone to migraine. Researches are being conducted to know if closure of this hole can help in getting rid of migraine.

Triggers of Migraine

  • Hormonal Medication, such as oral contraceptives, can make migraine worse. However in some cases reverse happens, where frequency of migraine attacks decrease are using such medication. 
  • Hormonal changes in women during pregnancy, menopause and periods can trigger headaches.
  • Sensory stimulus such as bright lights, loud noise and strong smell can trigger migraine.
  • Too much caffeine, alcohol or wine.
  • Stress at work or home
  • Physical exertion
  • Lack of sleep, jet lag or too much sleep
  • Change of weather or barometric pressure
  • Skipping meals, fasting or eating processed foods

Migraine in USA

  • 47 million people in US are suffering from migraine.
  • Out of them 6 million are chronic migraine patients, which means more than 15 headaches per month.
  • Direct medical expenses on migraine medication amounts to $11 billion per year.
  • Other indirect costs and disability expenses also cost around $11 billion per year.

Medication of Migraine

According to an estimate 40% of migraine patients should be on preventive medicine while just 13% get it. 4 oral drugs are approved by FDA, two anti-seizure drugs and two beta-blockers. Patients of chronic migraine can get injections of Botox.

Note : If you have frequent headaches then you should keep a record of its duration and medication used to get it analysed by a medical practitioner. 

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