MIGRAINE THE THROBBING HEADACHE

7 min


Migraine is a pretty common term. Many people tend to confuse other types of headaches with migraines. Further, some people tend to confuse any type of severe headache with migraines. Firstly, a migraine is not just a headache. It is a complex neurological disease.

To clarify, migraine is said to impact almost 1 million people across the globe. About 33% of women and 13% of men are affected in their lifetime. Also, women are more commonly affected than men.

What is a migraine?

Nerves are an integral part of the human body. These are somewhat similar to the telecommunication lines. Their main function comprises receiving, transmitting and relaying electrical signals across the length of the body. This is the main reason we can sense and feel the world around us. Moreover, these nerve signals are received by various sensors located in different parts of the body.

These signals to our brain are carried on by a series of nerve cells. The cascade is carried by the neurons through passageways called ion channels. The ions usually pass through these channels along the nerve and generate an electric current at the end of the nerve. This way the signals move from one part of the nerve to another via chemicals called neurotransmitters.

The sensations come from a change in the charge across the cell membranes. Further, this change brings about significant differences in brain activity and blood flow across the brain.

MECHANISM OF MIGRAINE:

The base of the brain or the brain stem is responsible for activities like heart rate, breathing, sleep etc. Migraine is a disease where there is a defect in one or more parts of this communication system. Migraine is an inherited condition. Moreover, defects in the structure of the gene or mutations can directly be inherited. The problem mainly lies in the ion channels or neurotransmitters. Moreover, the communication systems become hyperactive. Mutations alone do not cause migraines. Further, other underlying conditions combined with this disease may be the culprit behind a migraine attack.

Further, this explains the variety of symptoms people exhibit even though they have the same disease.

THE PART PLAYED BY THE HYPOTHALAMUS:

If all the symptoms of migraine point to one part of the brain it’s the hypothalamus. The hypothalamus normally controls the system behind the symptoms. Some of the activities controlled by the hypothalamus include water regulation, hormonal balances and circadian rhythm.

This particular part of the brain has a wide connection throughout. Also, this part is very active in the days leading to an episode of the attack.

CONDITIONS THAT CAN CO-EXIST WITH MIGRAINE:

Certain conditions are very common and can co-exist with migraines for a variety of reasons. These include,

STIMULI OR TRIGGERS OF A MIGRAINE ATTACK:

Like many other neurological conditions, migraines might have some specific triggers or stimuli. Meanwhile, some of the common stimuli include,

  • A weather change
  • A sudden stress
  • Certain type of foods
  • An excess or lack of sleep (Hypersomnia or insomnia)
  • Harmonal changes in women are also quoted as a major stimulus. Further, the changes in the oestrogen levels in the female body between puberty, menstruation, pregnancy and menopause trigger these attacks frequently. Similarly, post-menopause women experience a significant reduction in the migraine frequency. This is due to the fact that the fluctuations of the sex hormones is lesser during this phase. In the same vein, pre-menopausal phase might trigger migraine.

Since all these are pretty common and familiar events, avoiding the triggers as much as possible could help. Further, leading a healthy and a scheduled life would be of great help. Most importantly, marking and keeping a track of the episodes and attacks is necessary for the diagnosis.

TYPES:

Based on the frequency of the attack, migraines can be classified as,

EPISODIC MIGRAINE:

In this type of migraine, the attack is less than 15 headache days in a month

CHRONIC ATTACK OF MIGRAINE:

In this type, there are more than 15 headache days. Moreover, studies show that each year 3% of episodic migraine becomes chronic.

Further, the other types of include,

  • The ocular migraine
  • The vestibular
  • Hemiplegic
  • Migraine with brainstem aura (classical migraine)
  • Status migrainosus or the intractable migraine
  • The migraine without head pain or the silent migraine (common migraine).

PHASES:

Typically there are 4 phases in migraine namely,

  • Prodrome
  • Aura
  • Headache
  • Postdrome

THE PRODROME:

This is the initial phase of a migraine attack. These bring about a very subtle set of symptoms. They last between a few hours to days. The prodrome phase is usually experienced only by some. The symptoms include,

  • Yawning
  • Moodiness or mood swings
  • Fatigue
  • Increased thirst

THE AURA:

Aura is the second stage or phase of a migraine. In this phase, there might be short term visual changes. The symptoms of aura include,

  • Visual changes like flashes, zig-zag lines in the field of vision or even blind spots at times
  • Numbness
  • Confusion
  • Vertigo
  • Muscle weakness

THE HEADACHE:

This is the phase where the headache occurs in a person. The typical migraine pattern of headache takes place that can last anywhere between 4 to 72 hours. The symptoms include,

  • A pounding headache on one side of the head usually lasting between 4-72 hours. The headache usually shows a pulsating quality.
  • These people experience sensitivity to noise and bright lights (ponophobia and photophobia). They usually prefer to lie down in a dark and quiet place until this phase comes to an end.
  • Regular tasks may increase the pain.
  • Nausea is also a very common symptom of this phase.

THE POST-DROME:

The post-drome is the final phase of the migraine attack. In this phase, the person might feel dull and fatigued. This is similar to a hang-over. The person might experience drowsiness, a loss of appetite and a lack of focus or concentration.

This phase lasts anywhere between 1-2 days and usually, the attack slowly recedes away.

OTHER BODILY SYMPTOMS:

Experts suggest and believe that migraine is not just a problem concerning the head. As we already read in the initial paragraphs, it’s a complex neurological condition. To clarify, it affects the entire nervous system. In addition to the above-mentioned conditions, a person with migraine might experience,

  • A drastic change in the sleep pattern
  • Undue pressure on the ears and the sinus
  • Anxiety and poor balance control
  • Speech is impaired.

SIMPLE TIPS TO PREVENT A MIGRAINE ATTACK:

Firstly, avoiding the triggering factors plays a major role in preventing migraines. While medicines can temporarily fix the pain, always a long term relief through lifestyle changes is desirable. Therefore, some simple tips to avoid an episode of migraine includes,

A GOOD SLEEP:

We have read about the importance of a good night’s sleep in many articles. Similarly, a good sleep of about 7-8 hours a day can go a long way in preventing episodes. Further, going to bed and waking up at the same time is beneficial. In addition, practising good sleep hygiene goes a long way. Further, a good sleep cycle avoids any major or sudden changes in the brain.

DRINKING ENOUGH WATER:

Making it a routine to get that 2 – 3 litre of water on a daily basis is very essential. Most importantly, it is one of the effective ways of avoiding a migraine attack. Further, in a tropical country like ours, heatwaves cause dehydration in the body instantly. Always make it a point to carry a bottle of water and keep yourself hydrated.

AVOIDING STRESS:

This might not be very easy as it sounds. But, with the right practice and lifestyle changes, we can nail a stress-free routine. Firstly, practise meditation. A mindful meditation of even 10 minutes can go a long way in relieving stress. This has a very calming effect on the brain.

Secondly, spend some time on the activities you love. Make sure that they are in a constructive manner and try avoiding gadgets as far as possible.

LIMIT CAFFEINE AND EXERCISE REGULARLY:

Most importantly, limiting the intake of caffeine can greatly help in avoiding episodes. Try to cut down on caffeine-rich food. Never take more than 2 cups of coffee or tea per day. Caffeine is a known trigger of episodes.

Performing 30-45 minutes of regular exercise can improve your health in general and is also beneficial to prevent migraines.

CONSULT A PHYSICIAN AND NEVER SELF-MEDICATE:

Firstly, it is very important to consult a doctor. This is a primary step. Acknowledging that you have a problem is an initial step to finding ways to cure the condition. Further, a doctor can rightly diagnose the type of migraine and guide you properly to avoid them.

Further, never self-medicate or go high on painkillers. Consequently, self-medication is one of the worst things we can do to our bodies. With half-cooked knowledge and the wrong drugs, we do more harm than good. Further, over-dosing on pain killers is a whole new demon by itself.

To sum up, migraine is not an utterly deadly condition. But, this can subtly steal away many days or even years of quality life. Further, this condition can rob us of the pleasure of experiencing things in their fullness without being able to worry about an attack.


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Dr Kavitha M

I am an undergraduate degree holder in dentistry. I have a great interest in music and reading. I am a linguaphile. My areas of interest lie in psychology, medical imaging, diagnostics, and oncology. I am a person who focuses more on the emerging areas of forensics.

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