Migraine

Migraines are recurring attacks of moderate to severe pain. The pain is throbbing or pulsing, and is often on one side of the head. During migraines, people are very sensitive to light and sound. They may also become nauseated and vomit.

Migraine is three times more common in women than in men. Some people can tell when they are about to have a migraine because they see flashing lights or zigzag lines or they temporarily lose their vision.

Many things can trigger a migraine. These include

  • Anxiety
  • Stress
  • Lack of food or sleep
  • Exposure to light
  • Hormonal changes (in women)

Migraine is a neurological disease characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous systemsymptoms

Migraine is a neurological disease characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous systemsymptoms. The word is derived from the Greek ἡμικρανία (hemikrania), “pain on one side of the head”, from ἡμι- (hemi-), “half”, and κρανίον (kranion), “skull”.

Typically, the headache affects one half of the head, is pulsating in nature, and lasts from 2 to 72 hours. Associated symptoms may include nausea, vomiting, andsensitivity to light, sound, or smell. The pain is generally made worse by physical activity. Up to one-third of people with migraine headaches perceive an aura: a transient visual, sensory, language, or motor disturbance which signals that the headache will soon occur. Occasionally, an aura can occur with little or no headache following it.

Migraines are believed to be due to a mixture of environmental and genetic factors. About two-thirds of cases run in families. Changing hormone levels may also play a role, as migraines affect slightly more boys than girls before puberty, but about two to three times more women than men.  The risk of migraines usually decreases during pregnancy. The exact mechanisms of migraine are not known. It is, however, believed to be a neurovascular disorder.  The primary theory is related to increased excitability of the cerebral cortex and abnormal control of pain neurons in the trigeminal nucleus of the brainstem.

Initial recommended management is with simple pain medication such as ibuprofen and paracetamol (also known as acetaminophen) for the headache, medication for the nausea, and the avoidance of triggers. Specific agents such as triptans or ergotamines may be used by those for whom simple analgesics are not effective. Globally, approximately 15% of the population is affected by migraines at some point in life.