What It Is:
The word Migraine is French in origin and has its roots in Greek hemicrania. Literally, hemicrania means half the head.Migraine is a neurological syndrome characterized by altered bodily experiences and painful headaches. A typical migraine headache is one-sided and pulsating, lasting 4 to 72 hours. Migraine headache may be accompanied with nausea and vomiting and photophobia( heightened sensitivity to bright lights) . The patient may also complain of hyperacusis( heightened sensitivity to noise). 33% of people who experience migraine get a preceding aura, in which the patient may sense a strange light or unpleasant smell. The episodes of migraine may be triggered by certain foods and beverages( like chocolate or alcohol), stress or menstruation. In some migraine types there are typical features but the headache remains absent, and in children abdominal pain may be a prominent feature. Migraine shows gender bias. Although till the age of puberty, boys and girls are equally likely to suffer from migraine, after puberty the scale becomes tilted. 75% of patients complaining of migraine are from the fairer sex. One curious fact is that migraine seems to disappear during pregnancy.
The exact cause of migraine has continued to baffle medical fraternity. The most widespread theory is that it is a disorder of the serotonergic control system. There may be genetic factors too. Studies on twins show that genes have a 60 to 65% influence on the development of migraine. Migraine also seems to be related to fluctuating hormonal levels.
Migraines are difficult to diagnose. This has led to migraines being underdiagnosed and misdiagnosed. International Headache Society has come out with ‘ 5,4,3,2,1 criteria’ for diagnosis of migraine. For migraine with aura, only two attacks are sufficient to justify the diagnosis.
Triggers could be behavioral, environmental, infectious, dietary, chemical or hormonal. The medical word for triggers is ‘precipitants’. The triggers could be:
- Allergic reaction, smoking , alcohol, skipping meals
- Bright Lights, loud noise, and certain odors or perfumes
- Physical or emotional stress
- Changes in sleep patterns
Conventional treatment focuses on three areas: trigger avoidance, symptomatic control, and preventive drugs. Patients who experience migraines often find that the recommended treatments are not 100% effective at preventing migraines, and sometimes may not be effective at all.