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Migraine

Migraine

The precise causes of the particular kind of headache referred to as migraine are not very clear, though they are related to blood-vessel contractions in the head, usually on one side. They may also be related to some inherited abnormalities in particular areas of the brain. The pain, mostly described as a throbbing in the head, ranges from moderate to severe, and can last from four hours to three days. The attacks are associated with symptoms like sensitivity to light, noise, or odours, nausea or vomiting, loss of appetite, and stomach upset or abdominal pain. Some people experience a warning symptom called an ‘aura’ before the onset of the pain. An aura is a cluster of symptoms, normally vision disturbances, that serve as a warning sign of an impending migraine attack.

Symptoms

  • A migraine headache is a chronic condition with recurrent attacks. The following are some of its warning signs:
  • Migraine headaches are usually an intense, throbbing or pounding pain in the area of the temple. Sometimes it may also be located in the forehead, around the eye, or at the back of the head.
  • The pain is usually on one side of the head, although sometimes it may occur on both sides.
  • The one-sided headaches often change sides during different attacks. In fact, if they always occur on one side the person should consult a doctor, as there may be a possibility of a brain tumour.
  • Daily activities such as walking upstairs usually aggravate the condition.
  • Nausea, vomiting, diarrhoea, facial tone, cold hands and feet, and sensitivity to light and sound are the symptoms that commonly accompany a migraine attack. Due to this sensitivity to light and sound, sufferers prefer to lie in a quiet, dark room during an attack.

An estimated 40-60% of the attacks are preceded by warning symptoms lasting from a few hours to days. The symptoms may include sleepiness, irritability, fatigue, depression or euphoria, yawning, and cravings for sweet or salty foods. Parents and family members usually recognise these symptoms.

How is the condition diagnosed?
Migraine headaches are usually diagnosed when the symptoms described above are present. Migraine generally begins in childhood or early adulthood. While its first occurrence in an individual beyond the age of 50 is possible, advancing age makes other types of headaches more likely. There is usually a family history, suggesting a genetic predisposition in migraine sufferers. Patients with the first headache ever, worst headache ever, a significant change in the characteristics of the headache or an association of the headache with the nervous system, like visual or hearing or sensory loss, may require additional tests to exclude diseases other than migraine.

How is the condition treated?
Treatment includes therapies that may or may not involve medications. Therapy that does not involve medications can provide symptomatic relief. Using ice, and relaxation techniques may be helpful in stopping an attack once it has started. Sleep may be the best medicine if it is possible.
Patients may need to change some lifestyle habits that trigger a migraine attack. They should quit smoking and avoid certain foods, which are high in tyramine such as sharp cheeses or those containing sulphites (wines) or nitrates (nuts, pressed meats).  Generally, leading a healthy lifestyle adequate intake of food and fluids, sufficient sleep and exercise are helpful. Many believe acupuncture to be an effective therapy.

People who experience occasional mild migraine headaches that do not interfere with daily activities usually medicate themselves with over-the-counter pain-killers (analgesics). Many OTC analgesics are available. They have been shown to be safe and effective for short-term relief of headache (as well as muscle aches, pains, menstrual cramps, and fever) when used according to the instructions on their labels.

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