Migraine headaches are caused by changes within the blood vessels in the brain, and are currently the most common ailment seen in emergency rooms. They can last for a few hours or several days and affect almost 15 percent of the population, with women being three times more susceptible then men. Mere utterance of the word "migraine" is enough to send several individuals into panic mode, as migraine sufferers know all too well the debilitating pain, nausea, vision impairment, and other symptoms that are experienced far too often.
Within the broad category of "migraines" three subcategories exist. Common migraines account for approximately 80 percent of all migraines. Classic migraines are typically preceded by an aura, or some type of visual distortion, and are frequently more painful than common migraines. Status migraines are headaches that do not dissipate without medical intervention.
Experts cite a progression of five phases in the migraine cycle: prodrome, aura, headache, headache termination, and postdrome. The prodrome phase is characterized by a variety of pre-headache symptoms, or warning signs, that a migraine is imminent. Such warnings can be fatigue, muscle twitches, sensory alterations, and mood swings. The aura phase, as stated earlier, often involves visual changes like blind spots, loss of sight on one side, or flashing geometric patterns. The headache itself can be localized on one side; however, it typically affects both sides and is frequently accompanied by nausea, vomiting, throbbing, and photosensitivity. Headache termination can occur anywhere from four to 72 hours after initial prodrome onset, and even without medication or other medical interventions, usually subside with sleep. Finally, the postdrome phase encompasses any other physical issues once the headache is gone, oftentimes, loss of appetite, fatigue or lack of concentration.
Despite the absence of any definite cause of migraines, experts assert that an amalgamation of the aforementioned structural changes in the brain's blood vessels and the release of certain biochemicals combine to produce migraine symptoms.
Migraines can occur any time; however, there are certain triggers which tend to directly precede a migraine attack. These triggers range from various foods such as chocolate, nuts, cheese, MSG, and alcohol to hunger to stress. Furthermore, both smoking and the use of birth control pills have been known to trigger migraines as well.
While most migraines do not require medical intervention, certain serious symptoms may exist which would require further care. Headaches which change in intensity or frequency; headaches caused by coughing, sneezing, or straining on the toilet; extreme weight loss; and lingering weakness after dissipation of the headache itself are serious effects which require immediate medical attention. In rare cases, the following symptoms require emergency attention: headache as a result of head trauma; loss of consciousness; fever and/or stiff neck; confusion; paralysis; and seizure.
Migraine diagnosis is merely a diagnosis of elimination. Once other conditions which mimic migraine have been ruled out, the resulting diagnosis is migraine. Blood tests, spinal taps, X-rays, CT scans and MRIs can successfully detect stroke, infections, and tumor; therefore, the absence of these identifiable afflictions would likely prompt physicians to diagnose migraine.
A variety of at-home, self-care treatments are available. Cold compresses, over the counter analgesic medication, sleeping, consumption of caffeine to dilate blood vessels, and resting in a dark, quiet room are frequently successful remedies. Unfortunately, however, half of all migraine sufferers eventually seek further medical treatment; with such treatment being either abortive or preventative. Abortive therapy aims to either prevent a migraine attack or to address a current headache through the use of prescribed pharmaceuticals; commonly triptans, which target serotonin levels within the brain. If necessary, further treatment can include anti-nausea medications or mild narcotics. On the other hand, preventative therapies utilize medication to prevent migraine onset in the first place and are typically beta blockers, antihistamines, antidepressants, and anti-seizure medicines.
Essential to successful migraine management is establishing a good rapport with one's physician and providing him or her with necessary information to customize an effective treatment plan. Keeping a pain journal, maintaining regular follow-up visits, and following all directions regarding eliminating triggers through diet and lifestyle modification are all vital for success. Furthermore, patience is crucial as it often takes a trial-and-error period to discover each patient's unique course of treatment.
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