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What is Migraine ?
The medical term for a chronic form
of a headache accompanied by nausea, photophobia or sensitivity
towards light and phonophobia or sensitivity towards sound can
be defined as a migraine. The International Headache Society has
categorized migraines into two kinds – one that is accompanied
by aura (or visual change) and the other that is not accompanied
by aura.
The
migraine pain has a few characteristics
• Pain generally happens on one side.
• The pain is usually excruciating and throbbing.
• It can range from moderate to intense.
• Daily chores like the regular housework are likely to worsen
it.
Migraine is a neurological illness and comes from the Greek word
hemi crania which mean “half the head". The history of headache
goes back to 9000 years ago. The ancient Egyptian doctors
recorded the excruciating and throbbing headaches in their
medical diaries. In the year 400
B.C., Hippocrates mentioned about the aura that precedes a
migraine attack and the relief attained after vomiting. In the
Medieval Ages, migraine was considered to be a major illness and
the treatment varied from using hot iron the head to witchcraft.
It was only in 1950 when Harold Wolff studied about headaches
and described the vascular theory of migraine.
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The
signs & symptoms associated with migraine
The symptoms of migraine vary from one patient to another. So it
is very difficult to explain the exact experience before and
after the attack. However, after a lot of research, scientists
have four symptoms that are more or less common to all the
sufferers.
• Prodrome, the symptom that appears a few hours or even a few
days before the migraine
• Aura, the symptom that immediately precedes the headache.
• The headache.
• The postdrome symptom that follows after the attack.
Prodrome: This symptom
occurs in about 60% of the patients. Prodrome is characterized
by mood swings, irritability, exhaustion, yawning, craving for
certain kinds of food, extreme sleepiness and depression (or
even a feeling of ecstasy). All these signs starts several hours
before the attack allowing the experienced patients and family
members to notice that the migraine attack is occurring.
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Aura:
This phase immediately precedes the actual headache. They
usually appear about 5 to 15 minutes before the attack and
disappears just before the pain starts. The migraine aura signs
are generally sensory in nature and the most common is the
visual aura. In this phase, the person’s vision is disturbed by
white or even multicolored flashes of light. Some patients have
also explained the experience of hazy or blurred vision,
somewhat similar to looking through a smoked glass. Some
migraine patients also undergo the somato sensory aura in which
the person gets a feeling of being pricked by innumerable pins
and needles in the hands and arms as well as the facial region
especially around the nose and mouth.
Headache: The headache
associated with migraine is one sided, pulsating ranging from
mild to extreme and is worsened by the mundane chores. However,
it is not necessary that all these symptoms will appear at one
shot. In some cases he pain might happen on both sides of the
head alternately. The pain has a typical pattern – it first
reahes the peak and then diminishes. In adults this pain can
last from 4 hours to about 72 hours; in children from 1 hour to
48 hours. The pain might appear several times a week or may be a
few times in a lifetime. The intensity of the pain is also
varied. The headache is accompanied by anorexia, nausea and
vomiting. Some patients also develop phonophobia, photophobia
and osmophobia and get relief in a dark and quiet room. Other
problems that might accompany the headache are stuffiness of the
nose, blurred vision, sweating, lightheadedness, localized
swelling and diarrhea.
Postdrome: After the attack
comes the final stage, the postdrome. The feelings again vary
from one person to another. While some experience a sense of
great reinvigoration others go through a sense of depression.
even after the attack a few symptoms like lightheadedness,
anorexia and photophobia continue for sometime.
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Factors
that Trigger Migraine
There has been a lot of studies to discover the causes of
migraine. The most common causes include:
• Stress
• Glare or over illumination
• Alcohol consumption
• Weather
• Excessive or inadequate sleep
• Certain kinds of food
Inspite of above discussed triggers, many a times migraine
occurs without any possible cause. Doctors now advise their
patients to maintain their own “headache diary” in which they
try to record the possible triggers for their attacks. Weather
is considered as one of the triggers of migraine. Studies have
revealed that almost 51% of the affected population are
extremely sensitive to the weather changes. The most possible
reasons for the migraine attack include:
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• Temperature combined with
humidity. Very high humidity and extreme of temperatures can
trigger an attack.
• Any changes in the barometric pressure.
• Some significant changes in the weather conditions.
A study has also revealed that warm westerly winds common in
Canada and Alberta (commonly called the chinook winds) are also
responsible for triggering migraine.
Treatment
The first step towards treating this illness is identifying and
avoiding the factors that are believed to trigger an attack.
This includes reducing the consumption of alcohol and caffeine,
taking regular and proper meals and maintaining a consistent
sleeping habit. Though these are the general methods to avoid
triggers, as discussed earlier migraine symptoms vary from one
person to another. To cope up with their unbearable pains, most
sufferers have developed their own methods. While some seek
relief in a dark and quiet room, others prefer a hot or cold
headbath. A simple, common and pretty effective method is
putting a spoon of ice cream on the tongue and holding it on to
the palate until it melts. This results in direct cooling of the
hypothalamus (which is believed to be responsible for the
headache) and in some cases also succeeds in stopping the pain.
For those suffering from recurrent attacks very frequently,
painkillers are prescribed. For the mild attacks analgesics like
paracetamols, aspirin and caffeine are recommended. Some
patients also use Benadryl or other anti nausea medications for
relief. If these drugs prove to be ineffective, physicians
prscribe fioricet or fiorinal which contains a combination of
butalbital, acetaminophen and caffeine. However, a frequent
usage of butalbital can cause rebound headaches. In cases where
vomiting dominates the symptoms, anti-emetics are given.
Alternative treatments
As all the conventional methods are not effective in reducing
the migraine completely, doctors suggest alternative approaches.
Some advise a regular physical exercise for 15 to 20 minutes
everyday to reduce the frequency of migraines.Massage therapy is
also believed to effective in reducing the oftenness of the
attacks. But this therapy must be performed by professionals who
are aware of the pathophysiology of the migraines.Botox therapy
is also used to combat migraine attacks. Some people find relief
from this attack through acupuncture.
Other methods
There is a point between the humb and the index finger that can
reduce headache if it is not very severe. Put pressure with the
opposite index finger and thumb at the point where the thumb
meets the index. If a slight pain is experienced then it can be
assumed that the pressure has been given at the correct point.
Another mothod is the use of aroma therapy or smells. The smells
of lavender and apples have proved to be effective in curing
headaches to a great extent.
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Article Contributed By: Sukanaya Banerjee
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