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Migraine is a chronic disorder characterized by recurrent moderate to severe headaches often in association with a number of autonomic nervous system symptoms. The word actually means pain on one side of the head or half of the skull.
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Typically the headache is unilateral (affecting one half of the head) and pulsating in nature, lasting from 2 to 72 hours. Associated symptoms may include nausea, vomiting, photophobia (increased sensitivity to light), phonophobia (increased sensitivity to sound) and the pain is generally aggravated 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.
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There are three different types of migraines:
Classic migraines which are associated with an aura;
Common migraines with no aura;
Complicated migraines associated with neurologic symptoms such as weakness or visual problems. The headache is usually intense and incapacitating and is frequently accompanied by nausea and vomiting and an intolerance to light (photphobia). Also known as vascular headaches and may be related to dilation of blood vessels of the head although the exact cause of these headaches is not know.
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Migraines usually first occur during the teenage years and are more common in women. Patients who have family members with migraines are at increased risk to develop these headaches.
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Symptoms of migraines;
Severe headache (throbbing, pounding, pulsating),
nausea,
vomiting,
sensitivity to light or sound,
loss of appetite,
fatigue,
numbness,
tingling,
weakness.
An aura may precede the headache consisting of seeing stars or zigzag lines, tunnel vision, or a temporary blind spot.
Therapy depends on the severity of the headaches. Several different types of medications may be used including: ergots like dihydroergotamine, ergots with caffeine (cafergot); and or triptans like sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), frovatriptan (Frova), and zolmitriptan (Zomig). They can be taken orally, nasally or as a self injection.
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Medications such as antidepressants, blood pressure medications, and anti seizure drugs may be used to prevent the migraines.
Tests to rule out other causes of the headaches may be done.
Lumbar puncture is a possible test also aim to resolve migraines.
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