What Is Migraine?
By Arvind M. Dhople, Ph.D., Professor Emeritus, Florida Tech
If you suffer from migraine, you’re not alone. About 12 percent of U.S. population gets them. Migraines are recurring attacks of moderate to severe pain. The pain is throbbing or pulsing, and is often on one side of the head. Migraines occur most frequently in the morning, especially upon waking. During migraines, people are very sensitive to light and sound. Migraine is three times more common in women than in men.
Migraines occur in both children and adults. Now doctors believe the cause is related to genes that control the activity of some brain cells, and most migraine sufferers having a family history of the disorder. Depression, anxiety, bipolar disorder, sleep disorder, and epilepsy are more common in individuals with migraine than in the general population. Migraine in women may be related to changes in hormones. Women who do not suffer from headache may develop migraines as a side effect of oral contraceptive.
A number of environmental influences can trigger a migraine, and their effects vary from person to person. Triggers include sudden changes in weather or environment, too much or not enough sleep, strong odors or fumes, emotion, stress, overexertion, loud or sudden noises, motion sickness, low blood sugar, skipped meals, missed medications, tobacco smoke, depression, anxiety, head trauma, alcohol, some medications, hormonal changes, and bright or flashing lights.
In some 50 percent of migraine sufferers, foods or ingredients can trigger headaches. These include aspartame, caffeine (or caffeine withdrawal), wine and other types of alcohol, chocolate, aged cheeses, monosodium glutamate, fruit and nuts, fermented or pickled goods, yeast, and cured or processed meats.
The two major types of migraine are: (a) Migraine without aura, or common migraine, is the more prevalent form of migraine. Symptoms include headache pain that occurs without warning and is usually felt on one side of the head, along with nausea, confusion, blurred vision, mood changes, fatigue, and increased sensitivity to light, sound, or noise. (b) Migraine with aura, previously called classic migraine, include visual disturbances and other neurological symptoms that appear 10 to 60 minutes before the onset of the headache and usually last no more than an hour. Individuals may temporarily lose part or all of their vision. The aura may occur without headache pain, which can strike at any time.
Migraine is divided into four phases, all of which may be present during the attack: (1) premonitory symptoms occur up to 48 hours prior to developing a migraine. These include food cravings, unexplained mood, fluid retention, or increased urination. (2) Aura: Some people will see flashing or bright lights immediately prior to or during the migraine, while others may experience muscle weakness. (3) Headache: A migraine usually starts gradually and guilds in intensity. (4) Postdrome (following headache): Individuals are often exhausted or confused following migraine. The postdrome period may last up to a day before people feel back to normal.
Migraine treatment is aimed at relieving symptoms and preventing additional attack. Quick steps to ease symptoms may include napping or resting with eyes closed in a quiet, darkened room; placing a cool cloth or ice pack on the forehead, and drink lots of fluid, particularly if the migraine is associated with vomiting.
Drug therapy for migraine is divided into acute and preventive treatment. Acute or “abortive” medications are taken as soon as symptoms occur to relive pain and restore function. Preventive treatment involves taking medicines daily to reduce the frequency and severity of future attacks or keep them from happening. Other non-pharmacological measures such as relaxation techniques and regular eating and sleeping schedules also help.
Pain, in all of its forms, from migraines to chronic low-back pain, is a condition that can defy our best efforts to control it. We know that many Americans experience the pain of migraines, about 12 percent of the U.S. population. Genetics may contribute to a predisposition for migraines. Most migraine sufferers have a family member with migraine. Researchers are studying the activity of different genes to see if they make some people more likely to have migraine.