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Migraine : Definition, Causes, Symptoms, Diagnosis and Treatment

Tuesday, December 25th 2012. | Brain and Nerves, Disease

Migraine Defintion

Migraine is not an ordinary headache. This is a real disease. That is characterized by the repeated occurrence of crisesusually on one side of the head . The person feels the heart beat and its pulsations are painful. Seizure frequency, which last between 4 and 72 hours, varies from person to person: some suffer several times a week, others a few times a year.In 70% of migraine attacks are repeated from one to four times a month. They are aggravated by physical effort, noise and light, and are accompanied by nausea and vomiting.

The disease begins in childhood or adolescence, reaching its maximum between 30 and 40 years and then fades. An estimated 5 to 10% the percentage of children with migraine, their attacks are usually shorter than in adults. Furthermore, sleep helps relieve the child during a migraine attack.

After puberty, migraine is more common in girls than in boys. In fact, among women, migraines may be hormonal rhythm of life: it can occur only during menstruation and usually disappears during pregnancy and after menopause.

Migraine

Migraine (img thanks to ; infiniteunknown.net)

Migraine Types

There are different types of migraine according to the location of the pain and signs that accompany it.

  • There are first the crisis with signs manifested by severe headache and headache preceded by visual or neurological signs lasting less than an hour, called “auras.” Sometimes called the recent ophthalmic migraines . The visual signs are usually bright spots in the visual field (scotomata or phosphenes) and neurological signs of tingling, dizziness and sometimes language disorders.
  • There are also migraine without aura, the most common , in which the headache is initially localized to one side, and felt as a pulse that can be accompanied by vomiting, intolerance to light (photophobia) , noise or stress.
  • Moreover, there are migraines that are triggered in menstruating women  : they are migraines or catamenial menstruellesqui are probably due to the sudden drop in estrogen levels in the blood. This type of migraine affects half of female migraineurs.
  • Finally, the drug migraines are caused by excessive intake of pain medication which, to a degree, increase the pain rather than alleviate it.

Migraine Causes

 However, genetic factors that predispose a person to crises. When a close family member suffers from migraine attacks, the likelihood of suffering such crises increases. The genes involved have not been identified and scientists look for the involvement of several genes and the involvement of environmental factors. There is a very rare form of migraine, familial hemiplegic migraine. It is linked to a single gene whose transmission is dominant: the risk that a child will be affected is 50% when one parent suffers from familial hemiplegic migraine.

Possible causes of migraine:

  • Hormonal: hormonal rhythms may play a role as evidenced by the greater frequency of seizures in women, better known during pregnancy and their reduction after menopause. This does not mean that migraine is hormonal.
  • Digestive: a migraine attack may be accompanied by gastrointestinal symptoms they are the consequence not the cause.
  • Vision problems  : While some are ophthalmic migraines with visual disturbances, true migraines are not related to a vision problem. The headache that may be due to visual impairment are different from migraines.
  • Sinusitis  : often cause headaches, sinus conditions are not responsible for true migraines.
  • Psychological  : the onset of crises by stress or psychological relaxation after stress, adversity, the emotions … is well known. However, symptoms of the crisis are not the brainchild of the patient as an underlying meaning in a sometimes pejorative term “psychological”. The confusion in the public between the trigger that can be psychological and the crisis itself is organic increases the feeling of incomprehension that sometimes feel the migraine.

What are the triggers?

If we do not know exactly the causes of migraine, many events may trigger migraine attacks.These triggers are not the same for all. The best known are:

  • The psychological factors . This is usually after an episode of stress, strong emotions or great annoyance that migraine attacks are triggered.
  • The pace of life changes . Some people have seizures especially at weekends, when going on holiday or traveling. Migraines can be intensified in case of burnout, career change or certain life events like weddings. In children, they are more frequent than during school holidays.
  • The environment . Climatic factors (wind, storm, excessive heat or cold, storms) or sensory factors (light, noise, odors) are also implicated in the occurrence of seizures.
  • The changes in sleep.
  • The food . The most often implicated are chocolate, white wine and some spirits, cheese and citrus.
  • The hormones . This is the case in catamenial migraine.

As these factors are not all responsible for the occurrence of migraine, it is advisable to keep adiary of migraine in which the person entered the circumstances in which the migraines report.This agenda can tailor treatment and to avoid triggering or aggravating factors.

Several theories attempt to explain migraine.

Just as the cause of migraine, the mechanisms involved are not known. However, it seems that pain is related to both the vascular and neurological processes .

According to the most recent theory, the trigeminal nerve, which innervates that much of the face, is stimulated. It then releases a large amount of a molecule, substance P, at the vascular network of the brain.

Substance P has the effect vasodilation and inflammation of the vessel. This change in dilatation of the vessel in turn stimulates the trigeminal nerve as a painful message.

Migraine Sign

In some individuals migraine attacks may be preceded by warning signs such as:

  • Mood disorders (depression or euphoria)
  • Eating disorders (lack of appetite or abnormal hunger, especially for sweets), or
  • Concentration difficulties .

Some people perceive an increased sensitivity to noise, light and odors .

In 5 to 20% of people with migraine, the crisis may be preceded by a will . For a period varying from a few minutes to an hour, visual disturbances manifest as a dark spot surrounded by a halo shimmering, geometric lines or spots of bright and shiny in the middle of the field of vision.

The aura can also manifest as visual field loss, a double vision or temporary loss of vision in one eye or both eyes.

Migraine Symptoms

A few hours to three or four days, the duration of migraines varies greatly. Meanwhile, the person experiences a headache more intense than a regular headache. Pain, usually located on one side of the head is throbbing and throbbing. During migraine attacks, the person lack of appetite and may have nausea or vomiting. Of blurred vision accompanied by photophobia (light sensitivity) may also occur. Often get in a room in the dark relieves pain.

After migraine, the person experiences extreme fatigue and difficulty concentrating.

Migraine is a benign condition and is not dangerous in itself.What can be what are the different medications you may need to take possible interactions.

What other diseases migraine should not she be confused?

The tension headaches are distinguished from migraine by their main event: a feeling of tightness in the forehead and temples, unlike the headache of migraine are throbbing and accompanied by nausea or vomiting. Less serious, they are caused by anxiety.

However, other headaches are harbingers of a more serious and require emergency consultation. When the headache is very sudden, there may be a sign of bleeding. When it is increasing day by day, he could testify to the presence of a tumor, infection (abscess, meningitis). In people over 60 years, it may be a sign of giant cell arteritis.

Migraine Diagnosis

The clinical neurological examination of the individual migraine is always normal. Additional examinations such as CT, X-rays of the skull and sinuses or EEG are normal. These exams can be made as to exclude serious disease manifesting as headache, although different from migraine, such as meningitis, hemorrhage of the meninges, abscess, tumor or giant cell arteritis.

Migraine Treatment

There are non-drug methods that relieve in case of crisis.Each person has its own tricks such as applying hot or cold packs to his head, drink coffee, be alone in a dark room or sleeping.

Drugs nonspecific migraine attack can be used. These are analgesics (pain killers) such as paracetamol, aspirin, nonsteroidal anti-inflammatory drugs, opiates or minor noramidopyrine.

We may also make use of specific drugs for migraine . There are two types: the derivatives of ergot and triptans. These drugs that act directly in the brain causes constriction of arteries in the brain (which expand during the migraine attack) and fight against inflammation.

What are the DMARDs of Migraine?

The basic treatment is indicated when the crises, severe and frequent ringing of everyday life. But also when the use of the treatment of crisis becomes too frequent and that this treatment loses its effectiveness. The goal of treatment of migraine background is reducing the frequency and intensity of crises . Several molecules are available: derivatives of ergot, beta blockers, anti-serotonergic, flunarizine or indoramin. The molecules are tested one at a time. We must wait for one to four months, during which the person must keep his agenda migraines, so that the doctor evaluates the effectiveness of treatment. Increasing the dosage is gradually to determine the lowest effective dose.

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