Migraine is common all over the world, it has been estimated that it affects around 1 in every 5 women and around 1 in every 15 men.Migraine is not a just common headache, it is a chronic condition affecting all aspect of life. 90% of people who suffer from migraines are unable to function or work properly during their migraines. According to a report published by Work Foundation UK “Migraine costs the UK economy £8.8 billion per year in lost productivity.
Migraine symptoms vary from person to person, however the majority of patients presented with three main symptoms;
- Headache which is usually onesided.people with migraine describe it as throbbing, crushing or pounding.
- Sensitivity to light and sound
- Nausea and vomiting
There are different phases of migraine like; prodrome phase, aura phase and resolution phase.
Many migraineurs experience vague vegetative or affective symptoms
as much as 24 hours prior to the onset of a migraine attack. This phase is called the prodrome and should not be confused with the aura phase. Aura phase is consist of neurological symptoms like sensitivity to light or sound.
Within an hour of resolution of the aura symptoms, the typical migraine headache usually appears with its unilateral throbbing pain and associated nausea, vomiting, sensitivity to light(photophobia), or sound (phonophobia). This headache may persist for up to 72 hours if untreated and ended with resolution phase which is characterized by deep sleep.
The exact cause of migraine remains unclear, but there is often family history of migraine, suggestive of genetic predisposition. Additionally, research suggests that variations within the dopamine D2 receptor gene also may have some effect on susceptibility to migraine. Thus, genetic studies are providing important information about the molecular basis
of migraine. Migraine is also considered as a neurovascular disease because of throbbing nature of headache. According to Dr. John Detre, a professor of neurology and radiology:
Abnormalities in both the circle of Willis and blood flow were most prominent in the back of the brain, where the visual cortex is located. This may help explain why the most common migraine auras consist of visual symptoms such as seeing distortions, spots or wavy lines.”
Every one has different migrain trigger but there are few common triggers which may initiate the attack of migraine like;
- Hormonal changes; The great female preponderance and the tendency for some women to have migraine attack at certain points in their menstrual cycle hint at hormonal influence.
- Emotional stress; According to the American Headache Society, about 4 to 5 people with migraine report stress as a trigger.
- DIET; certain food like alcohol, chocolates, curried meat, smoked fish, yeast extract, food preservatives that contain nitrities and nitrates, artificial sweetener and monosodium glutamate(MSG) may trigger a migraine.
- Sleep; poor sleep reduces the levels of dopamine and serotonin, neurotransmitters, essential for and trigger migraine headache. one study shows that good sleep reduces both the number and frequency of mgraine in the participants.
Treatment and management
There is no specific treatment for migraine but certiain medicine can be effective for acute attack like
- Painkillers like paracetamole, Aspirin with an antiemetic for vomitting like Metoclopramide
- Antinflammatory like ibubrophin
- Triptans like sumatriptan
if attacks are frequents, prevention of migraine can be treated by propranolol or tricyclic such as amitriptilyin
If you suspect a specific trigger is causing your migraines, such as stress or a certain type of food, avoiding this trigger may help reduce your risk of experiencing migraines.
It may also help to maintain a generally healthy lifestyle, including regular exercise, sleep and meals, as well as ensuring you stay well hydrated and limiting your intake of caffeine and alcohol.
Keeping track of your migraine headach bu using migraine journal can help you identify the triggers and potentially reduces the frequency of your attack
If your migraines are severe or you have tried avoiding possible triggers and are still experiencing symptoms, a GP may prescribe medicines to help prevent further attacks.