Migraines are by far the most common form of headache we see in our clinic, and they are the most prevalent source of incapacitating, recurrent headache pain.
SYMPTOMS
Individual migraines range in severity from mild to severe, and are frequently accompanied by a throbbing or pounding sensation. Although they are usually one-sided, they can appear anywhere on the head, neck, and face ? or all over. They are often linked with sensitivity to light, noise, and/or odours at their worst. One of the most prevalent symptoms is nausea, which increases with activity and frequently leads in patient impairment. Migraines are similar to alcohol-related hangovers in many ways.
Migraine pain can be felt in the face, where it might be confused with sinus headache, or in the neck, where it can be confused with arthritis or muscular spasm. Migraine diagnosis is complicated by the fact that the headaches may be accompanied by other "sinus-like" symptoms such as watery eyes, nasal congestion, and a sensation of face pressure. The majority of individuals who believe they have a sinus headache actually have migraines.
An aura, a transient neurological condition that slowly increases and then generally fades just as the pain begins, may precede migraine headache symptoms in up to 25% of individuals. While visual disturbances (flashing lights, zigzags, blind spots) are the most frequent kind of migraine aura, many patients also suffer numbness, disorientation, difficulty speaking, vertigo (spinning dizziness), and other stroke-like neurological symptoms. Auras may occur in some people who do not have headaches.
HOW PREVALENT ARE MIGRAINES?
Migraines afflict around three times more women than males and may impact more than 12% of the adult population in the United States. Migraines are typically passed down through families and can begin as early as elementary school, but most commonly in early adulthood. They usually fade away later in life, but they can occur at any moment. Migraines are the most frequent underlying cause of debilitating chronic, daily headache pain and the most prevalent cause of recurrent, disabling headache pain. While migraines are the most common cause for patients to see a neurologist, the majority of instances are treated by general care physicians.
WHAT TRIGGERS A MIGRAINE?
1. Alcohol
2. Weather changes
3. Hunger
4. Lack of sleep
5. Dehydration
6. Menstruation
HOW ARE MIGRAINE DIAGNOSED?
Despite their severe symptoms, migraines are virtually seldom the result of an underlying issue that may be detected by testing, including brain MRIs. Many doctors do not advocate brain imaging, even in severe situations, if the patient's symptoms are characteristic of migraines and a complete neurological evaluation is normal.
There are exceedingly uncommon families that suffer from migraines as a consequence of a single genetic mutation in one of four known genes, a disease known as familial hemiplegic migraine. For the great majority of patients, there are no genetic testing available. Because the illness cannot be identified by a scan or blood test, the diagnosis is "clinical," which means it is made by an expert physician.
HOW ARE MIGRAINES TREATED?
Migraines that are severe, frequent, or accompanied by neurological symptoms are best managed prophylactically, often with a combination of dietary modifications, lifestyle changes, vitamins, and daily prescription medicines. The bulk of our greatest preventative medications are also used for other medical objectives; the majority of them are blood pressure meds, antidepressants, or epilepsy treatments. Individual headache episodes are best treated as soon as possible, frequently with one or more of the following medications: triptans, nonsteroidal anti-inflammatory medicines (NSAIDs), anti-emetics (anti-nausea), and, in rare cases, opioids or steroids.
Migraines usually last a few hours to a few days and react favourably to certain therapies. However, in other individuals, the migraine is extremely intense and long-lasting ? and may even become chronic, recurring on a weekly, monthly, or even yearly basis. Intermittent migraines, if mismanaged or ignored, can basically develop into a persistent daily headache, with ongoing and smouldering symptoms that occasionally erupt into a "full-blown" migraine. This is a very tough problem to cure.
Other individuals may experience more frequent headaches as a result of overuse of their short-acting headache medicines. See Medication Overuse Headache for more information. While migraines are classified as primary headaches since there is no known underlying cause, they are linked to an increased risk of stroke, brain scarring as observed on MRI scans, a heart defect known as a patent foramen ovale (PFO), and other medical problems.
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