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  Migraine

A Migraine is a heading that is severe, debilitating and accompanied by other acute symptoms. Migraine has been classified as a neuron-vascular-muscular condition that is characterized by severe head pain, without stroke, tumor, and head trauma. Accompanying symptoms are hypersensitivity to sound and light (photophobia), nausea and vomiting.

Migraine
Migraine


Symptoms:

Migraines have four phases. Some migraine sufferers experience all four phases, some do not. Some migraine sufferers experience different lengths of time for each phase and the time length may vary from migraine to migraine.

The prodrome phase is the phase that occurs before the onset of the painful migraine headache, it can last hours or days. The prodrome phase occurs in forty to sixty percent of migraine patients. Symptoms for this phase are mood changes – depression, elatedness or irritability, tiredness, stiffness (in neck, usually), constipation or diarrhea, or increased urination. Patients who have repeated migraines will be able to recognize the onset of a migraine attack, by tracking the prodrome symptoms.

The Aura phase is noted in twenty to thirty percent of migraine sufferers. A migraine aura appears gradually from five to twenty minutes and usually lasts less than an hour. An aura may be a visual, sensory, motor manifestation.

The pain phase is the unequivocal, moderate to severe pain that is on either side or both sides of the head. This pain can be aggravated by exercise or physical activity. The onset of a migraine is usually gradual and peaks and then subsides. Adult patients have migraines that last from four to seventy-two hours. Children patients have migraines that last from one to forty-eight hours. The pain phase may be accompanied by a hypersensitive nervous system –that causes migraine sufferers to seek a dark, quiet room. Nausea, blurred vision, sweating, and diarrhea may also be present.

A migraine patient may experience a migraine one or twice in a life time to several migraine attacks per week. Typically, migraine patients experience up to three headaches per month.

The postdrome phase is the phase after the pain has subsided or disappeared completely. This phase is marked by a feeling of exhaustion, irritability and mood changes. Some patients may feel revitalized during this phase. Some patients may have a minor lingering headache with.

There are four types of migraines that: Migraine without aura, Migraine with aura, basilar type migraine, Familial hemiplegic migraine, abdominal migraine and an Acephalgic migraine. The type of migraine present in a patient is defined by the symptoms.

Diagnosis

Diagnosis is made via patient history, physical examination and time. Physicians specializing in headaches are most experienced in diagnosing migraines.

Causes:

Three fourths of all migraine sufferers are female. Ten percent of the world population is diagnosed with migraines and it is believed that five percent are undiagnosed. There is a strong correlation of migraine attacks to hormonal cycling. It was previously believed that migraines were caused by a vascular disorder. Current evidence suggests that migraines are just one many symptoms of a few different disorders of the serotonergic control system. This system of nerves or neurons is capable of releasing serotonin as a neural transmitter at their endings.

According to patients, migraines are a frustrating, chronic disorder. All knowledge of migraines is individualized to the experience of the sufferer. Current thinking is that cortical spreading depression is responsible for migraines. This is depressed neurological activity over an area of the cortex. This causes a release of inflammatory substance the irritates the nerve roots originating in the cranium, more specifically the trigeminal nerve that supplies the sensory systems of the face and head.

The word ‘trigger’ is used to describe any factor that leads to the development of a migraine. Triggers are categorized as behavioral, environmental, infectious, dietary, hormonal and chemical. Many migraine sufferers track their behavior and report at least one dietary, physical or environmental trigger to their physicians.

Treatment:

Current treatment includes a four-fold approach – trigger management, attack-aborting, pain management and prevention. Trigger management and prevention go hand in hand, determining migraine triggers requires logging and journaling headache behaviors along with behaviors prior to the headache onset. Cerebral vasoconstrictor abortive agents are a class of drugs taking during the initial attack of a migraine. They do not work for all migraine sufferers. Pain management includes over the counter pain medication and medication prescribed by a doctor.

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