Nervous System
Migraine

​​​Abstract:

  • A common health condition, causing bouts of severe headaches with a feeling of pulse in the head.
  • Migraine episodes can cause severe pain for hours or days.
  • Symptoms usually develop over approximately five minutes and last up to an hour.
  • Many effective treatments are available to reduce symptoms and prevent additional headache episodes.
  • There is no way to prevent it, but some tips may help reduce the number and severity of episodes.
Overview:
It is a common health condition, usually beginning at an early age, where it causes episodes of severe headache with a sense of pulse in the head accompanied by nausea, vomiting, excessive sensitivity to light and sound with the inability to continue daily duties and activities. It is usually on one side, and migraine episodes could cause severe pain for hours or days. 

Types:
  • Migraine with alert (focal or classic headache); there are specific warning signs before it starts (e.g. seeing flashing lights).
  • Migraine without alert (common migraine); it occurs without specific warning signs, lasts longer, and affects daily activities.
  • Migraine alert without a headache (silent migraine); you experience an alert or a sign, but a headache does not occur.
Names:
Migraine, pathological headache.

Cause:
Although its causes are unknown, it may be the result of abnormal activity that temporarily affects the nerve and chemical signals or blood vessels in the brain.
Symptoms:
  • Severe headache on one side of the head with a pulse sensation, worsening when moving
  • Pulse around the eyes and in the head
  • Nausea or vomiting
  • Sensitivity to light and sound
  • Weak concentration
These symptoms usually last anywhere between four hours and three days
Alert symptoms:
  • Vision issues (e.g. seeing flashing lights or blind spots)
  • Numbness in hands
  • Feeling dizzy or imbalanced
  • Difficulty speaking
  • Loss of consciousness
These symptoms usually develop over approximately five minutes and last up to an hour. Some may also experience alert symptoms with mild or without headache.
Migraine triggers:
  • Hormonal changes in women, especially when estrogen is low as well as before and during the menstrual cycle
  • Pregnancy or menopause
  • Some medicines (e.g. vasodilators) or hormonal drugs (e.g. contraceptives)
  • Some foods (e.g. salty and processed) as well as some types of cheese and meat
  • Fasting
  • High-caffeinated beverages or caffeine abstinence for those who regularly consume it
  • Psychological stress and fatigue
  • Sensory stimuli (e.g. bright lights, sunlight, loud sounds or strong smells)
  • Sleep disturbances
  • Strong physical exertion
  • Changes in weather or air pressure
Risk factors:
  • Family history.
  • Age: it often occurs during adolescence. 
  • Gender: women are at higher risk than men.
When to see a doctor?
When you are constantly experiencing signs and symptoms of migraine episodes, or when you notice the following:
  • Sudden and severe headache (e.g. thunderclap)
  • Headache accompanied by fever, stiff neck, double vision, weakness, numbness or difficulty speaking
  • Headache after head injury
  • Chronic headache after making an effort (e.g. cough or sudden movement)
These symptoms may also be a sign of a more serious condition.
Diagnosis:
  • Medical history: A detailed history of headache (e.g. how often they occur, how severe is the pain, the symptoms associated with it) and how it affects daily activities
  • Family history
  • Clinical examination
  • Other tests, including MRI scans
Treatment:
Many effective treatments are available to reduce symptoms and prevent additional headache episodes, including:
  • Medications either to relieve symptoms during an episode or even to completely abort them, or preventive medications taken regularly. The patient may be advised to use both types. 
  • Rest while keeping eyes closed in a quiet, dark room, and going to sleep.
  • Placing a cool cloth or ice on the forehead or behind the neck.
  • Avoiding migraine triggers.
Prevention:
There is no way to prevent it; however, some strategies may help reduce the number and severity of migraine episodes, including:
  • Making sure to eat regularly and do not skip mealtimes;
  • Taking enough rest on a regular basis while avoiding staying up late;
  • Exercising regularly.
Guidelines for people with migraine:
  • Do not take too many analgesics;
  • Maintain a healthy lifestyle;
  • Limit the intake of caffeine;
  • Reduce and manage stress;
  • Get sufficient rest;
  • Exercise regularly;
  • Avoid the migraine triggers;
  • Make sure the sleeping environment is comfortable by keeping devices away from the bed.
FAQ: 
  • What is the difference between a migraine and a sinus headache?
    • Migraine symptoms do not occur with sinus headaches; sinus headaches often affect the front of the head, with the possibility of pain on both sides of the face along the nose, especially when pressed. 
  • Is migraine a genetic disease?
    • It is not a genetic disease, but it is more common in some families than others.
  • Is Botox efficient as a temporary remedy for migraine episodes?
    • Yes, Botox has recently been proven as a new, effective treatment of migraine.
  • Is there a link between migraine and winter?
    • Migraine episodes may increase in winter, especially with those with sinus problems

Clinical Education General Department
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