Migraine

by admin | Aug 11, 2010 | Miscellaneous

What Are Symptoms of a Migraine Headache?

The pain of a migraine can be unilateral or bilateral, and is most often pulsating, pounding, or throbbing in quality. Fifty per cent of migraine sufferers report the onset of migraine pain in the occipital region (back of the head), or even neck pain. Up to  80% of migraineurs may experience posterior pain (back of the head, or even neck pain) before or during an attack.  Regardless of where pain begins, it often settles into a one-sided headache. Often, migraine pain is made worse by routine physical activity, such as climbing stairs. The vast majority of migraine attacks have moderate to severe pain intensity.

How long do migraines last?

The vast majority of migraines last between 4 hours and 72 hours. Rarely, a migraine attack will last longer than three days. This can be an indicator of a more serious problem, and should lead you to seek medical attention. If not treated early, up to 80% of migraine sufferers can develop a highly sensitized pain called allodynia, in which a usually normal level of touch is perceived as painful. While this usually affects the face and head, it can on occasion spread to the upper torso and extremities as well, and migraine sufferers will find it uncomfortable to put up with usual things, like jewelry, eyeglasses, neckties, clothing, hats and similar things.

What are other symptoms of a migraine attack?

There is usually associated avoidance of light (photophobia), sound, or even smell. There is often nausea or loss of appetite. Many migraine sufferers have difficulty thinking or concentrating during an attack. Some experience dizziness, lightheadedness or vertigo. Recent information regarding migraine sufferers indicate that neck pain is present in many migraine attacks, and may be even more common than nausea.

The Warning Phase: Migraine aura and prodrome

About 20% of migraine sufferers report a prodrome, or warning phase, preceding their headaches, consisting of vague symptoms like mood changes, yawning, food cravings, thirst, or excessive urination. This can be brief, lasting a few minutes, or can be prolonged, lasting hours, a day, or longer.

Fifteen to twenty per cent of migraine sufferers sometimes or always have an aura preceding their headaches. Auras are neurologic symptoms, most often affecting vision with spots, colors, sparkles, or vision loss. An aura can also cause stroke-like symptoms like tingling, numbness, or weakness in the face, an arm, or sometimes an entire side. Most migraine auras last 15-30 minutes; some will last up to an hour.  If an aura lasts longer than an hour, and this is not your characteristic aura pattern, it would be prudent to seek medical evaluation. It is also possible to experience the aura phase of the migraine without any headache pain. When this happens, it is still considered a migraine, and is sometimes called acephalgic migraine, which just means migraine without pain.

Other Phases of Migraine

The prodrome phase and the aura phase of migraine are the first two of four possible phases of migraine. In some migraines, the prodrome phase may be brief or subtle, and not everyone realizes they are experiencing a prodrome. Symptoms you’ve always just thought were “part of the migraine” may be prodromal symptoms. The headache phase of the migraine is the obvious phase in which the headache pain and associated symptoms develop. This typically lasts from 4 to 72 hours. Finally, there is the postdrome phase. In the postdrome, you may feel drained, empty, or tired. Some people refer to this as a “migraine hangover.”

Migraine Treatment

You should treat your migraine headache as soon as you begin to feel headache pain. While early treatment of acute migraine attacks is important, trying to treat in the prodrome phase is too early, and there is not yet sufficient study data to recommend treating during the aura phase, although it may help in some people. Treatment of migraine can be abortive, which means taking medication intended to stop the migraine attack, or preventive, in which medication intended to prevent migraine attacks is taken on a daily basis. If abortive treatment has not worked, or not worked well enough, rescue medication can also be used later in the attack.

What Do Pirates and Migraine Sufferers Have in Common?

by admin | Jun 25, 2010 | Miscellaneous

Pirates wore eyepatches not because they had all lost an eye. They did so as a defensive mechanism. When you are in a bright environment and go suddenly into the dark, it takes a while to be able to see. Pirates would patch one eye so that when they were relaxing in the ship’s hold by candlelight or lamplight and suddenly were called up to the decks to fight off intruders, they would be able to see well enough to fight their intended targets. By keeping one eye “in the dark” with a patch, they were always at the ready. (This historical myth has been deemed “plausible” by Mythbusters.)

So what does this have to do with migraine? Migraine sufferers experience photophobia, or the avoidance of light. Specifically, however, most migraine sufferers avoid bright light when they have a migraine headache because exposure to light makes the headache worse.

Why might this be? Dr. Rami Burstein has presented his recent research into this today at the American Headache Society 52nd Annual Scientific Meeting. To really track down this phenomenon, Dr. Burstein studied blind migraine sufferers. The first group studied were migraine sufferers who were totally blind, with no perception of light. Some of these people will still develop migraine aura, and “see” visual images, because these come from the brain. It is, in fact, the only time they are able to see anything. When observed during a migraine aura, their pupils were noted to constrict in response. The second group studied was a group of migraine sufferers who were unable to see visual images but who could still see light. This group included both migraine with aura and migraine without aura, and who had blindness due to a variety of conditions affecting the retina or other parts of the eye. In this group, the effects of light were either unpleasant, or had no effect—unless they were in the midst of a migraine. There was intensification of migraine pain in all with exposure to light. But what was most interesting—and most “pirate-like”—was that there was a long-lasting effect of light exposure. Exposure to light worsened migraine headache pain within 1 to 5 minutes. Retreating to a dark environment to obtain relief took from 5 minutes to an hour. This occurs in sighted persons as well; it was studied in the blind to exclude interference of other visual input.

Dr. Burstein reported a newly identified visual processing pathway from the retina to the thalamus that accounts for this phenomenon. Blogging live from Los Angeles at the American Headache Society meeting.