Migraine is a chronic disease that manifests itself in periodic attacks of severe, often one-sided headaches.
A characteristic feature of pathology is the absence of organic causes for its occurrence, such as trauma, tumors, circulatory disorders, etc. The attack can last from 2-3 hours to 2-3 days, during which the patient often becomes almost helpless since any movement contributes to increased pain.
According to statistics, at least every tenth person on the planet suffers from migraines.
Women get sick about twice as often as men. It is associated with cyclical hormonal changes during the menstrual cycle. Usually, the disease makes itself felt up to 30-35 years old; cases of pathology in childhood are known.
What causes migraines?
The biomechanism of the development of the disease is not precisely known. There are several theories about the causes of migraine and associated symptoms, the most popular of which is neurovascular. According to this point of view, migraine begins against the activation of the trigeminal nerve nucleus, which causes spasm and then expansion of the cerebral vessels. As a result, the tissues around the arteries become swollen, leading to pain and becoming a headache cause. Moreover, the pathological process is associated with impaired serotonin metabolism.
Some scientists believe that pain occurs exclusively against the background of a sharp spasm and subsequent relaxation of the vessels, resulting in tissue edema. It has been unequivocally proven that the risk of developing the disease is significantly higher in women and in people whose parents or close relatives also suffered from migraines.
Causes headache to appear
Migraine occurs against the background of the action of various external and internal causes, each of which can cause another attack:
- Mental and psycho-emotional stress.
- Constant severe stress.
- Sleep disturbances, lack of rest at night.
- Chronic overwork (mental and physical).
- Previous head injuries (even many years ago).
- Excessive physical activity for a particular person.
- Hormonal surges: puberty, menstruation, pregnancy.
- Eating foods containing tyramine (chocolate, coffee, citrus fruits, nuts, cheese, smoked meats).
- Drinking alcohol, especially low alcohol drinks.
- Sharp fluctuations in atmospheric pressure, drop in air temperature.
- Overexertion of the senses, for example, harsh sound, bright light, strong unpleasant odor, etc.
- Staying in a hot or stuffy room, etc.
Each person has their headache causes. Most of them can be calculated, and in the future, if possible, avoided.
Symptom of migraine
A migraine attack follows a standard scenario, which consists of several sequential stages.
- Initial stage. A person’s mood begins to change, yawning and drowsiness appear, or, conversely, insomnia. Some people report sensitivity to noise and glare. Sometimes there is a slight numbness in one of the hands. For most patients, these symptoms are enough to know a full-fledged migraine attack is on the way. The initial stage lasts from several hours to several days; symptoms of migraines are not present in all patients.
- Aura. It occurs against the background of spasms of the vessels of the brain. It often manifests itself in visual disturbances, like flashes in the form of spots, zigzags or lightning in front of the eyes, distortion of the contours of objects, or loss of specific fields of vision. Less often, there are taste or hearing disorders, problems with coordination of movements, etc. Aura is not observed in all patients.
- Migraine attack. In most cases, it manifests itself as a one-sided headache that is pulsating in nature. It starts with a bit of discomfort and gradually gains strength, becoming simply unbearable. Movements, changes in body position, bright lights, and loud sounds intensify the sensations, which is why patients try to spend this time lying in a darkened room. Against the background of a headache, many patients experience nausea, vomiting, soreness in the muscles of the neck and shoulders, nasal congestion, lacrimation, chills, and even fever. The duration of the attack is individual and ranges from 2-3 hours to several days.
- Resolution stage. At this time, the headache goes away on its own or after taking medications. Many patients fall asleep first, but within 24 hours after an attack, they may feel weak, lethargic, dizzy, and depressed. Also, symptoms of migraines such as increased sensitivity to light, sounds, and smells do not go away immediately. Less common is the opposite type of resolution stage, in which patients note increased activity.
Types of pathologies migraine
Most often, migraines are classified according to the presence of an aura and its type. The following types of disease are distinguished:
- A classic migraine before an attack of pain occurs a typical aura with visual, auditory, olfactory, and other disorders.
- Migraines without aura symptoms appear suddenly against the background of relative well-being; the rest of the clinical picture is typical for the disease.
Depending on the predominant symptoms of migraines, the following types of migraine are distinguished:
- Ophthalmic is accompanied by classic visual disturbances of glare, flickering, and flare in specific areas of the visual fields.
- The retinal disease manifests itself as complete or partial loss of vision in one eye due to impaired blood circulation in the retinal vessels.
- Ophthalmoplegia is manifested by double vision, visual distortions, and drooping of the eyelid.
- Basilar is accompanied by dizziness, ringing in the ears, unsteadiness when walking, and blurred speech.
- Hemiplegic is characterized by loss of sensation and disorder of motor function of one of the arms or arms and legs on one side.
- Cervical occurs against a background of impaired blood flow in the vertebral arteries and is accompanied by a very severe headache.
- Apathetic pain is accompanied by speech impairments, as in stroke.
- Abdominal additionally manifests itself as severe pain throughout the abdomen, diarrhea, nausea, and vomiting. This form is prevalent in children.
- Status migraine is a serious condition in which two or more attacks occur in a row with less than 4 hours between them. This type also includes pain that lasts more than three days. Against the background of a migraine status, the patient develops repeated vomiting, which does not allow them to eat, drink, and take medications usually.
The most challenging condition in terms of complications is migraine status. Due to constant vomiting, the patient begins to suffer from dehydration, which can lead to the development of severe pathology:
- Cerebral edema.
- Myocardial infarction.
In this regard, patients who have a suspicion of migraine status are necessarily hospitalized.
Diagnosis of migraine
The patient’s headache has characteristic features that can immediately indicate symptoms of migraines. The doctor uses the following methods to diagnose:
- Collection of complaints and anamnesis to find out the nature of the pain. Particular attention is paid to:
- The time of the beginning and the end of the attack.
- Provoking factors.
- The nature of the pain.
- The absence or presence of an aura and its symptoms.
- Feelings after an attack.
- A detailed neurological examination to determine the quality of reflexes, motor function, and sensitivity.
- X-ray of the sella turcica to detect possible tumors.
- Duplex examination of the vessels of the neck and brain. Allows excluding vascular causes of headache, for example, atherosclerotic plaques narrowing the lumen of the artery.
- Ophthalmological examination with obligatory fundus examination.
- Magnetic resonance therapy or computed tomography of the brain with contrast.
- Magnetic resonance therapy of the cervical spine.
- General analysis of blood and urine.
- Ultrasound examination of the abdominal organs in the abdominal form of the disease.
- Determination of the level of the main hormones.
- Research of allergic status.
For the relief of migraine attacks, combined analgesics, acetylsalicylic acid, non-steroidal anti-inflammatory drugs, and special drugs, mainly from the group of triptans, are used today.
If you feel that an attack is imminent, you cannot wait. Be sure to take the medication your doctor has prescribed and try to limit the factors that aggravate the attack as much as possible.
It is essential to learn to recognize an impending migraine to reduce the number of attacks.