MIGRAINE

Migraine is a type of headache that is often localized in a certain area of the head and is sometimes accompanied by a pronounced sensitivity to light and sound. Other common migraine symptoms include nausea and vomiting. Migraines are usually gradual in onset, progressively more painful and then undergo a gradual resolution. When migraines are mild to moderate, they are usually described as being dull, deep and steady. When severe, migraines are throbbing or pulsating.


Some migraines are worsened by head motion, sneezing, straining or physical exertion. Since many patients also become sensitive to light and sound, some migraine sufferers will lie down in a darkened and quiet room to relieve symptoms.


More common in women than in men, migraine is a chronic condition, and migraine headaches may occur infrequently or as often as several times a week. Although migraines can begin at any time, the most common time is in the early morning. While migraines can begin during sleep, this is uncommon and must be evaluated to rule out other conditions.


The onset of migraine usually occurs between the ages of 5 and 35. It is treatable but not curable, and it is not considered a life-threatening condition, though rarely a severe migraine may cause a stroke. However, if the headaches are severe and frequent, migraine can have a debilitating impact on a person’s life.


Symptoms and Types of Migraine

Depending on the symptoms, most migraine headaches are categorized as "migraine with aura" (previously called classic migraine) or “migraine without aura” (previously called common migraine).

Migraine with aura begins with certain neurologic symptoms, the most common of which are visual disturbances. The typical visual aura presents as a flickering jagged (or zigzag) line, usually at the side of the visual field. The next symptom in frequency is numbness and tingling of the lips, lower face and fingers of one hand. Some patients experience temporary paralysis on one side of the body. Auras rarely last longer than an hour and are followed by a headache 93 percent of the time.

Migraine without aura has been called common migraine because it has a greater incidence in the population (accounting for 80 percent of cases) and is not preceded by an aura. It may be preceded by mood changes, fatigue, mental fuzziness and fluid retention. In common migraine, the patient also may have diarrhea, increased urination, nausea and vomiting. The common migraine can persist three or four days, depending on treatment.

Either type of migraine may also be accompanied by nasal congestion, runny nose, tearing, and/or sinus pain or pressure. This has sometimes led to the mistaken diagnosis of “sinus headache.” True sinus headache is typically associated with an acute sinus infection, and symptoms often also include fever and thick mucous discharge.

Different Forms of Migraine

Besides the categories of migraine with or without aura, migraines also occur in other forms, such as:

  • Hemiplegic migraine: Marked by temporary paralysis on one side of the body (hemiplegia), impaired vision and vertigo.
  • Ophthalmologic migraine: The pain of this rare type of headache is localized around the eye; the headache may be accompanied by a droopy eyelid and vision problems. It is now thought that this may not actually be migraine, but another neurologic condition entirely.
  • Basilar artery migraine: Occurs mostly in adolescent and young women. It results from a spasm to the basilar artery, a major blood vessel at the base of the brain. Symptoms can include vertigo, impaired vision, poor motor coordination, difficulty speaking or hearing, and altered consciousness.
  • Benign exertional headache: A type of vascular headache triggered by physical exertion, such as running, bending and lifting, or even coughing or sneezing. This headache rarely lasts more than several minutes.
  • Status migrainosus: A rare, sustained and extremely severe type of migraine with pain and nausea so intense that the person may have to be hospitalized.
  • Headache-free migraine: A condition characterized by migraine symptoms, such as visual impairment, nausea, vomiting, constipation or diarrhea, but no headache.

  • Migraine headaches may be precipitated by a variety of factors called “triggers”:
  • Hunger (missed meals)
  • Drinking alcohol (especially red wine)
  • Eating foods containing monosodium glutamate (MSG), or that are high in caffeine (coffee, tea, colas) or nitrates and nitrites (preserved meats), or contain tyramine (aged cheeses)
  • Menstruation or oral contraception use
  • Getting too little or too much sleep
  • Stress in your work and personal life
  • Factors in the environment, such as glaring lights, strong smells, weather changes or high altitude