Migraine

Migraine Pain

A migraine is characterized as an intermittent pulsative pain on one side of the head. While migraine is a fairly common symptom, which affects women more so than men. The onset of migraines usually occurs in early adulthood, and rarely after 40 years of age.

Factors which may trigger to the onset of a migraine spell include:

• Extreme emotion
• Stress
• Fatigue
• Menstruation
• A sudden change in climate
• Overeating
• Eating certain foods such as, chocolate, eggs, pork, fish, crustaceans, watermelon etc

Migraine Symptoms

Migraines may be accompanied by symptoms such as:

• Photosensitivity
• Enhanced sensitivity to sound
• Nausea
• Vomiting

Types of Migraine

Migraine is further divided into specific types, including:

• Migraines with aura
  (an aura is a sort of warning sign before the headache, the patient sees flashing lights)
• Migraines without aura

Aura and other symptoms may be experienced without a headache developing.

Migraines with Aura

In cases of migraines with aura, the prodromal phase (relating to or denoting the period between the appearance of initial symptoms and the full development of the headache).

Symptoms appearing 24 to 48 hours in advance:

• The patient becomes silent
• The patient may become silent
• The patient may become irritable or excited at the same time
• At times the patient may experience a lack of appetite, or a sudden increase in appetite
• At times the patient experiences diarrhea or constipation
• The patient may experience insomnia, or difficulty falling asleep, or in the contrary become somniferous

Symptoms appearing 2 to 3 hours in advance:

• Most often visual disruptions occur.
• The patient may see bright yellow stains with red and green tinges in one eye. These dark marks appear to move to and from the patient (scotoma).

Migraines without Aura:

• The development of a headache is the main symptom.
• This pain is usually limited to only one side of the head (hemicranial pain)
• After a few hours following the onset of the headache, the pain spreads over the entire head
• The pain is throbbing, pulsating
• The patient is extremely photosensitive, and extremely sensitive to noise
• The patient usually appears pale
• At times, the patient appears bloodshot
• At times, the patient experiences nose bleeding
• At times, the patient experiences excessive
• At times, the patient may experience watery eyes
• At times, the patient may experience shivering, cold sweats
• At times the patient may experience a loss of equilibrium, so-called ‘spinning’ vertigo

Migraines can last from a few hours to 72 hours. The interval between migraines differs from patient to patient, ranging from 2 to 3 weeks, every 2 weeks, every month, etc. Migraines may also occur in women, as part of the premenstrual syndrome.

Treatment

Treatment of migraines:

• Painkillers – medicine that can be usually acquired over the counter, such as ibuprofen or paracetamol.
• Triptans – medications that may help reverse the changes in the brain that may cause migraines.
• Anti-emetics – medications often used to reduce vomiting or nausea.

Prevention

Prevention of migraines:

• Elimination of stress factors
• Avoiding the previously mentioned types of food
• Limiting the consumption of caffeine and alcohol
• Maintaining a healthy, balanced diet, and a healthy lifestyle, including regular exercise and sleep.

Especially in female patients, migraine attacks occur less frequently with the passage of time.

Doctor's Advice

It is helpful for patient to understand that migraine is an inherited tendency headache; that migraine can be modified and controlled by lifestyle adjustments and medications, but it can not be eradicated.

Most patients benefit by the identification and avoidance of specific headache triggers.

What is Helpful?

A regulated lifestyle is helpful, including:

• A healthful diet
• Regular exercises
• Regular sleep patterns
• Avoidance of the excess caffeine and alcohol
• And also avoidance of acute changes in stress levels.

Techniques that are Helpful

Since the stresses of everyday living can not be eliminated,various techniques are helpful for many patients.

These may include:

• Yoga
• Transcendental meditation
• Hypnosis

Migraine Therapy

Migraine therapy should be used as soon as possible after the onset of an attack. When all fails, simple putting the patient to sleep can solve the problem at least temporarily.

Benzodiazepins are used among other options to facilitate sleep.

Preventive Therapies

Preventive therapies include:

• Botox injections
• Neuromodulation non invasive: Cephaly,Vagus nerve stimulation
  Invasive: Sphenopalatine ganglion stimulation.

Food Trigger to Migraine

Many food triggers may be not potent enough to cause migraine alone, but in combination with other partial triggers, a patient may be pushed over their personal migraine threshold and experience episodic or continuous symptoms.

Patient with migraine should be encouraged to reduce known migraine food triggers in their diet such as:

• Banana and peanuts have unknown causes of chemical provocation of migraine.

General Groups of Food Triggers

Food triggers of migraine fall into three general groups:

1. Food that contain complex products of food ageing and fermentations:
   • Wines
   • Aged cheese
   • Yogurt
   • Fresh baked bread
   • Aged meats
   • Avocado
   • Buttermilk
   • Beef jerky
   • Breadcrumbs
   • Broad Italian beans
   • Caviar
   • Chicken livers
2. Food that contain chemicals and are neurostimolators:
   • Caffeine
   • Chocolate
   • Tyramine in aged cheese, Blue cheese, Brick cheese, Cheddar cheese
   • Protein concentrate
   • Champagne, Heavy alcoholic drinks, Iced tea, Grapefruits and juice, Red vinegar
   • Chinese food, Restorant food
   • Hot dogs, Smoked fish, Sausages, Salami, Sauerkraut
3. Foods to which we have mild or silent allergies or sentivities:
   • Major protein groups such as milk,corn soy and gluten.
     Gluten sensitivity is particularly a common issue with migraine suffers.

Preventive Medicines-Suplemments

For patient with more frequent symptoms it is better to use a daily medicine to reduce the frequency and intensity of symptoms.

The supplements that have the best evidence of effectiveness are :

• Magnesium 200-1200mg daily
• Vitamin B2 500mg daily
• Feverfew 6,25mg daily