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MIGRAINE

Migraine

Migraine is a prevalent neurological condition characterized by recurrent headache attacks, often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. It affects approximately 25% of women and 8% of men at some point in their lives, typically manifesting first in childhood or early adulthood. The frequency and severity of migraine attacks vary among individuals, ranging from occasional episodes to frequent debilitating attacks.

Types and Symptoms of Migraine

Migraine Attack without Aura (Common Migraine)

  • Headache Characteristics:

    • Typically unilateral, localized to the front or side of the head, though it can be bilateral or diffuse.

    • Described as throbbing or pulsating in nature, often exacerbated by head movements.

    • Onset may occur at any time of day, gradually intensifying over 2-12 hours before gradually subsiding.

  • Associated Symptoms:

    • Nausea and vomiting.

    • Sensitivity to light (photophobia) and sound (phonophobia).

    • Additional symptoms such as food aversion, blurred vision, poor concentration, nasal congestion, abdominal discomfort, sweating, or scalp tenderness may also occur.

Migraine Attack without Aura (Classic Migraine)

  • Aura Symptoms:

    • Precede the onset of headache, typically lasting a few minutes to an hour.

    • Visual disturbances, such as blind spots, flashing lights, or zigzag lines.

    • Sensory symptoms, including numbness, tingling, or weakness in one side of the body.

    • Speech difficulties or language disturbances.

    • Other sensory or motor phenomena, such as olfactory hallucinations or feelings of well-being.

Diagnosis of Migraine

Migraine is primarily diagnosed based on clinical symptoms and history. There are no specific diagnostic tests for migraine. A thorough evaluation by a healthcare provider, coupled with an examination ruling out other potential causes of headache, is usually sufficient to establish a diagnosis of migraine.

Understanding Migraine Pathophysiology

The exact cause of migraine remains elusive, though current understanding implicates alterations in brain chemistry and neuronal activity. It was previously thought to involve vascular changes, but emerging research suggests a complex interplay of neurochemical and genetic factors contributing to migraine pathophysiology.

Understanding Migraine Pathophysiology

Medication

  • Analgesics: Paracetamol or aspirin may provide relief if taken early in the attack.

  • Anti-inflammatory Agents: Ibuprofen or aspirin may be more effective than paracetamol for migraine relief.

  • Triptans: Prescribed for moderate to severe migraines, triptans help alleviate pain and associated symptoms by constricting blood vessels and inhibiting pain pathways in the brain.

Injections

  • Occipital Nerve Block: Injection of local anesthetics and steroids around the occipital nerves can provide relief for chronic migraines.

  • Sphenopalatine Ganglion Block: Used to alleviate headache pain by blocking pain signals in the sphenopalatine ganglion.

  • BOTOX® Injections: Approved for chronic migraine prevention, BOTOX® injections reduce the frequency and severity of migraine attacks by targeting specific neurotransmitters involved in pain signaling.

Lifestyle Modifications and Preventive Strategies

  • Identifying Triggers : Recognizing and avoiding migraine triggers, such as certain foods, stress, or hormonal fluctuations, can help reduce the frequency of attacks.

  • Regular Sleep Patterns: UEstablishing consistent sleep schedules and practicing good sleep hygiene can mitigate migraine frequency.

  • Dietary Changes: Adopting a balanced diet rich in fruits, vegetables, and whole grains while minimizing consumption of trigger foods may aid in migraine management.

  • Stress Management: Stress reduction techniques, such as meditation, yoga, or deep breathing exercises, may help alleviate migraine symptoms.