Migraine headaches are a type of vascular headache that affects 28 million Americans, 75
percent of whom are women 1)
Institute of Health, a good source of general information on migraine headaches.
Annually, migraines cost the American taxpayers $13 billion in missed work and reduced
productivity 1)
Institute of Health, a good source of general information on migraine headaches.
Migraines are not a disorder unique to overworked Americans. In fact, the World Health
Organization identified migraine among the world's top 20 leading causes of disability name="2">2)
articles about migraine headaches. According to the World Health Organization, aside
from the physiological experience of the headache for the individual whom it affects,
there exists the "burden" of the migraine. In particular, this burden includes "the
economic and emotional difficulties that family experiences as a result of migraine" name="2">2)
articles about migraine headaches. According to one report, migraine headaches account
for 1.4% of total years of life lost due to disability in both sexes of all ages name="2">2)
articles about migraine headaches. Despite all this data, migraines are not considered by
many to be a legitimate medical problem.
1)
Migraine headaches, as previously noted, are not unique to Americans, nor are they an
exclusively modern disorder. In fact, there exists a rich body of historical literature that
demonstrates the progression of mankind's knowledge of the headache from the "magical
to the molecular level" 3)
Neurology, provides a historical perspective on topics related to neurology. Five
thousand years ago, Mesopotamian physicians were not in the practice of precisely
diagnosing different types of headaches. This can be attributed to their acceptance of
"supernatural pathophysiologic properties" 3)
Neurology, provides a historical perspective on topics related to neurology. In
particular, they viewed headaches as a disease caused by the evil spirit Tiu. Many of the
treatments used in ancient times were based on dealing with evil spirits. For example in
ancient Egypt, a clay effigy of a sacred crocodile was bandaged to the head of the
sufferer. If this treatment, along with praying, did not bring relief to the sufferer, then
trephination was practiced. This process involved the "releasing of the evil spirit through
a hole gouged in the skull by a trephine" 3)
Neurology, provides a historical perspective on topics related to neurology. The
next step in mankind's evolving knowledge of headaches was the recognition that
particular types of headaches existed.
Hippocrates classified the migraine as a specific kind of headache. Unlike the
Mesopotamians, he did not attribute migraine to evil spirits, but rather to an "imbalance
of natural forces in the body" 3)
Neurology, provides a historical perspective on topics related to neurology.
According to Hippocrates, migraine headaches were caused by the rise of vapors from the
liver to the head. This view of migraine pathophysiology persisted until the 17th century
when Thomas Willis revolutionized thinking about "megrim". More specifically, he
attributed migraine headaches to nerves themselves and to the congestion of blood
vessels, rather than to the ascent of vapors. The recognition that migraine headaches
result from cranial vasodilatation, although not immediately accepted, did eventually lead
to changes in migraine treatment. In particular, treatment involving the opening of the
skull and the use mercury to drain vapors was phased out and replaced by more
pharmaceutically based treatment.
Migraines are unilateral (felt on one side of the head) in about 60% of migraine sufferers,
and the associated pain is typically described as throbbing in nature
name="4">4)
provides information on all types of headaches. Although the brain itself lacks pain
receptors, the meninges (membranes that surround the brain), blood vessels, and bony
anatomy of the head have a complex system of nerve branches that respond to pain
name="8">8)
comprehensive look at migraine headaches. Migraine headaches differ from other types
of headaches in that they are potentially disabling and are associated with various
combinations of symptoms. Severe pain, nausea, vomiting, and sensitivity to light, sound
or odor are only a few of the possible migraine-related symptoms. In fact, nausea occurs
in up to 90% of patients and vomiting occurs in about one third of Migraineurs
name="5">5)
Forest University Baptist Medical Center, lecture notes of a professor at the medical
school. Although the precise step-by -step pathophysiology of migraine headaches is still
unclear, there exists a general consensus that blood flow change in the brain is key to
understanding the origin of migraine headaches. More specifically, it has been suggested
that individuals who suffer from migraine headaches have blood vessels that overreact to
various triggers due to an inherited abnormality in blood vessel regulation
name="1">1)
Institute of Health, a good source of general information on migraine headaches.
According to the current theory on migraines, the nervous system responds to a trigger
such as stress by creating spasms in the nerve-rich arteries at the base of the brain. These
spasms constrict several arteries and result in a reduction in the amount of blood flowing
to the brain. At the same during which this vasoconstriction is occurring, platelets, blood
clotting factors, clump together in a process that promotes the release of the
neurotransmitter serotonin. Serotonin serves to further constrict arteries and reduce blood
and oxygen to the brain. In response to the reduced oxygen supply, the trigeminal nerve
stimulates specific arteries around the brain dilate. The vasodilatation spreads and
eventually affects the neck and scalp arteries. The dilation of these arteries triggers the
release of pain producing chemicals called prostaglandins. These in turn activate specific
blood cells and cause them to release substances that cause inflammation, swelling and
sensitivity to pain. These physiological changes serve to stimulate pain-sensitive
nociceptors and result the throbbing pain that is commonly associated with migraines.
1)
Institute of Health, a good source of general information on migraine headaches
Migraine is a genetically based disorder. According to one study, individuals who have
one parent who is a Migraineur have a 50% chance of having migraine headaches
name="6">6)
suffer from migraine headaches. At least 7 genes contribute to the events that lead to
migraine headaches 5)
Forest University Baptist Medical Center, lecture notes of a professor at the medical
school. One of these genes, located on chromosome 19, has recently been implicated in
familial hemiplegic migraine, a severe form that is coupled with paralysis
name="6">6)
suffer from migraine headaches. Not all migraines are associated with paralysis. As
such, it is important to distinguish between the migraine subtypes. In particular, there are
four main migraine subtypes?migraine without aura, migraine with aura,
opthalmoplegic migraine, and retinal migraine. Of these, the two most common subtypes
are migraine with aura and migraine without aura.
Migraine with aura, also known as a classic migraine, is one in which an aura occurs 20
to 40 minutes before the headache starts 7)
School. An aura is a single symptom or set of symptoms that a Migraineur experiences
prior to the onset of a headache. The aura may consist of visual disturbances, numbness
in parts of the body, motor weakness, dizziness, vertigo, abdominal symptoms, ringing in
ears, speech disturbance, and/or olfactory hallucinations. The most common auras are
visual and involve flashing lights, wavy lines, or brief vision loss. The end of the aura
marks the beginning of a throbbing or pulsating headache on one side of the head. The
headache may be accompanied by the previously mentioned symptoms of nausea,
vomiting, sensitivity to light (photophobia), or sound (phonophobia), and it may spread to
both sides of the head 7)
School. The duration of the headache can vary from one hour to one to two days.
Migraine without aura, also known as a common migraine, affects a larger number of
patients than the classic migraine. Individuals who suffer from common migraines have
the same headache as those who suffer from a classic migraine. However, they do not
experience the very obvious warning sign of an aura.
Beyond the physiological and genetic underpinnings of the disorder, migraine headaches
are brought about by various trigger mechanisms. Trigger mechanisms fall into two main
categories: uncontrollable and controllable 6)
suffer from migraine headaches. Triggers vary amongst individuals, and they often work
in combination. Controllable triggers include foods, certain activities, and medications.
Uncontrollable triggers relate to environmental stimuli. Factors related to emotional
well-being can also act as triggers, and can not be classified by controllable vs.
uncontrollable dichotomy. Common triggers include:
-Food- caffeinated foods and beverages, alcohol, dairy products, monosodium
glutamate (MSG), soy sauce, garlic, certain fruits, smoked meats
-Emotions- stress, anger, depression, anxiety, and sudden excitement
-Environmental stimuli- sudden changes in temperature, barometric pressure, or
altitude; strong odors (especially perfumes); loud noises; bright lights or glare
-Activities- riding in a car, plane; intense exercise; changes in sleep patterns;
skipping a meal
-Medications- vitamin supplements, nonprescription pain relievers, certain medicines
for high blood pressure and heart disease, certain birth control pills and hormone
supplements 7)
Medical School
Migraine is a disorder that leads to the heightening of one's senses, and as a result a
Migraineur is more sensitive to his or her environment 6)
suffer from migraine headaches. For example, it is known that weather patterns serve as
trigger for migraines in many patients. A recent study entitled "The Effects of Weather
on the Frequency and Severity of Migraine Headaches" concluded that: "wind from the
southeast was shown to be associated with more attacks than wind from any other
direction" 6)
suffer from migraine headaches.
Another very common uncontrollable trigger amongst women is the menstrual cycle.
Migraine often develops around the time of the first menstrual period, menarche, and is
related to falling levels or reduced availability of estrogen 6)
suffer from migraine headaches. In fact, a recent study involving female students at
Belgrade University found that both migraine and nonmigraine headaches were worse
during menstruation 2)
articles about migraine headaches. In addition, researchers found that both types of
menstrually related headaches occurred around the first day of menstruation. These
findings suggest that menstrual migraines occur during peak fluctuation in estrogen
levels. This relation of migraine to menstruation occurs in only 14% of women sufferers
4)
provides information on all types of headaches. In fact, in 60% of women there is no
definitive association between the two 4)
provides information on all types of headaches. In addition, other hormonally related
events?pregnancy, breastfeeding, and menopause?are also linked with changes in
headache frequency and severity 4)
provides information on all types of headaches.
The use of medication to treat migraine can be divided into two categories: abortive
treatment and prophylactic or preventive treatment 8)
comprehensive look at migraine headaches. Medications used to treat acute migraines
include analgesics, serotonin, receptor medications, triptans, ergots and antiememtics.
Preventive treatment includes the usage of beta-blockers, antidepressants, valproate, and
calcium channel blockers.
I am a Migraineur. I suffer from the classic migraine. My aura involves visual
disturbances. Specifically, everything in my field of vision becomes incredibly bright,
and then dark. My migraines always lead me to experience the symptoms of throbbing
pain, nausea and vomiting. Vomiting is more often, than not followed by fainting. An
hour or two later I wake up from these episodes physically exhausted. Fortunately, I've
never experienced migraine symptoms for longer than a few hours.
I started getting my headaches at a very young age. In fact, I have vivid elementary
school memories of having to go to the nurse's office, and wait for my mother as the pain
in my head grew unbearable. My mother is a Migraineur as well. As such, she had
plenty of helpful tips on how to deal with the disorder. Over the years, I've noticed many
changes in the triggers and in the frequency of my migraines. In particular, as a child the
consumption of certain dairy products often led me to experience migraines. Today, I
don't react the same way to dairy products, but skipping meals, standing outside in the
sunlight, and changes in barometric pressure remain as primary migraine triggers for me.
Although I still have the occasional random migraine, my migraines are less frequent and
tend to cluster around the days of my menstrual cycle. I feel as though I finally have the
vocabulary to understand my disorder, and as such, I feel empowered to overcome it.
References
Institute of Health, a good source of general information on migraine headaches
2)
articles about migraine headaches
3)
Neurology, provides a historical perspective on topics related to neurology (3)
4)
provides information on all types of headaches
5)
Forest University Baptist Medical Center, lecture notes of a professor at the medical
school
6)
suffer from migraine headaches
7)
School
8)
comprehensive look at migraine headaches
| Forums | Serendip Home |
Send us your comments at Serendip
© by Serendip 1994-
- Last Modified:
Wednesday, 02-May-2018 10:53:07 CDT