Know more about Migraine

A migraine is a medical condition which usually causes a pounding, throbbing headache on one side of the head. The pain may be very bad and hurt so much that a person may have a hard time doing anything. While most people who have migraines get a headache, not everyone does. There are different kinds of migraines and some do not cause a headache but do have other symptoms.

Most migraines cause a headache and nausea and might make the person dizzy or very sensitive to bright lights or loud noises. Some people have "auras" before a migraine starts, which means their ability to see becomes different. They may see funny patterns, have blurry vision, or may not be able to see at all. Other senses can change before or during a migraine, and the person may sense funny smells or tastes. Migraines can last a long time. Most migraines only last about 4 hours. Some can last up to 72 hours.

The exact causes of migraines are not known for sure. People used to believe that the main cause of migraines were unusual things in the blood vessels in the brain. However, now people believe that migraines start with a problem in the central nervous system. When this problem is triggered by various factors it sets off a cascade of neurological and biochemical reactions. Among these are reactions that disturb the trigeminal nerve. This nerve is the largest nerve in the head (cranial nerve) and the blood vessels (vascular system) which supply blood to the brain.

It can be of two types and many subtypes. The main two types are aura and without aura

Migraine withAura Phase: Strange Sensations Arise About 1 in 5 people with migraine develop an "aura" that begins before the headache or starts along with it. An aura may not occur with every headache.

An aura can include:

Changes in vision. Often visual symptoms begin first during the aura phase. During a migraine you may experience these vision changes:

• A flickering, jagged arc of light. This may take a complicated shape. It usually appears on the left or right side of your vision. Over a few minutes, it may spread in size.

• An area of vision loss. This problem combined with the flickering lights can make driving or focusing your eyes on small objects difficult.

• "See" images from the past or hallucinations.

These symptoms may continue to grow more severe over the next several minutes.

Skin sensations. This part of the aura may cause tingling or "pins and needles" sensations in the body. It may also cause numbness. These feelings often affect the face and hands but can spread out across the body. The sensations may continue to expand over the next several minutes.

Language problems. During the aura phase of a migraine, you may have trouble communicating with others. Symptoms may include:

• Difficulty expressing thoughts while speaking or writing

• Trouble understanding spoken or written words

• Confusion

• Trouble concentrating

Migraine with aura

Acephalgic migraine also called a silent migraine is a kind of migraine with aura but without the head pain. This type of migraine usually starts sometime during middle-age, which is after a person is 40 years old, and becomes more common as a person gets older. Unlike other migraines, males have acephalgic migraines more often than females do.

Basilar-type migraine is a type of migraine with aura that causes headache usually in the occipital region of the brain with neurological symptoms that is believed to come from the brainstem, occipital cortex, and cerebellum and/or affects both hemispheres of the brain at the same time. Most people who have basilar-type migraine also experience migraines with aura without the basilar symptoms. This type of migraine usually more common in people under age 20 and young females.

Familial hemiplegic migraine (FHM) is a type of migraine with aura that also may cause paralysis on one side of the body. When the migraine stops, the person can move normally again.

Retinal migraine has repeated times of vision loss in one eye, that may happen before or during a headache. People who have retinal migraines usually have a history of having one of the other more common types of migraine.

Migraine without aura

Menstrual migraine or catamenial migraine is a type of migraine that happens perimenstrually, which means around the time of menstruation during a woman's monthly menstrual cycle. Menstrual migraine is usually a migraine without aura, but sometimes a menstrual migraine with aura happens. About 7%-14% of women have migraines exclusively at the time of menstruation. These are considered true menstrual migraines. Most female migraneurs experience migraine attacks at all times during the menstrual cycle, with an increased number perimenstrually. These are referred to as menstrually related or menstrually triggered migraine. Both true menstrual migraines and menstrually related migraines are categorized under menstrual migraine.

Estrogen is a hormone that is mostly made in a woman's ovaries. There are three types of estrogen: estrone, estradiol and estriol. In women who have migraines it is usually connected with their menstruation cycle. About 60% of women have these menstrual or menstrually-related migraines and the main trigger is believed to be reduced circulating estrogen levels, i.e. the amount of estrogen in the body, specifically estradiol. In some cases, fluctuation (going up and down) in the amount of circulating estrogen levels may trigger a migraine, i.e. not only too little but sometimes too much estrogen may trigger a migraine.

Risk factors

Gender: Women are three times more likely to have migraine headaches than men.

Family history: A person has more of a chance of getting migraines if one of their parents has had them. The International Headache Consortium are doctors from a lot of different countries who study headaches and what causes them. They have found four genetic variations - these are differences in a person’s genes - that are risk factors for migraine without aura in people who have these differences. Two of these genetic variations had already been shown to play a role in migraine with aura. Hormonal changes

Obesity: has shown to be a risk factor for chronic migraine not episodic migraine.

Triggers

Dietary habits: fasting, dehydration, or skipping meals.

Diet: Eating certain foods such as those that contain tyramine which is found in certain foods and is the end result of the natural breakdown of the amino acid tyrosine. Various food contain tyramine such as aged cheeses, smoked fish, some kinds of beer. Tyramine as a trigger for migraine is thought to effect less than 10% of people with migraines.