What is Migraine ?
Migraine is a form of vascular headache.Migraine headache is caused by vasodilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibers that coil around the large arteries of the brain. Enlargement of these blood vessels stretches the nerves that coil around them and causes the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.Migraine attacks commonly activate the sympathetic nervous system in the body. The sympathetic nervous system is often thought of as the part of the nervous system that controls primitive responses to stress and pain, the so-called "fight or flight" response, and this activation causes many of the symptoms associated with migraine attacks; for example, the increased sympathetic nervous activity in the intestine causes nausea, vomiting, and diarrhea. The best neurologists in India for the treatment of migraine or headache are Dr Reena Thukral and Dr. Vikas Sharma at GNH Hospital Gurgaon
Symptoms of Migraine Headache
Migraine is a chronic condition with recurrent attacks. Most (but not all) migraine attacks are associated withheadaches.
- Migraine headaches usually are described as an intense, throbbing or pounding pain that involves one temple. (Sometimes the pain is located in the forehead, around the eye, or at the back of the head).
- The pain usually is unilateral (on one side of the head), although about a third of the time the pain is bilateral (on both sides of the head).
- The unilateral headaches typically change sides from one attack to the next. (In fact, unilateral headaches that always occur on the same side should alert the doctor to consider a secondary headache, for example, one caused by a brain tumor).
Diagnosis of Migraine Headache
Migraine headaches are usually diagnosed when the symptoms described previously are present. Migraine generally begins in childhood to early adulthood. While migraines can first occur in an individual beyond the age of fifty, advancing age makes other types of headaches more likely. A family history usually is present, suggesting a genetic predisposition in migraine sufferers. The examination of individuals with migraine attacks usually is normal.
Patients with the first headache ever, worst headache ever, a significant change in the characteristics of headache or an association of the headache with nervous system symptoms, like visual or hearing or sensory loss, may require additional tests to exclude diseases other than migraine. The tests may include blood testing, brain scanning (either CT or MRI), and a spinal tap.
Treatments for Migraine Headache
Therapy that does not involve medications can provide symptomatic and preventative therapy.
- Using ice, biofeedback, and relaxation techniques may be helpful in stopping an attack once it has started.
- Sleep may be the best medicine if it is possible.
Preventing migraine takes motivation for the patient to make some life changes. Patients are educated as to triggering factors that can be avoided. These triggers include:
- avoiding certain foods especially those high in tyramine such as sharp cheeses or those containing sulphites (wines) or nitrates (nuts, pressed meats).
Generally, leading a healthy life-style with good nutrition, an adequate intake of fluids, sufficient sleep and exercise may be useful. Acupuncture has been suggested to be a useful therapy.