Are my headaches Migraines?

Migraine is a condition that causes episodes of headaches and is known to be the most disabling type of headache. It is often accompanied by nausea, vomiting and blurry vision. Migraine causes very severe attacks of headache with no known cure or particular cause. It can sometimes be avoided by avoiding the triggers causing migraine. Painkillers, anti-inflammatory painkillers, anti-sickness medicines and triptan medicines help in easing the headache but do not cure migraine completely.
Causes
There is no clear cause of migraine. As per an unverified theory, blood vessels in the brain get narrow and go into a spasm. This often makes the vision blurry and creates an aura like sensation.
The blood vessels dilate soon afterwards. Some chemicals in the brain increase in activity and send out confusing signals to parts of the brain. In women, a major cause is the hormonal changes in body during menstrual cycles.
Menstrual migraine is due to the fall of the level of oestrogen (hormone) that occurs at this time in the cycle.
Even though medically it is not proven that migraine is an inherited condition, it is generally found that several members of the same family suffer migraine headaches.
Treatment
Simple painkillers work best as migraine medication. Triptan class of drugs is popular to subdue migraine headaches. Alternative medicines to prevent migraine should be taken daily. They are available with variety of chemical compositions and should be prescribed by the doctor as per a person’s needs.
Types of Migraine
Migraine without aura
This is a very common type of migraine, where the headache is usually on one side of the head either on the front or one of the sides. It may even start on one side and then spread all over the head. There is moderate pain with pulsating or throbbing sensation. The head needs to be kept steady else the pain worsens with movements of the head. The pain shoots up in morning hours and peaks within 2-12 hours, then gradually subsides. This is known to last from 4 to 72 hours, depending on the person. The allied symptoms may include, nausea, vomiting, avoidance of bright light, blurred vision, irritability, hunger pangs, abdominal pain, a stuffy nose, or sweating. There is tenderness in the scalp and one feels extreme sensations of heat or cold.
Migraine with aura
This is less prevalent than migraine without aura but has similar symptoms as that of migraine without aura. A migraine aura acts as a warning signal before the headache begins. A bright shimmering light in a zigzag or C-shaped pattern forms an aura. This visual aura usually affects one side of the vision and continues to expand over the next 5-20 minutes. The aura usually goes before the headache begins. Often the aura occurs without a headache and is known as silent migraine. It may lead to a temporary loss of vision.
Other types of Migraine:
- Pins and Needles or Numbness is the second most common type of migraine aura. The numbness starts in hands, travels up the arm even affects the face, lips, and tongue. The legs are also involved during severe bouts of migraine.
- Aura migraine also causes problems in speech. Other types of include sensations of an odd smell, food cravings and other odd sensations like a general feeling of well-being.
- Ocular migraine (retinal migraine) or ophthalmic (eye) migraine causes temporary loss of vision in one eye. This may or may not be with a headache. Each attack occurs in the same eye without any abnormalities in the eye. The vision returns to normal once the migraine subsides.
- Hemiplegic migraine is a rare condition where in addition to severe headache the body also experiences a temporary paralysis of one side of the body. This lasts up to several hours or even days and is often confused with a stroke.
- Vestibular migraine causes recurring episodes of vertigo (severe dizziness) along with regular symptoms of migraine. It lasts between 5 minutes and 72 hours.
- Basilar-type migraine is a rare form of migraine that starts in the brain stem. This is caused by constriction of blood vessels that limit blood flow to the brain. Headache occurs at the back of the head and may include aura vision. Other symptoms like, temporary loss of vision, double vision, dizziness, hearing impairment or slurred speech is also seen to develop for as long as the migraine attack occurs. There is a high risk of having a stroke when under attack with this type of migraine.
Triggers
Most migraine attacks occur without a specific warning or trigger. A trigger can be anything in the environment like,
- Meals related: Dieting, irregular meals, eating or smell of fruits, cheese, chocolate, red wines, foods containing a food additive (tyramine) can trigger migraine. Dehydration or less intake of water is also a strong trigger.
- Environment related: Triggers include dust or smoke, cigarette smoke, glaring light, flickering TV sets, loud noises, or strong smells. People with migraine are advised to avoid all such areas.
- Psychological: Triggers include emotional states of depression, anxiety, anger, stress.
- Physical tiredness is also a trigger for some persons.
- Many people with migraine are able to cope well with stress in daily routine but have attacks when they are in relaxed atmosphere this is known as a weekend migraine, and can ruin holidays.
- Medicines: Several medicines like hormone replacement therapy (HRT), sleeping tablets, contraceptive pills or painkillers can be triggers for migraine.
- Other triggers: These include onset of menstruation in women, late night shift work, odd sleep pattern and menopause in older women.
It is advised to maintain a regular diary to keep a note of triggers. Details regarding time, duration and severity of migraine should be recorded. Also record the food eaten, your mental state, emotional state, environmental scenario. A pattern emerges which can be used to avoid any such trigger to avoid migraine attacks in future.
Phases of a migraine attack:
Typically, the headache of a migraine lasts from 4 hours to as long as 72 hours. A migraine attack is typically divided into four phases:
- A warning phase occurs with many people before the onset of migraine. One starts to feel irritable, depressed, exhausted and has peculiar food cravings before onset of a migraine attack. These feelings may last for hours or even days before an onset of a migraine headache.
- The aura phase occurs in many people where the vision blurs and a bright light is visualized for 5 minutes to 60 minutes before a migraine attack.
- The headache phase proves the migraine attack and lasts from 2 hours to 24 hours or more in persons.
- The resolution phase is the fading of the headache phase towards normalization. The overall mental state turns irritable or depressed and leads to physical tiredness.
Effect of Migraine on children:
Migraine is common in children as well. The symptoms are like those in adults but the attacks are generally of shorter duration. Headaches are not accompanied by vomiting or nausea in children.
Children can also experience abdominal migraine in abdomen instead of head. The usual triggers of migraine in children include eating less carbohydrates, skipping meals, lack of proper water intake (dehydration), and weather extremities. Sleep and drinking water is enough to cure the children of the headache. In case of severity they are prescribed similar mild painkillers. It is not advised to use drugs meant for adults to be given to children for migraine (triptan class of drugs).
Migraines during pregnancy or in lactating mothers:
Migraine actually improves while one is pregnant or breastfeeding. This is possibly due to hormonal condition. Even if an attack of migraine occurs, one should avoid taking any medicines for migraine as long as the woman is pregnant or lactating other than paracetamol.
Diagnosis:
There is no specific test to detect migraine; it is only possible via symptoms. Tests are conducted to rule out other causes of headaches such as in ocular migraines (temporary loss of vision). Tension headaches are often confused with migraine. Migraine is a severe lingering form of headache and unlike tension headaches they do not subside with a regular painkiller dose.
Silent migraine
Migraine attacks without a headache fall into a category of silent migraines. They can occur in people with problems of migraine and give a false alarm. Aura symptoms occur from few minutes to up to an hour, but without any headache.
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