Migraine Symptoms and causes
WHAT IS MIGRAINE?
Migraine is characterized by recurrent attacks of headaches that is widely variable in intensity, frequency and duration. It can be associated with nausea and vomiting and may be preceded by associated neurological and mood disturbances. The characteristics of each attack may vary to every patient. A family history is frequent.
CLASSIFICATION OF MIGRAINE:
Migraine can be classification as followed
1. Migraine without aura:
It is also called as common migraine. It is characterized by headache with associated autonomic nervous system dysfunction such as pallor and nausea. Other features may include changes in mood and poor concentration. The headache may be pounding or throbbing typestarting anywhere and spreading to involve one half of the head. During the attack the patient is usually photophobic and phonophobic and may seek a quiet dark environment.
2. Migraine with aura:
It is also called as classical migraine.The attack is characterized by binocular visual aura in the central visual field and typically lasts 5–30 minutes.The aura may present as negative scotoma and is left unrecognized by the patient. Associated positive symptoms includes scintillating scotoma (zig zag or fortication spectra), heat haze. Full recovery of vision in 30 minutes is typical.
Other forms of aura includeparesthesia, weakness or disturbance of speech.
Headache follows the aura and is usually hemi cranial and on the side opposite to hemianopia accompanied by nausea and photophobia.
The international Headache Society criterion:
The following criteria is followed for the diagnosis of migraine with aura. The presence of three out of four of the following strongly suggest migraine with aura.
· One or more fully reversible aura indication focal cerebral cortical or brainstem lesion.
· At least one aura symptoms develops gradually over longer than 4 minutes, one or more symptoms occurs in succession.
· No single aura lasts longer than 60 minutes.
· Headache follows the aura within 60 minutes but may begin before or during the aura.
MIGRAINE TREATMENT:
General measure:
General measures include the elimination of conditions and agents that may precipitate the attack of migraine such as coffee, chocolate, alcohol, cheese, oral contraceptives, stress, lack of sleep and long intervals without food.
Acute attack:
Acute attack may be controlled with simple analgesics or if appropriate with an anti-emetic. Patients’ refractory to analgesics may use sumatriptan, ergotamine, zolmitriptans. Occasional intravenous agents are used.
Prophylaxis:
Prophylactic treatment may include drugs such as flunarizine and valproic acid.
