Migraine Definition The word source from the Greek language from the word (Hemicrania) means, literal translation: half of the skull. The name derives from one of the characteristics of migraines, as migraines usually affect half of the head. It is a chronic disease that manifests itself in frequent headaches, accompanied by physical and psychological phenomena, too. It is a common disease in about 12% of people.
A headache attack
In the first stage of a seizure, about a third of the sufferers will have pre-existing symptoms that last from hours to days before the seizure occurs. These symptoms include: mood changes, fatigue, difficulty concentrating, hunger or stiff neck.
Seizures occur in patients who suffer from migraines at a rate of about once a month, but some patients suffer from several seizures per week, and there are seizures that last more than 3 days without interruption (status migrainosus).
Types of migraines
Migraine attacks can be classified into two types:
Migraine without aura, which is the most common type, up to 66% of migraine attacks are with Aura (formerly called: classic sister). The International Headache Society has defined the definition of migraines according to the following indicators:
The patient has had five distinct typical bouts of his life.
Migraines last from 4 hours to 72 hours.
Pain characteristics include at least two of the following: (a) the pain is concentrated on only one side (unilateral); (b) the pain appears as a pulse; (c) the pain is moderate to severe; (d) the pain worsens when exercising Physical exertion.
During a seizure, the patient suffers from at least one of the following two symptoms: (a) nausea, vomiting, or both; (b) sensitivity to light or noise.
The seizures are not due to another problem.
Migraine with aura
Aura migraine is a migraine with at least two episodes accompanied by a distinctive aura due to the following disorders:
Numbness (lack of sensation) or speech disorder, they soon disappear completely
A disorder in one side, or on both sides of the field of vision, that appears as flashes, luster, lines, spots or lack of vision, accompanied by sensory disturbances on one side of the body, or without it
At least one of the following phenomena: One (or more) symptoms appear and continue for 5 minutes. The show lasts for more than 5 minutes but is less than 60 minutes.
A typical migraine develops during the aura or within 60 minutes of its appearance.
The spread of the disease
Migraines are very common in the population of western countries, and 18% of women and 6% of men have suffered, at least, from migraines at least once. 60% - 70% of those who suffer from migraines are women. Before puberty, the prevalence of migraines is about 4%, and then it increases, at a later stage, especially among girls until the age of 40. After the age of 40, with age, a decrease in migraine headaches begins. The highest prevalence rate among women is between the ages of 25 and 55. Migraines do not endanger patients' lives, but they do great harm to the quality of life and its normal course, causing work days and material losses.
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Migraine symptoms
Symptoms of migraines
Among the symptoms of migraines, aura appears in a quarter of patients: transient cerebral damage manifested by vision disorder (the most common), sensation disorder, decreased body strength, on the right or left side, balance disturbance or speech disorder. Usually, the aura appears before the headache starts, but it may also appear sometimes, during or after the headache, and takes less than an hour. Because of the similarity, it is sometimes thought to be a stroke, but it is not caused by a blockage in a blood vessel, nor even from a stop in the flow of blood to a specific part of the brain. The next stage is headache.
The pain usually begins on one side of the head, but sometimes it moves to the other side, too, then it gradually increases in intensity within hours, beats and affects the person's functionality.
Headaches are usually accompanied by nausea, sometimes vomiting.
Excessive sensitivity to stimuli, such as: light, noise and smell, and the patient prefers to lie in the dark and calm until the seizure is over and its disappearance.
The seizure can be accompanied by a feeling of tiredness, thirst, excessive urination, paleness, sweating, hunger or lack of appetite, nasal congestion, feeling cold or hot.
There may be a decrease in the ability to concentrate, feeling depressed, anxious and nervous.
The last stage of the migraine attack is the "absorption" stage, in which the patient remains exhausted, nervous or uneasy, with little ability to focus, with marked sensitivity in the scalp. While some patients may feel depression and discomfort, others feel refreshed and cheerful after the seizure is over.
Causes and risk factors for migraines
Causes of migraines
Causes of migraines include:
1- Family influence
A disease with a large family impact. About 70% of those who suffer from migraines have a first-degree relative who suffers from it, and first-degree relatives of a person who suffers from migraines are more likely to develop migraines than other people, at a rate of 1.5 - 2 times more. If the migraine is with aura, the rate rises to four times. To date, Mutation mutations have been discovered in a number of genes that cause specific and rare migraines, such as Familial hemiplegic migraine. Studies show that migraines are not, in most cases, caused by a defect in one gene, but rather are related to several factors, whether genetic or environmental.
2- Catalysts
Catalyst most common triggers for seizures are:
Stress and fatigue
Sleep too much
Fasting and irregular eating skip some meals
Some of the active substances in the blood vessels (Vasoactive)
Caffeine and alcoholic beverages
Menstruation
Barometric pressure
Changes in geographical altitude
There are some drugs that can accelerate the occurrence of a seizure, such as: nitrates (Nitrate), estrogenic hormones, indomed or reserpine.
The true cause of migraines is still unknown and not completely clear, but it is known today that there are processes that affect it and are related to its appearance. A device called the Trigeminovascular System is designed to protect the brain from harmful factors. When an external factor (lack of sleep, certain food) stimulates the nerve Trigeminal nerve in the skull, this nerve secretes pain mediators (Substance P and CGRP) into the blood vessels in the brain's covering, causing secretions of other inflammatory mediators from Mast cells, which in turn attract inflammatory cells (Polymorfonuclear neutrophil) to that region. These last cells also secrete chemicals that cause changes in the diameter of blood vessels and increase the permeability (Penetrability) of the walls of the blood vessels, thus creating a state of neurogenic inflammation. In this case, the penetration of the pain mediators and the expansion of the blood vessels will be the triggers, too. Aura occurs as a result of the spread of cortical depression, the process of changing the polarization of neurons in the cerebral cortex, spreading slowly at a rate ranging from 3 to 5 mm per second on the surface of the brain, accompanied by changes in the blood flow to these areas.
Diagnosis of migraine
Physical neurological examination, and other tests, such as blood tests, a computed tomography (CT) brain scan, magnetic resonance imaging (MRI), or an EEG scan that shows a healthy, usually normal Mostly, no checks are needed at all. The disease can be diagnosed based on the patient’s description - (history of the disease - Anamnesis) and on the basis of a normal, healthy neurological examination.
Migraine treatment
Migraine treatment
Migraine treatment consists of several types of treatment:
Behavior therapy to prevent seizures:
Regular sleep
Regular meals
Medium physical activity
Avoid some foods that contain caffeine, tyramine, monosodium glutamate, or nitrates.