Migraine types, symptoms, causes, and treatments
Migraine is a type of primary headache that occurs in an episodic pattern. 10% of the world’s population is estimated to have migraine. There are numerous migraine types. Typically, the disease starts during childhood or early adult age. People who experience migraines describe it as a throbbing or pulsating type of pain that is frequently unilateral (occurring on one side) mostly involving the front, temporal and ocular regions of the head. The pain progressively increases over 1 – 2 hours and sometimes moves posteriorly to involve the entire head and neck.
Symptoms of migraine
Migraine has a characteristic set of symptoms.
- Moderate to the severe unilateral or bilateral headache that worsens with head movements and physical activity.
- Typically occurs episodically, each episode lasts from 4 hours to 3 days.
- Photophobia – sensitivity to light
- Phonophobia – sensitivity to sounds
- Nausea and vomiting
- Preceding auras
- Usually, the person prefers to sleep in a silent and dark room during the episodes.
Auras of migraine/ Pre migraine symptoms
Auras are abnormal events that precede migraine. It can be visual auras, which is the most common. The person may see flickering lights, abnormal zig-zag lines (fortification), or even partially lose vision (scotomas).
Auditory auras – Abnormal sounds or noises
Sensory auras – Sometimes the patient may experience abnormal sensations or lose the sensations of a part of the body. (e.g. – numbness, pinning sensation)
Hemiplegic migraine – Rarely the person may experience paralysis of one half of the body mimicking a stroke.
Auras approximately last for about 20 minutes. But never more than 60 minutes.
Types of migraine
Migraine is classified as,
- Migraine without aura – This is the most common type of migraine occurring in about 80% of the cases.
- With aura – Also called classical migraine. It occurs only in 20% of the cases.
- Menstrual migraine – A type of migraine that occurs in close relation to the menstrual cycle.
- Chronic migraine – If the person experiences migraines more than 15 days a month, it’s a chronic migraine.
- Basilar migraine – A migraine that occurs with brainstem symptoms.
- Abdominal migraine – Migraine with a rising sensation from the abdomen. Often occur in children.
Classical migraine can also be classified according to the type of auras. For example, Ocular migraine, and Hemiplegic migraine.
Causes of migraine
The pathophysiology of migraine remains not well understood. The most accepted hypothesis says that migraine occurs due to a neurovascular pathology of the brain. The initial event is neurological which is then followed up by changes in blood flow to the brain.
Migraine has a higher occurrence among females. Also, it shows a strong genetic component. Approximately 70% of the people with migraine have a family member with migraine.
Migraine may be associated with triggering factors. The commonly known triggering factors are,
- Disturbing sounds
- Food types (e.g. – Chocolate, cheese)
- Meal skipping
- Low blood sugar
- Lack of sleep
- Beer and wine.
Virtually anything can trigger a migraine. However, the triggering factors are specific to each person.
Complications of migraine
Luckily migraine itself almost never causes any complications. Theoretically, it has the capability to trigger strokes due to its association with impaired cerebral perfusion. But in practice, this is extremely rare to happen.
However, the drugs given for migraine may cause complications if used frequently for a long period of time.
Treatments of migraine
Migraine has effective medical methods of treatment. It consists of two main arms, abortive therapy, and prophylactic therapy.
Acute management during an episode (abortive therapy) is targeted to stop or reverse the progression of the pain. It includes analgesics, NSAIDS, serotonin agonists, and ergot alkaloids. Therefore, one should take the prescribed drugs, ideally within 15 minutes of the onset of the headache or when the pain is mild.
The primary target of preventive (prophylactic) therapy is to increase the gap between the migraine episodes. Antiepileptic drugs, β blockers, Tricyclic antidepressants, or Serotonin uptake antagonists can be given for it.
In addition to these, the person is advised to avoid the triggering factors, manage stress, and maintain a healthy lifestyle.
Is migraine curable?
Unfortunately, migraine is not curable. Whereas, the drugs prescribed by your doctor may relieve or even prevent migraine headaches.