MIGRAINE
I've been wanting to write a piece on headache and especially migraine for some time but assembling useful information on this topic without getting overly technical has been difficult. Most of the following was borrowed from three different sources but offers a concise, and I think, accurate description of the dreaded migraine.
There are many types and causes of headaches. A migraine is a type of vascular (related to the blood vessels) headache and it is among the most severe. It is also common, affecting about 1 person in 10. It affects women more than men and often runs in families. Migraines usually appear before the age of 40, frequently at a time when hormonal body changes occur (such as during adolescence).
A classic migraine is often preceded by strange visual symptoms, such as flashing lights, zigzag lines, or even temporary loss of vision. The source of these visual problems is rarely, if ever, related to the eyes themselves, but to the blood vessels inside the head. The term "ocular migraine" refers to a type in which the affected blood vessels are those providing circulation to one eye. It sometimes causes a temporary loss of vision in that eye.
The exact cause of migraine is not known, though research has found a possible link to abnormal levels of certain chemicals in the brain. An attack begins with narrowing (spasm) of the blood vessels inside the head followed by their dilation (enlarging) and stretching, which is probably what creates the pain.
Although migraine attacks occur for no apparent reason at all, a wide variety of factors can trigger them: certain foods and additives, including citrus fruit, smoked meat, and products containing nitrates or monosodium glutamate (MSG); cigarette smoke; strong odors; changes in the weather; emotional factors; tension and stress; loud noises or glaring lights; certain drugs; alcohol; hormonal changes and oral contraceptives. Women sufferers have more severe attacks around the time of menstruation and a decrease during pregnancy and after menopause. Migraine may be related to personality: sufferers are often perfectionists who demand a lot of themselves.
Symptoms vary from one person to another. When the blood vessels first go into spasm, it is common to feel uneasy, anxious, dizzy, or have an indescribable feeling (called an aura) that something is about to happen. Some people have numbness or tingling in the limbs. Some have a sensation of flashing lights, or a portion of their side vision may disappear for a brief time (this is called a scotoma).
The next phase, caused by dilation and stretching of the blood vessels, may result in a pounding headache so severe that you have to lie down. The pain is usually felt on one side of the head, in the temple area or behind the eye. You may become nauseated and may even vomit. This is why it is called a "sick headache." Bright lights may be particularly bothersome. One type -- cluster migraine -- recurs in a periodic pattern; this type can wake a person from a sound sleep and last as long as 18 hours.
You will have a thorough eye examination to rule out the presence of eye diseases, such as some types of glaucoma, that can cause symptoms similar to those of migraine. You may have a visual field test, to measure your ability to see objects that aren't directly in your line of vision, and tonometry, a painless test to check the pressure within your eyes.
You may be sent for a physical and neurological examination to rule out any other disease that can mimic migraine, such as vascular disease or high blood pressure. If there is any doubt about the diagnosis or your general condition, you will be referred to your personal physician or a neurologist.
Medications are available that can reduce the frequency of migraine attacks or lessen the severity of the headache if it is caught early. If you are taking any hormones or birth control pills, the medication or its dosage may be changed. (Women who have migraines and use birth control pills or other estrogens appear to have some increased risk for having a stroke.)
You may be able to decrease the severity of the pain by reducing blood flow to your head. Any of the following may help: applying cold compresses to your head and neck, pressing your palms firmly against the temples, putting your hands in hot (not burning) water, taking a hot shower, sleeping with your head higher than the rest of the body. Mild pain relievers such as aspirin, acetaminophen (Tylenol), or ibuprophen (Advil) are worth a try. At least they may help you get to sleep, which will often relieve the pain somewhat.
Although migraine in any form may be temporarily incapacitating, it seldom causes any permanent damage.