Migraine - Symptoms, Triggering Factors, Treatment, and Preventive Strategies

Introduction:

Migraine is one of the most prevalent debilitating illnesses in the world. A large part of the global population is affected by migraine, out of which the majority are women. Primarily, a migraine is experienced as a severe, throbbing pain on one side of the head, which lasts for days, coupled with a few other symptoms.

What Are the Classic Signs and Symptoms Associated With Migraine?

A migraine attack comes and goes bringing in a set of different symptoms. There is a beginning stage called the prodrome or pre-headache phase, which progresses to experiencing a certain migraine aura, leading to the actual headache and ending with a postdrome phase. Let us look at the symptoms linked with each stage;

1. Pre-headache Phase: These are the first symptoms to watch for before a migraine attack;

• Feeling of nausea.

• Tiredness, sore muscles, stiffness in the neck, sleep issues, and frequent yawning.

• Increased thirst and urination.

• Tend to eat more or lose appetite altogether.

• Depression, anxiety, and irritability.

• The individual may find it difficult to concentrate on the task at hand and hard to focus on reading and speech.

• Find loud noises and bright lights unbearable.

• Get cranky and moody.

2. The ‘Aura’ Stage: Aura is a set of symptoms specific to migraine attacks. A migraine attack may start with or without an aura stage. The usual symptoms are;

• Blurry eyesight.

• Flashing of light in front of the eyes, bright spots, and rings in the line of vision.

• Numbness or tingling in the face, legs, or arms like tiny pinpricks.

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• Changes in the way things smell and taste.

• A feeling of constant ringing in the ear

3. The Actual Migraine Headache: Headache is the most intense neurological symptom associated with migraine attacks. It can be;

• A nagging type of head-pounding that can be moderate to severe.

• A dull ache at the start gradually turned into a severe throbbing type of pain.

• It is mainly affecting one side of the head.

• It may last for four to 72 hours, depending on the individual.

• Rarely migraine attacks can affect both sides of the head, front and back.

• Some have reported experiencing pain even on the face, jaws, eyes, and neck.

Along with headaches at their peak, people also suffer from;

• Inability to tolerate certain smells, sounds, touches, and lights.

• Stuffy nose.

• Get nauseated and vomit a lot.

• Inability to eat or sleep properly.

• Indigestion, tummy aches, and diarrhea.

• Fatigue, chills, and occasional sweats.

• Mental anxiety and blues.

• Migraine (associated with vertigo and dizziness).

4. The Hangover Phase: This postdrome stage follows a migraine attack that may last for a day or two. One might feel:

• Physically weak and drained.

• Mental confusion and euphoria.

• Giddiness.

• Prefer to stay away from lights and noisy surroundings.

What Are the Major Migraine Symptoms Found in Children?

Children suffer migraine attacks too, and the symptoms are mostly related to the digestive system. One might experience;

• Regular and forceful vomiting.

• Involuntary eye movements.

• Behavioral changes.

What Are the Causes and Triggers of a Migraine Attack?

Migraines result from unusual neurological activity between the nerves and blood vessels in an individual’s brain. It keeps recurring in most people. Sometimes they are passed on from one generation to the next in a family. If both parents suffer from migraine attacks, there is a chance that the children will get them too. Women are at a greater risk for migraine. Also, individuals ailing from neurological disorders, mental anxiety, and depression are at risk of migraine. Studies have found a few conditions that act as a trigger in developing migraine. They are:

• Long-term emotional stress and anxiety.

• Lack of sleep.

• Staying hungry or dehydrated for a long time.

• Excessive consumption of caffeine.

• Hormonal changes in women, especially during menstruation.

• Exposure to bright lights and extreme heat for a long time.

• Smoking and alcohol abuse.

• Long traveling.

• High-intensity physical activities.

• Exposure to certain smells and food ingredients.

• Presence of loud and unpleasant noises in the surroundings.

• Consuming certain medicines like oral contraceptives.

How Is Migraine Medically Diagnosed?

Initially, one has to go through the medical and family history of the individual to determine the triggers. The doctor will then learn the nature of symptoms occurring every time a migraine attack happens. A physical examination follows this to rule out any other significant causes of headaches. Patients are often advised to keep a migraine journal to keep track of the intensity and onset of every migraine attack. Sometimes, the doctor will order imaging scans such as computed tomography (CT) or magnetic resonance imaging (MRI) to rule out brain tumors, structural abnormalities in the brain, and bleeding inside the brain.

How to Treat Migraines Effectively?

Migraine attacks cannot be cured completely. However, treatments can help manage them so that they appear less often and with less intensity. There are several treatment strategies and combinations available for migraine. With the help of a doctor, one may figure out what treatments suit them best.

A. Medical Management: The first step is to prevent migraine attacks from happening. The treatment plan may depend on the age, type of migraine a person is suffering from, how often they occur, severity level, how long the symptoms persist, and other health conditions. One or more of the following can be combined to treat migraine;

1. The doctor may prescribe migraine medications to be taken on a daily basis. These medicines prevent the attacks from setting in. They belong to the category of- beta-blockers (Atenolol, Propranolol), anticonvulsants (Sodium valproate, Topiramate), calcium channel blockers (Flunarizine), angiotensin inhibitors (Candesartan), along with necessary vitamin supplements.

2. They may also prescribe medications to consume at the onset of a headache to keep it from becoming severe. Most of them belong to the category ‘Triptans’ such as Sumatriptan, Almotriptan, Zolmitriptan, and Rizatriptan.

3. Over-the-counter stress-relieving medications such as Aspirin, Ibuprofen, Paracetamol, and Naproxen can also be used to relieve the symptoms during an attack.

4. Medications to help with nausea and vomiting, such as Domperidone.

5. Stress-relieving drugs such as tricyclics (Amitriptyline, Nortriptyline)

B. Other Treatment Modalities: Some other useful remedies may help relieve the symptoms and prevent migraine attacks, such as:

1. Lifestyle modifications on sleep, eating habits, and regular physical activity.

2. Identifying the individual triggers and eliminating them.

3. Psychological counseling to manage stress and anxiety.

4. Hormone therapy for menstrual cycle-related migraine attacks, where the reduced level of estrogen hormone in the blood is compensated in women during the menstrual cycle to prevent the onset of migraine.

5. Therapy biofeedback techniques help reduce triggers, where one monitors the body temperature and channels the blood from the head to the extremities to relax the head.

6. Procedures like trans-cranial magnetic stimulations and vagal nerve stimulations are effective, where one monitors the tension building in the muscles using electrodes attached to the head. This pressure is relieved by practicing mental relaxation exercises to lower blood pressure.

7. Yoga and meditation.

8. Cold packs placed on the forehead and back of the neck may give relief during the attack.

9. Head and neck massages.

Conclusion:

Preventing and controlling migraine attacks requires active participation from the affected individual as well the healthcare professionals. From the part of the affected, they can do their best to maintain a healthy lifestyle with regular exercise and timely meal plans. Staying hydrated is important too. And the doctor can help by providing preventive medications and symptomatic relief. Chronic migraine can be a cause of disability, as they can affect a person’s ability to perform typical everyday tasks. Though it does not have a comprehensive cure, a qualified medical professional can help avoid the triggers, minimize the symptoms and prevent migraine attacks to a large extent.